Theophylline in Weaning Adult Patients From Mechanical Ventilation

2009 ◽  
Vol 16 (4) ◽  
pp. 212-218 ◽  
Author(s):  
Manica Sodhi ◽  
James K. Stoller
Keyword(s):  
Mechanical Ventilation ◽  
Adult Patients

scholarly journals Prediction of prolonged mechanical ventilation for intensive care unit patients: A cohort study

2013 ◽  
pp. 184-188 ◽  
Author(s):  
Alvaro Sanabria ◽  
Ximena Gomez ◽  
Valentin Vega ◽  
Luis Carlos Dominguez ◽  
Camilo Osorio
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Critically Ill ◽  
Medical Condition ◽  
Prolonged Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Adult Patients ◽  
Saps Ii Score

Introduction: There are no established guidelines for selecting patients for early tracheostomy. The aim was to determine the factors that could predict the possibility of intubation longer than 7 days in critically ill adult patients. Methods: This is cohort study made at a general intensive care unit. Patients who required at least 48 hours of mechanical ventilation were included. Data on the clinical and physiologic features were collected for every intubated patient on the third day. Uni- and multivariate statistical analyses were conducted to determine the variables associated with extubation. Results: 163 (62%) were male, and the median age was 59±17 years. Almost one-third (36%) of patients required mechanical ventilation longer than 7 days. The variables strongly associated with prolonged mechanical ventilation were: age (HR 0.97 (95% CI 0.96-0.99); diagnosis of surgical emergency in a patient with a medical condition (HR 3.68 (95% CI 1.62-8.35), diagnosis of surgical condition-non emergency (HR 8.17 (95% CI 2.12-31.3); diagnosis of non-surgical-medical condition (HR 5.26 (95% CI 1.85-14.9); APACHE II (HR 0.91 (95% CI 0.85-0.97) and SAPS II score (HR 1.04 (95% CI 1.00-1.09) The area under ROC curve used for prediction was 0.52. 16% of patients were extubated after day 8 of intubation. Conclusions: It was not possible to predict early extubation in critically ill adult patients with invasive mechanical ventilation with common clinical scales used at the ICU. However, the probability of successfully weaning patients from mechanical ventilation without a tracheostomy is low after the eighth day of intubation.

scholarly journals Normal sleep on mechanical ventilation in adult patients with congenital central alveolar hypoventilation (Ondine’s curse syndrome)

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Valérie Attali ◽  
Christian Straus ◽  
Michel Pottier ◽  
Marie-Annick Buzare ◽  
Capucine Morélot-Panzini ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Adult Patients ◽  
Ondine’S Curse ◽  
Alveolar Hypoventilation ◽  
Normal Sleep ◽  
Ondine's Curse

scholarly journals Impact of natural light exposure on delirium burden in adult patients receiving invasive mechanical ventilation in the ICU: a prospective study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Roland Smonig ◽  
Eric Magalhaes ◽  
Lila Bouadma ◽  
Olivier Andremont ◽  
Etienne de Montmollin ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Light Exposure ◽  
Invasive Mechanical Ventilation ◽  
Multivariate Logistic Regression Analysis ◽  
Adult Patients ◽  
Natural Light ◽  
Potential Exposure ◽  
Single Room ◽  
Light Group ◽  
Reduced Risk

Abstract Objective To determine whether potential exposure to natural light via windows is associated with reduced delirium burden in critically ill patients admitted to the ICU in a single room. Design Prospective single-center study. Setting Medical ICU of a university hospital, Paris, France. Patients Adult patients receiving invasive mechanical ventilation. Methods Consecutive patients admitted to a single room with (LIGHT group) or without (DARK group) exposure to natural light via windows were evaluated for delirium. The primary endpoint was the incidence of delirium. Main secondary endpoints included incidence of severe agitation intervened with antipsychotics and incidence of hallucinations. Results A total of 195 patients were included (LIGHT group: n = 110; DARK group: n = 85). The incidence of delirium was similar in the LIGHT group and the DARK group (64% vs. 71%; relative risk (RR) 0.89, 95% CI 0.73–1.09). Compared with the DARK group, patients from the LIGHT group were less likely to be intervened with antipsychotics for agitation episodes (13% vs. 25%; RR 0.52, 95% CI 0.27–0.98) and had less frequent hallucinations (11% vs. 22%; RR 0.49, 95% CI 0.24–0.98). In multivariate logistic regression analysis, natural light exposure was independently associated with a reduced risk of agitation episodes intervened with antipsychotics (adjusted odds ratio = 0.39; 95% CI 0.17–0.88). Conclusion Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However, natural light exposure was associated with a reduced risk of agitation episodes and hallucinations.

scholarly journals Clinical profiles and prognosis of acute heart failure in adult patients with dystrophinopathies on home mechanical ventilation

2017 ◽  
Vol 4 (4) ◽  
pp. 527-534 ◽  
Author(s):  
Abdallah Fayssoil ◽  
Rabah Ben Yaou ◽  
Adam Ogna ◽  
France Leturcq ◽  
Olivier Nardi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Ventilation ◽  
Acute Heart Failure ◽  
Adult Patients ◽  
Home Mechanical Ventilation ◽  
Clinical Profiles

Mechanical ventilation in Ontario, 1992–2000: Incidence, survival, and hospital bed utilization of noncardiac surgery adult patients*

2004 ◽  
Vol 32 (7) ◽  
pp. 1504-1509 ◽  
Author(s):  
Dale M. Needham ◽  
Susan E. Bronskill ◽  
William J. Sibbald ◽  
Peter J. Pronovost ◽  
Andreas Laupacis
Keyword(s):  
Mechanical Ventilation ◽  
Noncardiac Surgery ◽  
Adult Patients ◽  
Hospital Bed

Does Earlier Cannulation With Veno-Venous Extracorporeal Membrane Oxygenation in Adult Patients With Acute Respiratory Distress Syndrome Decrease Duration of Artificial Mechanical Ventilation?

