Association between rectus femoris cross-sectional area and diaphragmatic excursion with weaning of tracheostomized patients in the intensive care unit.

Objective: To verify the relationship between the rectus femoris cross-sectional area and diaphragmatic excursion with successful weaning from mechanical ventilation in chronic critically tracheostomized patients.

Methods: This was a prospective observational cohort study. We included chronic critically ill patients (those who underwent tracheostomy placement after 10 days under mechanical ventilation).

Mechanical insufflation/exsufflation improves respiratory mechanics in critical care: Randomized crossover trial.

This study evaluated the ventilatory and haemodynamic effects of the mechanical insufflator-exsufflator (MI-E) in critically ill patients. Sixteen mechanically ventilated patients performed three protocols: MI-E (-30/+30 cmHO) plus endotracheal suctioning; 50S: MI-E (-50/+50 cmH2O) plus endotracheal suctioning; and isolated endotracheal suctioning (IES). The protocols were applied randomly in all subjects, with 3 -h intervals in between.

Comparison of bronchial hygiene techniques in mechanically ventilated patients: a randomized clinical trial.

Objective: To compare the effects of vibrocompression and hyperinflation with mechanical ventilator techniques alone and in combination (hyperinflation with mechanical ventilator + vibrocompression) on the amount of aspirated secretion and the change in hemodynamic and pulmonary parameters.

Methods: A randomized clinical trial with critically ill patients on mechanical ventilation conducted in the intensive care unit of a university hospital. The patients were randomly allocated to receive one of the bronchial hygiene techniques for 10 minutes (vibrocompression or hyperinflation with mechanical ventilator or hyperinflation with mechanical ventilator + vibrocompression).

Critical illness polyneuromyopathy in septic patients: Is it possible to diagnose it in a bedside clinical examination?

Objective: To determine the sensitivity and specificity of peripheral and respiratory muscle strength tests in diagnosing critical illness polyneuromyopathy (CIPNM), compared with an electrophysiological examination.

Methods: Fifty septic patients who required mechanical ventilation for at least five days, and without a previous history of muscle weakness, were included. Peripheral muscle strength was assessed using the Medical Research Council (MRC) score, handgrip strength by dynamometry, and respiratory muscle strength with maximum respiratory pressures.

Effectiveness assessment of a guideline based protocol for ventilatory support management of COPD exacerbations in an emergency department.

Objectives: To investigate clinical outcomes according to ventilatory support indication in subjects with chronic obstructive pulmonary disease exacerbation in a "real-life" Emergency Department and to analyze potential predictors of successful noninvasive positive pressure ventilation.

Methods: Retrospective cohort performed over an 18-month period, comparing the following patient groups with chronic obstructive pulmonary disease exacerbation: Group A composed of patients initially selected to receive noninvasive positive pressure ventilation without the subsequent need for invasive mechanical ventilation (successful-noninvasive positive pressure ventilation); Group B composed of patients transitioning from noninvasive positive pressure ventilation to invasive mechanical ventilation (failed-noninvasive positive pressure ventilation); and Group C composed of patients who presented with immediate need for invasive mechanical ventilation (without prior noninvasive positive pressure ventilation).

Results: 117 consecutive chronic obstructive pulmonary disease exacerbation admissions (Group A=96; Group B=13; Group C=8) of candidates for ventilatory support were reviewed.

[Factors associated to the length of time on mechanical ventilation in the postoperative period of cardiac surgery].

Our objective was to identify factors associated with the duration of mechanical ventilation (MV) postoperative to cardiac surgery and assess the association between duration of endotracheal intubation, length of stay in the Intensive Care Unit (ICU) and hospital. Longitudinal, retrospective study of medical records of 116 adults undergoing cardiac surgery from March 2012 to May 2013. The mean age was 57 +/- 14 years, predominantly male and coronary artery bypass grafting surgery (52.