Mechanical ventilation during long-range aeromedical transport presents significant challenges. Patient, crew member, and equipment are placed in an environment with reduced barometric pressure, noise, vibration, and limited space, oxygen, electrical power, and access to imaging technology. It is the transport team's responsibility to provide care in this environment, which approximates that given in the ICU as closely as possible. This is achieved through careful preparation and planning. Preparation starts with training of the personnel and selection of optimal equipment. Planning needs to consider the patient's physiologic reserve, available supplies of oxygen and electrical power, and the crew's ability to sustain high performance for the duration of the mission.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/s1078-5337(02)00016-3 | DOI Listing |
Rationale: Prior work has shown a preference among most people with dementia and their families for comfort-focused care near the end-of-life. Nonetheless, intubation and mechanical ventilation are increasing over time without concurrent trends in improved survival, including among those with advanced dementia. A better understanding of prehospital decision-making about intubation for people with dementia will guide efforts to increase goal-concordant care at onset of critical illness.
View Article and Find Full Text PDFCrit Care Resusc
December 2024
Department of Intensive Care, Alfred Health, 55 Commercial Road, Melbourne, 3181, VIC, Australia.
Objective: To describe the epidemiology and clinical features of pressure injury (PI) development in adult patients supported with extracorporeal membrane oxygenation (ECMO).
Design: Retrospective, observational, cohort study from January 2018 to May 2023.
Setting: A single-centre high-volume ECMO specialist intensive care unit (ICU).
Electrolyte Blood Press
December 2024
Department of Internal Medicine, College of Medicine, Dankook University, Republic of Korea.
Background: Elevated intracranial pressure (ICP) is a potentially life-threatening condition requiring prompt intervention. While both mannitol and hypertonic saline (HTS) are commonly used hyperosmotic agents for treating elevated ICP, there is insufficient evidence comparing their renal safety profiles and overall effectiveness. This study protocol outlines a pragmatic randomized trial to compare protocol-based 11.
View Article and Find Full Text PDFJTCVS Open
December 2024
Department of Cardiac Surgery, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France.
Objective: This study investigated the efficacy of a multimodal analgesia (MMA) with an opioid-sparing strategy, incorporating a parasternal plane block (PPB) within a systematic standardized Enhanced Recovery After Surgery (ERAS) program for patients undergoing elective cardiac surgery.
Methods: From 2015 to 2021, 3153 patients underwent elective coronary artery bypass grafting and/or valve procedures. Patients were dichotomized by the presence or absence of an ERAS program including a perioperative MMA with an opioid-sparing approach and PPB protocols.
JTCVS Open
December 2024
Division of Cardiac Surgery, Seattle Children's Hospital, Seattle, Wash.
Objective: To evaluate the effect of a blood conservation program on trends in use of donor blood products and early clinical outcomes in infants undergoing open heart surgery.
Methods: Four hundred nine patients younger than age 1 year undergoing open-heart surgery between October 1, 2020, and June 30, 2023, were reviewed. The study period was divided into 4 eras with the first era as a before blood conservation baseline using traditional blood management.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!