Publications by authors named "Robert Wolken"
Rationale: Diagnosis of ventilator-associated pneumonia (VAP) is imprecise.
Objectives: To (1) determine whether alternate-day surveillance mini-bronchoalveolar lavage (mini-BAL) in ventilated adults could reduce time to initiation of targeted treatment and (2) evaluate the potential for automated microscopy to reduce analysis time.
Methods: Adult intensive care unit patients who were anticipated to require ventilation for at least a further 48 hours were included.
Article Synopsis
- The study aimed to compare the effectiveness of different bag-valve-mask ventilation techniques: 1-handed, 2-handed, and modified 2-handed methods.
- Conducted on 52 health care providers, the trial assessed their performance on a model and measured the expired tidal volume over 5 minutes for each technique, with a focus on achieving maximum ventilation.
- Results showed that both the 2-handed and modified 2-handed techniques produced significantly higher expired tidal volumes than the 1-handed technique, with no notable difference between the two 2-handed methods.
Background: Head of bed elevation ≥ 30° reduces ventilator-associated pneumonia in mechanically ventilated patients, but adherence is variable and difficult to monitor continuously. Unlike many clinical variables, head of bed elevation is not electronically displayed or monitored with audible alarms.
Hypothesis: Continuous monitoring of head of bed elevation with audible alerts and visual cues when the elevation is < 30° will improve adherence by 15%.