scholarly journals Terminal weaning from mechanical ventilation in critically ill patients with or without severe brain damage

Critical Care ◽  
2001 ◽  
Vol 5 (Suppl 1) ◽  
pp. P254
Author(s):  
R Parizkova ◽  
V Cerny ◽  
P Dostal
Keyword(s):  
Mechanical Ventilation ◽  
Brain Damage ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Weaning From Mechanical Ventilation ◽  
Terminal Weaning

scholarly journals Comparison of International Consensus Conference guidelines and WIND classification for weaning from mechanical ventilation in Brazilian critically ill patients

Medicine ◽  
2019 ◽  
Vol 98 (42) ◽  
pp. e17534
Author(s):  
Alessandra Fabiane Lago ◽  
Ada Clarice Gastaldi ◽  
Amanda Alves Silva Mazzoni ◽  
Vanessa Braz Tanaka ◽  
Vivian Caroline Siansi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Consensus Conference ◽  
Weaning From Mechanical Ventilation ◽  
International Consensus

scholarly journals Acute renal failure prolongs weaning from mechanical ventilation in critically ill patients

Critical Care ◽  
2006 ◽  
Vol 10 (S1) ◽  
Author(s):  
J Vieira ◽  
I Castro ◽  
S DeMarzo ◽  
A Cuvello-Neto ◽  
R Abdulkader ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Weaning From Mechanical Ventilation

scholarly journals Exploration of Diaphragm Excursion Inflection Point in Predicting Weaning From Mechanical Ventilation in Critically Ill Patients: An Observational Study

2021 ◽  
Author(s):  
Zhijing Zhu ◽  
Yongxing Wu ◽  
Jiyu Bai ◽  
XingQing Zhu ◽  
Yanan Gu
Keyword(s):  
Mechanical Ventilation ◽  
Success Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Spontaneous Breathing ◽  
Inflection Point ◽  
Pressure Support ◽  
Deep Breathing ◽  
Weaning From Mechanical Ventilation ◽  
Chi Square

Abstract ObjectivePressure-supported ventilation is widely used in critically ill patients, and the patient's effort in spontaneous breathing is an important predictor of the success rate of weaning, but this index is difficult to measure accurately under clinical conditions. It has been demonstrated that the absolute value of diaphragm excursion is influenced by multiple factors and cannot be used as a predictor of weaning from mechanical ventilation. This study aims to reveal the characteristics of diaphragm excursion changes (respiratory excursion) at different levels of pressure support, and explore whether it can predict the weaning from mechanical ventilation.DesignProspective cohort study.SettingSingle-center.PatientsPatients admitted to the ICU who were mechanically ventilated and had met the criteria to perform an autonomic breathing test were enrolled. Patients with tracheal obstruction or after thoracic/gastric/esophageal surgery were excluded. InterventionsDifferent levels of pressure support (20,15,10,5 and 0 cm H2O) were applied in pressure-assisted ventilation mode, and the effort of each patient's inspiratory muscles at different support levels was observed by B- and M-mode ultrasonography to assess right side diaphragm mobility. Measurements and Main ResultsRespiratory mechanics parameters under deep/calm breathing, dynamic changes in diaphragm movement, diaphragm excursion inflection points and whether the patients were successfully deconditioned were recorded. Forty-one patients were enrolled, and the results showed that 78.6% (22/28) of patients with a deep breathing inflection point of 10 cmH2O (nadir of 5 cmH2O) and 33.3% (4/12) of patients with a deep breathing inflection point of 15 cmH2O (nadir of 10 cmH2O) successfully weaned from mechanical ventilation, with the former having a significantly higher rate than the latter. The success rate was statistically significant (Chi-square=7.556 P=0.006); 77.8% (21/27) of patients with calm breathing inflection point of 10 cmH2O (lowest point of 5 cmH2O) and 38.5% (5/13) of patients with calm breathing inflection point of 15 cmH2O (lowest point of 10 cmH2O). 13), the former had a statistically significant higher off-boarding success rate than the latter (Chi-square=5.962 P=0.0146).ConclusionsIn the process of weaning from mechanical ventilation patients, when performing a spontaneous breathing test, the right diaphragm excursion inflection point during deep/calm breathing can be measured by ultrasound to assess the patient's spontaneous breathing effort component, and this study found that the weaning success rate was lower in the group with an inflection point of 15 cm H2O than in the group with an inflection point of 10 cm H2O, so the diaphragm excursion inflection point may be a reliable indicator to predict the deconditioning success.

