Publications by authors named "Daniel H Arellano"
Article Synopsis
- Patient-ventilator asynchrony is a common issue in mechanically ventilated patients, but many healthcare professionals struggle to identify and manage it effectively.
- A 36-hour training program was implemented for healthcare professionals from 20 hospitals in Latin America and Spain, which included a mix of live lectures and daily follow-up sessions over a month.
- Results showed a significant improvement in participants' understanding and management of patient-ventilator asynchrony, with performance maintained one month after the training.
Background: Internal redistribution of gas, referred to as pendelluft, is a new potential mechanism of effort-dependent lung injury. Neurally-adjusted ventilatory assist (NAVA) and proportional assist ventilation (PAV +) follow the patient's respiratory effort and improve synchrony compared with pressure support ventilation (PSV). Whether these modes could prevent the development of pendelluft compared with PSV is unknown.
View Article and Find Full Text PDFBackground: In the acute distress respiratory syndrome (ARDS), specific lung regions can be exposed to excessive strain due to heterogeneous disease, gravity-dependent lung collapse and injurious mechanical ventilation. Computed tomography (CT) is the gold standard for regional strain assessment. An alternative tool could be the electrical impedance tomography (EIT).
View Article and Find Full Text PDFThe transition from controlled to partial support ventilation is a challenge in acute respiratory distress syndrome (ARDS) patients due to the risks of patient-self-inflicted lung injury. The magnitude of tidal volume (V) and intrapulmonary dyssynchrony (pendelluft) are suggested mechanisms of lung injury. We conducted a prospective, observational, physiological study in a tertiary academic intensive care unit.
View Article and Find Full Text PDFBackground: Waveform analysis by visual inspection can be a reliable, noninvasive, and useful tool for detecting patient-ventilator asynchrony. However, it is a skill that requires a properly trained professional.
Methods: This observational study was conducted in 17 urban ICUs.
Rationale: Positive end-expiratory pressure (PEEP) and prone positioning may induce lung recruitment and affect alveolar dynamics in acute respiratory distress syndrome (ARDS). Whether there is interdependence between the effects of PEEP and prone positioning on these variables is unknown.
Objectives: To determine the effects of high PEEP and prone positioning on lung recruitment, cyclic recruitment/derecruitment, and tidal hyperinflation and how these effects are influenced by lung recruitability.
Objectives: The aim of the study was to evaluate the safety of extended prone position ventilation (PPV) and its impact on respiratory function in patients with severe acute respiratory distress syndrome (ARDS).
Design: This was a prospective interventional study.
Setting: Patients were recruited from a mixed medical-surgical intensive care unit in a university hospital.