Pulmonology

2019 ◽  
pp. 124-132
Author(s):  
Ted Lytle ◽  
Marc J. Popovich
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Respiratory Failure ◽  
Critical Illness ◽  
Pulmonary Disease ◽  
Daily Basis ◽  
Critical Care Medicine ◽  
Functional Elements ◽  
Significant Component ◽  
The Core

The management of pulmonary disease and mechanical ventilation encompasses part of the core of critical care medicine. Because physician anesthesiologists routinely manage ventilators on a daily basis, functional elements of mechanical ventilation are not heavily emphasized in this chapter, though the authors seek to avoid taking knowledge of this topic by the reader for granted. On the converse, this chapter seeks to emphasize clinically realistic and testable concepts that address authentic management decisions for patients with respiratory failure or pathophysiology related to critical illness. Additionally, complications associated with ongoing mechanical ventilation and pertinent diagnostic processes are tested in this chapter with some questions that demand rote knowledge of mechanical ventilation. Pulmonary disease represents a significant component of all critical care examinations and is a key element of practice for the every intensivist.

scholarly journals A Perspective from the Neurocritical Care Society and the Society of Critical Care Medicine: Team-Based Care for Neurological Critical Illness

2020 ◽  
Vol 32 (2) ◽  
pp. 369-372 ◽  
Author(s):  
Lewis Kaplan ◽  
Asma M. Moheet ◽  
Sarah L. Livesay ◽  
J. Javier Provencio ◽  
Jose I. Suarez ◽  
...  
Keyword(s):  
Critical Care ◽  
Critical Illness ◽  
Neurocritical Care ◽  
Critical Care Medicine ◽  
Care Society ◽  
Team Based Care ◽  
Medicine Team

Critical Care Medicine Certification and Pulmonary Disease Trainees

1990 ◽  
Vol 142 (3) ◽  
pp. 495-496 ◽  
Author(s):  
Robert M. Rogers ◽  
Thomas L. Petty ◽  
Leonard D. Hudson ◽  
Dick D. Briggs
Keyword(s):  
Critical Care ◽  
Pulmonary Disease ◽  
Critical Care Medicine

Critical Care Medicine

2012 ◽  
Author(s):  
Otis B. Rickman
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Distress Syndrome ◽  
Life Support ◽  
Venous Access ◽  
Critical Care Medicine ◽  
Organ Support ◽  
Disease States ◽  
Cardiopulmonary Monitoring

Critical care medicine is a multidisciplinary branch of medicine encompassing the provision of organ support to patients who are severely ill. All areas of medicine may have relevance for critically ill patients; however, this review focuses only on aspects of cardiopulmonary monitoring, life support, technologic interventions, and disease states typically managed in the intensive care unit (ICU). Airway management, venous access, respiratory failure, mechanical ventilation, acute respiratory distress syndrome, shock, and sepsis are reviewed.

scholarly journals Mechanical Ventilation Training During Graduate Medical Education: Perspectives and Review of the Literature

2019 ◽  
Vol 11 (4) ◽  
pp. 389-401 ◽  
Author(s):  
Jonathan M. Keller ◽  
Dru Claar ◽  
Juliana Carvalho Ferreira ◽  
David C. Chu ◽  
Tanzib Hossain ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Medical Education ◽  
Critical Care ◽  
Best Practices ◽  
Graduate Medical Education ◽  
Assessment Tools ◽  
Critical Care Medicine ◽  
Subspecialty Training ◽  
Review Of The Literature ◽  
Graduate Medical

