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| http://dx.doi.org/10.1186/s13054-020-03081-4 | DOI Listing |
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Management of adult mechanically ventilated patients: A UK-wide survey.
J Intensive Care Soc
October 2024
General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Background: Mechanical ventilation is a common and often lifesaving intervention that is utilised in intensive care. However, the practices can vary between centres. Through this national survey we aim to gain more information about different strategies adopted across the UK.
View Article and Find Full Text PDFPressure Control Surrogate Formula for Estimating Mechanical Power in ARDS is Associated with Mortality.
Respir Care
September 2024
Department of Anesthesia and Perioperative Care University of California, San Francisco at San Francisco General Hospital.
Mechanical power applied to the respiratory system (MP) is associated with ventilator-induced lung injury (VILI) and ARDS mortality. Absent automated ventilator MP measurements, the alternative is clinically unwieldy equations. However, simplified surrogate formulas are now available and accurately reflect values produced by airway pressure-volume curves.
View Article and Find Full Text PDFImpact of extended lung protection during mechanical ventilation on lung recovery in patients with COVID-19 ARDS: a phase II randomized controlled trial.
Ann Intensive Care
June 2024
Laboratório de Pneumologia LIM-09, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, 455 Dr Arnaldo Ave, Room 2144, São Paulo, SP, Brazil.
Background: Protective ventilation seems crucial during early Acute Respiratory Distress Syndrome (ARDS), but the optimal duration of lung protection remains undefined. High driving pressures (ΔP) and excessive patient ventilatory drive may hinder lung recovery, resulting in self-inflicted lung injury. The hidden nature of the ΔP generated by patient effort complicates the situation further.
View Article and Find Full Text PDFProspective, randomized, controlled trial assessing the effects of a driving pressure-limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan.
Crit Care Sci
May 2024
Research Institute, Hcor-Hospital do Coração - São Paulo (SP), Brazil.
Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear.
Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia.
Dynamic lung aeration and strain with positive end-expiratory pressure individualized to maximal compliance versus ARDSNet low-stretch strategy: a study in a surfactant depletion model of lung injury.
Crit Care
August 2023
Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Background: Positive end-expiratory pressure (PEEP) individualized to a maximal respiratory system compliance directly implies minimal driving pressures with potential outcome benefits, yet, raises concerns on static and dynamic overinflation, strain and cyclic recruitment. Detailed accurate assessment and understanding of these has been hampered by methodological limitations. We aimed to investigate the effects of a maximal compliance-guided PEEP strategy on dynamic lung aeration, strain and tidal recruitment using current four-dimensional computed tomography (CT) techniques and analytical methods of tissue deformation in a surfactant depletion experimental model of acute respiratory distress syndrome (ARDS).
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