2020 ◽  
Vol 13 (2) ◽  
pp. 148-155
Author(s):  
Christine Hartner ◽  
Jacqueline Ochsenreither ◽  
Kenneth Miller ◽  
Michael Weiss
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
Vv Ecmo

BackgroundAcute respiratory distress syndrome (ARDS) is characterized by an acute, diffuse, inflammatory lung injury, leading to increased alveolar capillary permeability, increased lung weight, and loss of aerated lung tissue (Fan, Brodie, & Slutsky, 2018). Primary treatment for ARDS is artificial mechanical ventilation (AMV) (Wu, Huang, Wu, Wang, & Lin, 2016). Given recent advances in technology, the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) to treat severe ARDS is growing rapidly (Combes et al., 2014).ObjectiveThis 49-month quantitative, retrospective inpatient EMR chart review compared if cannulation with VV-ECMO up to and including 48 hours of admission and diagnosis in adult patients 30 to 65 years of age diagnosed with ARDS, decreased duration on AMV, as compared to participants who were cannulated after 48 hours of admission and diagnosis with ARDS.MethodsA total of 110 participants were identified as receiving VV-ECMO during the study timeframe. Of the 58 participants who met all inclusion criteria, 39 participants were cannulated for VV-ECMO within 48 hours of admission and diagnosis with ARDS, and 19 participants were cannulated with VV-ECMO after 48 hours of admission and diagnosis with ARDS.ResultsData collected identified no statistically significant (p < 0.579) difference in length of days on AMV between participant groups.ConclusionsFurther studies are needed to determine if earlier initiation of VV-ECMO in adult patients with ARDS decrease time on AMV.Implications for NursingAlthough the results related to length of time on AMV did not produce statistical significance, the decreased duration of AMV in the participants who were cannulated within 48 hours (21 days vs. 27 days) may support several benefits associated with this participant population including increased knowledge of healthcare providers, decreased lung injury, earlier discharge which decreases hospital and patient cost, ability for patients to communicate sooner, decreased risk of pulmonary infection, decreased length of stay, decreased cost, and improved patient and family satisfaction.

Tracheostomy and Dysphagia: True, True, and Unrelated?

2014 ◽  
Vol 23 (3) ◽  
pp. 116-122
Author(s):  
David Francis ◽  
Alexander Gelbard
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Patient Population ◽  
Care Setting ◽  
Adult Patients ◽  
Medical Illness ◽  
Intensive Care Setting ◽  
Underlying Illness ◽  
Clinically Significant ◽  
The Relationship

The relationship between tracheostomy and dysphagia remains controversial. Many centers require swallow evaluations for all patients after tracheostomy because of the assumed increased rate of dysphagia and aspiration that they are thought to promote. Tracheostomies are now most commonly placed in the intensive care setting in adult patients with polytrauma or severe medical illness who are on mechanical ventilation. While tracheostomy and dysphagia often coexist in this population, they may not be directly related, as physiologic alterations observed in tracheostomized patients have not demonstrably translated into clinically significant complications of dysphagia. Instead, there is growing evidence that chronicity and severity of underlying illness, comorbidities, and recent intubation are the major arbiters of dysphagia in patient population. This brief report reviews the literature investigating the association between tracheostomy and dysphagia in adults, and discusses the role that illness severity, comorbidity, and intubation play in dysphagia etiology and how they confound the tracheostomy-dysphagia relationship.

scholarly journals Non-Invasive Oxygenation Strategies in Adult Patients with Acute Respiratory Failure: A Protocol for a Systematic Review and Network Meta-analysis

2020 ◽  
Author(s):  
Bruno Leonel Ferreyro ◽  
Federico Angriman ◽  
Laveena Munshi ◽  
Lorenzo del Sorbo ◽  
Niall D Ferguson ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Non Invasive

Abstract Background: Acute hypoxemic respiratory failure is one of the leading causes of intensive care unit admission and associated with high mortality. Non-invasive oxygenation strategies such as high flow nasal cannula, standard oxygen therapy and non-invasive ventilation (delivered by either face mask or helmet interface) are widely available interventions applied in these patients. It remains unclear which of these interventions are more effective in decreasing rates of invasive mechanical ventilation and mortality. The primary objective of this network meta-analysis is to summarize the evidence and compare the effect of non-invasive oxygenation strategies on mortality and need for invasive mechanical ventilation in patients with acute hypoxemic respiratory failure. Methods: We will search key databases for randomized controlled trials assessing the effect of non-invasive oxygenation strategies in adult patients with acute hypoxemic respiratory failure. We will exclude studies in which the primary focus is either acute exacerbations of chronic obstructive pulmonary disease or cardiogenic pulmonary edema. The primary outcome will be all-cause mortality (longest available up to 90 days). The secondary outcomes will be receipt of invasive mechanical ventilation (longest available up to 30 days). We will assess the risk of bias for each of the outcomes using the Cochrane Risk of Bias Tool. Bayesian network meta-analyses will be conducted to obtain pooled estimates of head-to-head comparisons. We will report pairwise and network meta-analysis treatment effect estimates as risk ratios and 95% credible intervals. Subgroup analyses will be conducted examining key populations including immunocompromised hosts. Sensitivity analyses will be conducted by excluding those studies with high risk of bias and different etiologies of acute respiratory failure. We will assess certainty in effect estimates using GRADE methodology. Discussion : This study will help to guide clinical decision making when caring for adult patients with AHRF and improve our understanding of the limitations of the available literature assessing noninvasive oxygenation strategies in acute hypoxemic respiratory failure.

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