ABSTRACT Background Management of mechanical ventilation (MV) is an important and complex aspect of caring for critically ill patients. Management strategies and technical operation of the ventilator are key skills for physicians in training, as lack of expertise can lead to substantial patient harm. Objective We performed a narrative review of the literature describing MV education in graduate medical education (GME) and identified best practices for training and assessment methods. Methods We searched MEDLINE, PubMed, and Google Scholar for English-language, peer-reviewed articles describing MV education and assessment. We included articles from 2000 through July 2018 pertaining to MV education or training in GME. Results Fifteen articles met inclusion criteria. Studies related to MV training in anesthesiology, emergency medicine, general surgery, and internal medicine residency programs, as well as subspecialty training in critical care medicine, pediatric critical care medicine, and pulmonary and critical care medicine. Nearly half of trainees assessed were dissatisfied with their MV education. Six studies evaluated educational interventions, all employing simulation as an educational strategy, although there was considerable heterogeneity in content. Most outcomes were assessed with multiple-choice knowledge testing; only 2 studies evaluated the care of actual patients after an educational intervention. Conclusions There is a paucity of information describing MV education in GME. The available literature demonstrates that trainees are generally dissatisfied with MV training. Best practices include establishing MV-specific learning objectives and incorporating simulation. Next research steps include developing competency standards and validity evidence for assessment tools that can be utilized across MV educational curricula.

scholarly journals Non-Pharmacological Management of Symptoms during Mechanical Ventilation and Chronic Obstructive Pulmonary Disease in Critical Care: Patient Directed Music Listening

2021 ◽  
Author(s):  
Annie Heiderscheit
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Pulmonary Disease ◽  
Assessment Tool ◽  
Chronic Obstructive ◽  
Music Listening ◽  
Care Environment ◽  
Pharmacological Management ◽  
Obstructive Pulmonary Disease

This chapter provides a review of the literature on nonpharmacological management of symptoms with music listening for critically ill patients during mechanical ventilation and with chronic obstructive pulmonary disease. The critical care environment is high energy, intense, and noisy. These characteristics of the ICU can often exacerbate symptoms and overstimulate patients. Patients may experience increased agitation, anxiety, increased pain or discomfort, and sleep interruptions. Patients are often on various medications unique to their diagnosis and underlying health issues and may need additional medications to address symptoms associated with the hospitalization. Nonpharmacological management, such as music listening provides an intervention that can assist in managing multiple symptoms, can be utilized repeatedly or at various times through the day or evening, be tailored to patient preferences, can be safe and effective, and require minimal energy for patients to use. The chapter reviews the mechanisms of how music listening can help with symptom management and provides guidelines, recommendations, and contraindications for selecting music of patient use. A brief assessment tool is presented to help guide the process of determining patient music preferences and how music listening may be helpful. Lastly, recommendations are provided on how to make music listening accessible in the critical care environment.

scholarly journals Apnea-Hypopnea Index in Chronic Obstructive Pulmonary Disease Exacerbation Requiring Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Killen H. Briones-Claudett ◽  
Adela Romero Lopez ◽  
Mónica H. Briones-Claudett ◽  
Mariuxi del Pilar Cabrera Baños ◽  
Killen H. Briones Zamora ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
Disease Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Hypercapnic Respiratory Failure ◽  
Acute Hypercapnic Respiratory Failure

Introduction. This study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients. Materials and Methods. We designed a single-center prospective study. The coexistence of Apnea-Hypopnea Index and clinical, gasometric, spirometric, respiratory polygraphy, and ventilatory characteristics were determined. The clinical characteristics found were categorized and compared according to the Apnea-Hypopnea Index (AHI) < 5, AHI 5–15, and AHI >15. A p value <0.05 was considered statistically significant. Results. During the study period, a total of 100 patients were admitted to the ICU with a diagnosis of acute hypercapnic respiratory failure due to COPD exacerbation. 72 patients presented with acute respiratory failure and fulfilled criteria for ventilatory support. Within them, 24 received invasive mechanical ventilation and 48 NIV. After applying the inclusion criteria for this study, 30 patients were eligible. An AHI >5 was present in 24 of the 30 patients recruited (80%). Neck circumference (cm), Epworth scale, and Mallampati score evidenced significant differences when compared to the patient’s AHI <5, AHI 5–15, and AHI >15 ( p < 0.05 ). Furthermore, patients with an AHI >5 had longer hospital admissions, prolonged periods on mechanical ventilation, and a higher percentage of intubation rates. Conclusion. Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require NIV. This association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy.

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