scholarly journals Approaches to successful ventilator weaning

2021 ◽  
Vol 28 (6) ◽  
pp. 499-501
Author(s):  
Yuki Iida
Keyword(s):  
Ventilator Weaning

scholarly journals Parents' and young people's involvement in designing a trial of ventilator weaning

2015 ◽  
Vol 21 (3) ◽  
pp. e10-e18 ◽  
Author(s):  
Lyvonne N. Tume ◽  
Jenny Preston ◽  
Bronagh Blackwood
Keyword(s):  
Ventilator Weaning

scholarly journals Application of neurally adjusted ventilatory assist in ventilator weaning of infants ventilator weaning

2021 ◽  
Author(s):  
Shuna Xiao ◽  
Chengjiao Huang ◽  
Ying Cheng ◽  
Zhi Xia ◽  
Yong Li ◽  
...  
Keyword(s):  
Ventilator Weaning ◽  
Neurally Adjusted Ventilatory Assist ◽  
Ventilatory Assist

Ventilator Weaning

2018 ◽  
Author(s):  
Brian Brajcich ◽  
Ann Hwalek ◽  
Joseph Posluszny
Keyword(s):  
Respiratory Mechanics ◽  
Spontaneous Breathing Trial ◽  
Clinical Status ◽  
Ventilator Weaning ◽  
Evidence Based ◽  
Airway Patency ◽  
Diaphragm Dysfunction ◽  
Complex Process ◽  
Abcde Bundle ◽  
Based Medicine

Ventilator weaning/liberation is a complex process that requires focus on a patient’s respiratory mechanics, strength, awareness, airway patency, and secretions while also keeping in mind a patient’s overall clinical status and critical illness. The recommendations in the chapter are based on evidence-based medicine when available. When no clear data can definitively guide patient management, clinical guidelines and accepted practices are described.  Our hope is that the reader finds this chapter as a reliable and safe way to approach ventilator liberation. This review contains 4 figures, 6 tables and 77 references Key Words: ABCDE bundle, diaphragm dysfunction, negative inspiratory force, reintubation, RSBI, sedation, spontaneous breathing trial, tracheostomy, ventilator liberation, ventilator weaning

scholarly journals Video-assisted thoracoscopic extended thymectomy in myasthenic children

2013 ◽  
Vol 5 (1) ◽  
pp. 4 ◽  
Author(s):  
Rita Sonzogni ◽  
Lorenzo Novellino ◽  
Alberto Benigni ◽  
Ilaria Busi ◽  
Magda Khotcholava ◽  
...  
Keyword(s):  
Case Reports ◽  
Preoperative Evaluation ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Ventilator Weaning ◽  
New Drugs ◽  
Extended Thymectomy ◽  
Myasthenic Patient ◽  
Surgical Department ◽  
Video Assisted

Myasthenia gravis (MG) is an autoimmune disease marked by weakness of voluntary musculature. Medical and surgical therapy of adult myasthenia is well documented. There is little pediatric surgical evidence, only a few case reports being available. The aim of this paper is to verify whether the surgical and anesthesiological techniques can warrant an early and safe discharge from the operating room. The secondary aim is to assess the presence of perioperative indicators that can eventually be used as predictors of postoperative care. During the years 2006-2009, 10 pediatric patients were treated according to a surgical approach based on video assisted thoracoscopic extended thymectomy (VATET). Standard preoperative evaluation is integrated with functional respiratory tests. Anesthetic induction was made with propofol and fentanyl/remifentanyl and maintenance was obtained with sevoflurane/desflurane/propofol ± remifentanyl. A muscle relaxant was used in only one patient. Right or left double-lumen bronchial tube (Ruesch Bronchopart® Carlens) placement was performed. Six patients were transferred directly to the surgical ward while 4 were discharged to the intensive care unit (ICU); ICU stay was no longer than 24 h. Length of hospital stay was 4.4±0.51 days. No patient was readmitted to the hospital and no surgical complications were reported. Volatile and intravenous anesthetics do not affect ventilator weaning, extubation or the postoperative course. Paralyzing agents are not totally contraindicated, especially if short-lasting agents are used with neuromuscular monitoring devices and new reversal drugs. Perioperative evaluation of the myasthenic patient is mandatory to assess the need for postoperative respiratory support and also predict timely extubation with early transfer to the surgical department. Availability of new drugs and of reversal drugs, the current practice of mini-invasive surgical techniques, and the availability of post anesthesia care units are the keys to the safety and successful prognosis of patients affected by MG who undergo thymectomy.

scholarly journals Electrical Impedance Tomography Predicts Weaning Success in Adult Patients With Delayed Upper Abdominal Surgery: A Single-Center Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiajia Li ◽  
Fan Zeng ◽  
Fuxun Yang ◽  
Xiaoxiu Luo ◽  
Rongan Liu ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Electrical Impedance Tomography ◽  
Predictive Value ◽  
Electrical Impedance ◽  
Characteristic Curve ◽  
Ventilator Weaning ◽  
Impedance Tomography ◽  
Upper Abdominal Surgery ◽  
Generalized Estimation Equation ◽  
Upper Abdominal

Objective: To evaluate the predictive value of electrical impedance tomography (EIT) in patients with delayed ventilator withdrawal after upper abdominal surgery.Methods: We retrospectively analyzed data of patients who were ventilated >24 h after upper abdominal surgery between January 2018 and August 2019. The patients were divided into successful (group S) and failed (group F) weaning groups. EIT recordings were obtained at 0, 5, 15, and 30 min of spontaneous breathing trials (SBTs) with SBT at 0 min set as baseline. We assessed the change in delta end-expiratory lung impedance and tidal volume ratio (ΔEELI/VT) from baseline, the change in compliance change percentage variation (|Δ(CW-CL)|) from baseline, the standard deviation of regional ventilation delay index (RVDSD), and global inhomogeneity (GI) using generalized estimation equation analyses. Receiver operating characteristic curve analyses were performed to evaluate the predictive value of parameters indicating weaning success.Results: Among the 32 included patients, ventilation weaning was successful in 23 patients but failed in nine. Generalized estimation equation analysis showed that compared with group F, the ΔEELI/VT was lower, and the GI, RVDSD, and (|Δ(CW-CL)|) were higher in group S. For predicting withdrawal failure, the areas under the curve of the ΔEELI/VT, (|Δ(CW-CL)|), and the RVDSD were 0.819, 0.918, and 0.918, and 0.816, 0.884, and 0.918 at 15 and 30 min during the SBTs, respectively.Conclusion: The electrical impedance tomography may predict the success rate of ventilator weaning in patients with delayed ventilator withdrawal after upper abdominal surgery.

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