Validation of the Modified Integrative Weaning Index as a Predictor of Weaning from Mechanical Ventilation in Comparison to Conventional Weaning Indices in Adult Critically Ill Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hythem Mohamed Mamdouh Abdelmeguid Barakat ◽  
Galal Adel El-Kady ◽  
Adel Mohammed El-Ansary ◽  
Mohammed Abd El-Salam El-Gendy
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Good Predictor ◽  
Invasive Mechanical Ventilation ◽  
Ventilatory Support ◽  
Underlying Disease ◽  
Pulmonary Mechanics ◽  
Weaning From Mechanical Ventilation ◽  
Clinical Practices

Abstract Introduction Timely recognition of the return to spontaneous ventilation is essential for reducing costs, morbidity, and mortality. Delays in both removing invasive ventilatory support and excessively early removal are correlated with complications that vary according to the severity of the underlying disease. Several weaning indices and predictors were studied in an attempt to evaluate the outcome of removing ventilatory support. However, none of them have yet presented good results in discriminating the outcome of extubation, even those most used in clinical practices. Aim The aim of this study is to validate the modified integrative weaning index (mIWI) as a reliable weaning index in comparison to the conventional weaning indices in the weaning of critically ill patients from invasive mechanical ventilation. Patients Four hundred patients, above the age of 18 years, on mechanical ventilation for more than 48 hours through an endotracheal tube for any cause were randomly assigned to this study. Methods patients ready to be weaned were assessed using mIWI and conventional indices and monitored for 48 hours. The performance of the indices were assessed in both successful and unsuccessful groups. Results The performance of the mIWI was not significantly superior to the conventional weaning indices in predicting weaning success or failure than the traditional weaning indices. The cut-off value for the predicting successful weaning from mechanical ventilation for the mIWI was higher than suggested by the original study and yet in agreement with some other studies. The cut-off value for the mIWI is higher in patients above the age of 60 years. Conclusion The results of the study revealed that the mIWI is a good predictor of weaning from mechanical ventilation and assessment of pulmonary mechanics and is not significantly superior to the traditional weaning indices, yet is not a good predictor for extubation success.

scholarly journals Calculating minimum nutrition requirements in ICU patients

2020 ◽  
Author(s):  
Indubala Maurya ◽  
Ram Gopal Maurya
Keyword(s):  
Mechanical Ventilation ◽  
Wound Healing ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Current Evidence ◽  
Weaning From Mechanical Ventilation ◽  
Negative Outcomes ◽  
Icu Patients

Critically ill patients frequently receive inappropriate nutrition leading to underfeeding or overfeeding. This is associated with negative outcomes such as poor wound healing, difficulty in weaning from mechanical ventilation and an increase in mortality. This is due to due to lack of standard and appropriate formulas for calorie and protein calculation. We reviewed current evidence and recommendations for the minimum nutrition requirement for ICU patients. Received: 6 Oct 2018Reviewed: 16 Oct 2018Corrected: 28 Oct 2018Accepted: 05 Nov 2018 Citation: Maurya I, Maurya RG. Calculating minimum nutrition requirements in ICU patients Anaesth Pain & Intensive Care 2018;22 Suppl 1:S106-S108

Terminal weaning or immediate extubation for withdrawing mechanical ventilation in critically ill patients (the ARREVE observational study)

2017 ◽  
Vol 43 (12) ◽  
pp. 1793-1807 ◽  
Author(s):  
René Robert ◽  
Amélie Le Gouge ◽  
Nancy Kentish-Barnes ◽  
Alice Cottereau ◽  
Bruno Giraudeau ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Terminal Weaning ◽  
Immediate Extubation
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