A Distributed Microprocessor Respiratory Intensive Care Monitoring System with Mass Spectrometer, Proximal Flowmeter, and Airway Pressure Transducer

1983 ◽  
pp. 45-57
Author(s):  
Con Rader ◽  
Warren Taylor ◽  
Darrell Hansen
Keyword(s):  
Intensive Care ◽  
Monitoring System ◽  
Mass Spectrometer ◽  
Airway Pressure ◽  
Pressure Transducer ◽  
Intensive Care Monitoring

572: Radical Cystectomy in Octogenarian: Is Routine Post Operative Intensive Care Monitoring Necessary?

2007 ◽  
Vol 177 (4S) ◽  
pp. 191-191
Author(s):  
Murugesan Manoharan ◽  
Sachin Vyas ◽  
Rajinikanth Ayyathurai ◽  
Alan M. Nieder ◽  
Mark S. Soloway
Keyword(s):  
Intensive Care ◽  
Radical Cystectomy ◽  
Intensive Care Monitoring

Implementing Potentially Better Practices to Improve Neonatal Outcomes After Reducing Postnatal Dexamethasone Use in Infants Born Between 501 and 1250 Grams

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e534-e541
Author(s):  
Joseph W. Kaempf ◽  
Betty Campbell ◽  
Ronald S. Sklar ◽  
Cindy Arduza ◽  
Robert Gallegos ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Clinical Outcomes ◽  
Airway Pressure ◽  
Neonatal Intensive Care ◽  
Positive Airway Pressure ◽  
Late Onset ◽  
Late Onset Sepsis

Objective. The purpose of this article is to describe how a neonatal intensive care unit (NICU) was able to reduce substantially the use of postnatal dexamethasone in infants born between 501 and 1250 g while at the same time implementing a group of potentially petter practices (PBPs) in an attempt to decrease the incidence and severity of chronic lung disease (CLD). Methods. This study was both a retrospective chart review and an ongoing multicenter evidence-based investigation associated with the Vermont Oxford Network Neonatal Intensive Care Quality Improvement Collaborative (NIC/Q 2000). The NICU specifically made the reduction of CLD and dexamethasone use a priority and thus formulated a list of PBPs that could improve clinical outcomes across 3 time periods: era 1, standard NICU care that antedated the quality improvement project; era 2, gradual implementation of the PBPs; and era 3, full implementation of the PBPs. All infants who had a birth weight between 501 and 1250 g and were admitted to the NICU during the 3 study eras were included (era 1, n = 134; era 2, n = 73; era 3, n = 83). As part of the NIC/Q 2000 process, the NICU implemented 3 primary PBPs to improve clinical outcomes related to pulmonary disease: 1) gentle, low tidal volume resuscitation and ventilation, permissive hypercarbia, increased use of nasal continuous positive airway pressure; 2) decreased use of postnatal dexamethasone; and 3) vitamin A administration. The total dexamethasone use, the incidence of CLD, and the mortality rate were the primary outcomes of interest. Secondary outcomes included the severity of CLD, total ventilator and nasal continuous positive airway pressure days, grades 3 and 4 intracranial hemorrhage, periventricular leukomalacia, stages 3 and 4 retinopathy of prematurity, necrotizing enterocolitis, pneumothorax, length of stay, late-onset sepsis, and pneumonia. Results. The percentage of infants who received dexamethasone during their NICU admission decreased from 49% in era 1 to 22% in era 3. Of those who received dexamethasone, the median number of days of exposure dropped from 23.0 in era 1 to 6.5 in era 3. The median total NICU exposure to dexamethasone in infants who received at least 1 dose declined from 3.5 mg/kg in era 1 to 0.9 mg/kg in era 3. The overall amount of dexamethasone administered per total patient population decreased 85% from era 1 to era 3. CLD was seen in 22% of infants in era 1 and 28% in era 3, a nonsignificant increase. The severity of CLD did not significantly change across the 3 eras, neither did the mortality rate. We observed a significant reduction in the use of mechanical ventilation as well as a decline in the incidence of late-onset sepsis and pneumonia, with no other significant change in morbidities or length of stay. Conclusions. Postnatal dexamethasone use in premature infants born between 501 and 1250 g can be sharply curtailed without a significant worsening in a broad range of clinical outcomes. Although a modest, nonsignificant trend was observed toward a greater number of infants needing supplemental oxygen at 36 weeks’ postmenstrual age, the severity of CLD did not increase, the mortality rate did not rise, length of stay did not increase, and other benefits such as decreased use of mechanical ventilation and fewer episodes of nosocomial infection were documented.

scholarly journals Manual hyperinflation and the role of physical therapy in intensive care and emergency units

2017 ◽  
Vol 30 (suppl 1) ◽  
pp. 241-248
Author(s):  
Rafael Vinícius Santos Cruz ◽  
Fabiana do Socorro da Silva Dias de Andrade ◽  
Pollyanna Dórea Gonzaga de Menezes ◽  
Bruno Oliveira Gonçalves ◽  
Robson da Silva Almeida ◽  
...  
Keyword(s):  
Intensive Care ◽  
Physical Therapy ◽  
Airway Pressure ◽  
Physical Therapists ◽  
High Peak ◽  
Peak Airway Pressure ◽  
Routine Practice ◽  
Perceived Benefits ◽  
Therapy Technique ◽  
Emergency Units

Abstract Introduction: Although manual hyperinflation (MHI) is a physical therapy technique commonly used in intensive care and emergency units, there is little consensus about its use. Objective: To investigate the knowledge of physical therapists working in intensive care and emergency units about manual hyperinflation. Methods: Data were collected through self-administered questionnaires on manual hyperinflation. Data collection took place between September 2014 and January 2015, in Itabuna and Ilhéus, Bahia, Brazil. Results: The study sample was composed of 32 physical therapists who had between 4 months and 10 years working experience. All respondents affirmed that they used the technique in their professional practice. However, only 34.4% reported it to be a routine practice. 90.6% stated that the most common patient position during manual hyperinflation is “supine”. Participants were almost unanimous (93.8%) in citing secretion removal and cough stimulation as perceived benefits of MHI. High peak airway pressure was identified as being a precaution to treatment with MHI by 84.4% of participants, whilst 100% of the sample agreed that an undrained pneumothorax was a contraindication to MHI. Conclusion: The most common answers to the questionnaire were: supine position during MHI; secretion removal and cough stimulation as perceived benefits; high peak airway pressure as a precaution; and an undrained pneumothorax as a contraindication.

scholarly journals Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Sunil Raja Manandhar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Positive Airway Pressure ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Neonatal Intensive Care ◽  
Positive Airway Pressure ◽  
College Teaching ◽  
Medical College

Introduction: Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 – March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Results: Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of (38-62) whereas 24 (39%) babies required mechanical ventilation and other modalities. Conclusions: This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

scholarly journals Intensive care monitoring: past, present and future

2002 ◽  
Vol 2 (4) ◽  
pp. 349-355 ◽  
Author(s):  
Neil McIntosh
Keyword(s):  
Intensive Care ◽  
Intensive Care Monitoring
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