Comparing lung aeration and respiratory effort using two different spontaneous breathing trial: T-piece vs pressure support ventilation.

Objective: To assess the changes in lung aeration and respiratory effort generated by two different spontaneous breathing trial (SBT): T-piece (T-T) vs pressure support ventilation (PSV).

Design: Prospective, interventionist and randomized study.

Setting: Intensive Care Unit (ICU) of Hospital del Mar.

Association between histological diaphragm atrophy and ultrasound diaphragm expiratory thickness in ventilated patients.

Background: Diaphragm fiber atrophy has been evidenced after short periods of mechanical ventilation (MV) and related to critical illness-associated diaphragm weakness. Atrophy is described as a decrease in diaphragm fiber cross-sectional area (CSA) in human diaphragm biopsy, but human samples are still difficult to obtain in clinics. In recent years, ultrasound has become a useful tool in intensive care to evaluate diaphragm anatomy.

Aeration changes induced by high flow nasal cannula are more homogeneous than those generated by non-invasive ventilation in healthy subjects.

Background: Non-invasive mechanical ventilation (NIV) is a standard respiratory support technique used in intensive care units. High-Flow Nasal Cannula (HFNC) has emerged as an alternative, but further evidence is needed. The lung aeration and diaphragm changes achieved with these two strategies in healthy subjects have not been compared to date.

Structural differences in the diaphragm of patients following controlled vs assisted and spontaneous mechanical ventilation.

Purpose: Ventilator-induced diaphragm dysfunction or damage (VIDD) is highly prevalent in patients under mechanical ventilation (MV), but its analysis is limited by the difficulty of obtaining histological samples. In this study we compared diaphragm histological characteristics in Maastricht III (MSIII) and brain-dead (BD) organ donors and in control subjects undergoing thoracic surgery (CTL) after a period of either controlled or spontaneous MV (CMV or SMV).

Methods: In this prospective study, biopsies were obtained from diaphragm and quadriceps.

Severe vitamin D deficiency upon admission in critically ill patients is related to acute kidney injury and a poor prognosis.

Objectives: To evaluate the prevalence of vitamin D deficiency in critically ill patients upon admission to an Intensive Care Unit (ICU) and its prognostic implications.

Design: A single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge.

Diaphragm Dysfunction in Mechanically Ventilated Patients.

Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure.