Epidemiology of Weaning From Invasive Mechanical Ventilation in Subjects With COVID-19.

Background: Patients requiring mechanical ventilation due to COVID-19 have different characteristics of evolution and outcome compared to the general ICU population. Although early weaning from mechanical ventilation is associated with improved outcomes, inadequate identification of patients unable to be weaned may lead to extubation failure and increased days on mechanical ventilation. Outcomes related to mechanical ventilation weaning in this population are scare and inconclusive.

Dynamic Relative Regional Lung Strain Estimated by Electrical Impedance Tomography in an Experimental Model of ARDS.

Background: To analyze the role of PEEP on dynamic relative regional strain (DRRS) in a model of ARDS, respective maps were generated by electrical impedance tomography (EIT).

Methods: Eight ARDS pigs submitted to PEEP steps of 0, 5, 10, and 15 cm HO at fixed ventilation were evaluated by EIT images. DRRS was calculated as (V/EELI)/(V/EELI), where the tidal volume (V) and end-expiratory lung impedance (EELI) are the tidal and end-expiratory change in lung impedance, respectively.

Impact of liberal versus conservative saturation targets on gas exchange indices in COVID-19 related acute respiratory distress syndrome: a physiological study.

Objective: To compare gas exchange indices behavior by using liberal versus conservative oxygenation targets in patients with moderate to severe acute respiratory distress syndrome secondary to COVID-19 under invasive mechanical ventilation. We also assessed the influence of high FiO2 on respiratory system mechanics.

Methods: We prospectively included consecutive patients aged over 18 years old with a diagnosis of COVID-19 and moderate-severe acute respiratory distress syndrome.

Ventilator output splitting interface 'ACRA': Description and evaluation in lung simulators and in an experimental ARDS animal model.

The current COVID-19 pandemic has led the world to an unprecedented global shortage of ventilators, and its sharing has been proposed as an alternative to meet the surge. This study outlines the performance of a preformed novel interface called 'ACRA', designed to split ventilator outflow into two breathing systems. The 'ACRA' interface was built using medical use approved components.

Prevalence of Reverse Triggering in Early ARDS: Results From a Multicenter Observational Study.

Background: The prevalence of reverse triggering (RT) in the early phase of ARDS is unknown.

Research Question: During early ARDS, what is the proportion of patients affected by RT, what are its potential predictors, and what is its association with clinical outcomes?

Study Design And Methods: This was prospective, multicenter, and observational study. Patients who met the Berlin definition of ARDS with less than 72 h of mechanical ventilation and had not been paralyzed with neuromuscular blockers were screened.

Performance of Different Active Humidification Systems in High-Flow Oxygen Therapy.

Background: We sought to evaluate the performance in terms of absolute humidity (AH), relative humidity (RH), and temperature of different heated humidifiers (HH) and circuits that are commonly used to deliver high-flow oxygen therapy in conventional ranges (30-60 L/min) and unconventional ranges (70-100 L/min).

Methods: In this prospective, observational study, an electronic thermohygrometer was used to obtain the required measurements. A mechanical ventilator was used as a source for high-flow nasal cannula oxygen therapy.

Multimodal non-invasive monitoring to apply an open lung approach strategy in morbidly obese patients during bariatric surgery.

To evaluate the use of non-invasive variables for monitoring an open-lung approach (OLA) strategy in bariatric surgery. Twelve morbidly obese patients undergoing bariatric surgery received a baseline protective ventilation with 8 cmHO of positive-end expiratory pressure (PEEP). Then, the OLA strategy was applied consisting in lung recruitment followed by a decremental PEEP trial, from 20 to 8 cmHO, in steps of 2 cmHO to find the lung's closing pressure.

Effect of PEEP on Dead Space in an Experimental Model of ARDS.

Background: The difference between Bohr and Enghoff dead space are not well described in ARDS patients. We aimed to analyze the effect of PEEP on the Bohr and Enghoff dead spaces in a model of ARDS.

Methods: 10 pigs submitted to randomized PEEP steps of 0, 5, 10, 15, 20, 25 and 30 cm HO were evaluated with the use of lung ultrasound images, alveolar-arterial oxygen difference (P ), transpulmonary mechanics, and volumetric capnography at each PEEP step.

Dead space analysis at different levels of positive end-expiratory pressure in acute respiratory distress syndrome patients.

Purpose: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VD/VT) in patients with acute respiratory distress syndrome (ARDS).

Material And Methods: Fourteen ARDS patients under lung protective ventilation settings were submitted to 4 different levels of PEEP (0, 6, 10, 16 cmHO). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step.

Implementation and results of a new ECMO program for lung transplantation and acute respiratory distress.

Objective: The development of the extracorporeal membrane oxygenation in Latin America represents a challenge in this specialty field. The objective of this article was to describe the results of a new extracorporeal membrane oxygenation program in an intensive care unit.

Methods: This retrospective cohort study included 22 patients who required extracorporeal membrane oxygenation and were treated from January 2011 to June 2014.

Evaluation of an active humidification system for inspired gas.

Objectives: The effectiveness of the active humidification systems (AHS) in patients already weaned from mechanical ventilation and with an artificial airway has not been very well described. The objective of this study was to evaluate the performance of an AHS in chronically tracheostomized and spontaneously breathing patients.

Methods: Measurements were quantified at three levels of temperature (T°) of the AHS: level I, low; level II, middle; and level III, high and at different flow levels (20 to 60 L/minute).

Reference values for volumetric capnography-derived non-invasive parameters in healthy individuals.

The aim of this study was to determine typical values for non-invasive volumetric capnography (VCap) parameters for healthy volunteers and anesthetized individuals. VCap was obtained by a capnograph connected to the airway opening. We prospectively studied 33 healthy volunteers 32 ± 6 years of age weighing 70 ± 13 kg at a height of 171 ± 11 cm in the supine position.