Publications by authors named "Cecilia Hermosa"
Effect of Pressure Support vs T-Piece Ventilation Strategies During Spontaneous Breathing Trials on Successful Extubation Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial.
JAMA
June 2019
Importance: Daily spontaneous breathing trials (SBTs) are the best approach to determine whether patients are ready for disconnection from mechanical ventilation, but mode and duration of SBT remain controversial.
Objective: To evaluate the effect of an SBT consisting of 30 minutes of pressure support ventilation (an approach that is less demanding for patients) vs an SBT consisting of 2 hours of T-piece ventilation (an approach that is more demanding for patients) on rates of successful extubation.
Design, Setting, And Participants: Randomized clinical trial conducted from January 2016 to April 2017 among 1153 adults deemed ready for weaning after at least 24 hours of mechanical ventilation at 18 intensive care units in Spain.
Article Synopsis
- The study investigated the effectiveness of Proportional Assist Ventilation (PAV+) versus Volume-Assisted Control Ventilation (V-ACV) for patients with acute respiratory failure, focusing on shortening the length of mechanical ventilation.
- The research involved a randomized trial with 102 patients across four university ICUs, but ultimately found no significant differences in the duration of mechanical ventilation or other patient outcomes between the two methods.
- A high failure rate (42%) was observed with PAV+, attributed to issues like excessive sedation and high respiratory rates, suggesting the need for better patient selection and optimization of sedatives.
Article Synopsis
- Continuous assessment of respiratory status is essential in modern ICU monitoring, and Electrical Impedance Tomography (EIT) may enhance mechanical ventilation optimization for critically ill patients.
- EIT helps define ventilation settings, assess tidal volume distribution, and optimize positive end-expiratory pressure (PEEP) while evaluating the effects of different ventilator modes and maneuvers.
- Additionally, EIT aids in managing severe lung diseases and is being explored for monitoring cardiac function and lung perfusion in critical care.