scholarly journals Application of Automated Tube Compensation/Airway Resistance Compensation Modes for Liberation from Prolonged Mechanical Ventilation in Tracheostomized Patients

2021 ◽  
Author(s):  
C.-H. Wu ◽  
F.-C. Lin ◽  
J.-S. Jerng ◽  
M.-H. Shin ◽  
Y.-J. Wang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Airway Resistance ◽  
Prolonged Mechanical Ventilation ◽  
Tube Compensation

scholarly journals Endotracheal Tube Obstruction Among Patients Mechanically Ventilated for ARDS Due to COVID-19: A Case Series

2020 ◽  
pp. 088506662098189
Author(s):  
Samuel Wiles ◽  
Eduardo Mireles-Cabodevila ◽  
Scott Neuhofs ◽  
Sanjay Mukhopadhyay ◽  
Jordan P. Reynolds ◽  
...  
Keyword(s):  
At Risk ◽  
Mechanical Ventilation ◽  
Endotracheal Tube ◽  
Airway Resistance ◽  
Prolonged Mechanical Ventilation ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Inflammatory Cells ◽  
Pathological Examination ◽  
Tube Obstruction

Background: Patients with COVID-19 and ARDS on prolonged mechanical ventilation are at risk for developing endotracheal tube (ETT) obstruction that has not been previously described in patients with ARDS due to other causes. The purpose of this report is to describe a case series of patients with COVID-19 and ARDS in which ETT occlusion resulted in significant clinical consequences and to define the pathology of the obstructing material. Methods: Incidents of ETT occlusion during mechanical ventilation of COVID-19 patients were reported by clinicians and retrospective chart review was conducted. Statistical analysis was performed comparing event rates between COVID-19 and non-COVID 19 patients on mechanical ventilation over the predefined period. Specimens were collected and submitted for pathological examination. Findings: Eleven COVID-19 patients experienced endotracheal tube occlusion over a period of 2 months. Average age was 69 (14.3, range 33-85) years. Mean APACHE III score was 73.6 (17.3). All patients had AKI and cytokine storm. Nine exhibited biomarkers for hypercoagulability. Average days on mechanical ventilation before intervention for ETT occlusion was 14 (5.18) days (range of 9 to 23 days). Five patients were discharged from the ICU, and 4 expired. Average documented airway resistance on admission was 14.2 (3.0) cm H2O/L/sec. Airway resistance before tube exchange was 28.1 (8.0) cm H2O /L/sec. No similar events of endotracheal tube occlusion were identified in non-COVID patients on mechanical ventilation during the same time period. Microscopically, the material consisted of mucin admixed with necrotic cell debris, variable numbers of degenerated inflammatory cells, oral contaminants and red blood cells. Interpretation: Patients with COVID-19 and ARDS on prolonged mechanical ventilation are at risk for developing ETT obstruction due to deposition of a thick, tenacious material within the tube that consists primarily of mucin and cellular debris. Clinicians should be aware of this dangerous but treatable complication.

Determinants of the Need for Intensive Care and Prolonged Mechanical Ventilation in Patients Undergoing Bariatric Surgery

2004 ◽  
Vol 14 (8) ◽  
pp. 1036-1041 ◽  
Author(s):  
Thomas S. Helling ◽  
Thomas L. Willoughby ◽  
Daniel M. Maxfield ◽  
Patricia Ryan
Keyword(s):  
Bariatric Surgery ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Prolonged Mechanical Ventilation

scholarly journals Predictive role of perioperative neutrophil to lymphocyte ratio in pediatric congenital heart disease associated with pulmonary arterial hypertension

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoqiang Yin ◽  
Mei Xin ◽  
Sheng Ding ◽  
Feng Gao ◽  
Fan Wu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Prolonged Mechanical Ventilation ◽  
Pulmonary Arterial ◽  
Mechanical Ventilation Time

Abstract Background We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. Methods A retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected. Results We found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05). Conclusion For patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.

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