A brief survey among members of the German Neurorehabilitation Society aimed to document the hospital capacities ("beds") for prolonged weaning from a mechanical ventilator for patients with neuro-disabilities that require simultaneous multi-professional neurorehabilitation treatment. Sixty-eight institutions declared to have capacities with a broad distribution across Germany and its federal states. Overall, 1094 "beds" for prolonged weaning (and neurorehabilitation) were reported, 871 together with further information regarding their identification and hence regional location. These units had on average 16.1 beds for prolonged weaning (95% confidence interval 12.6 to 19.6) with a range from 2 to 68 beds per organization. The data indicate substantial capacities for the combined prolonged weaning and neurorehabilitation treatment in Germany. For most "beds" included in this analysis a basic validation was possible. While a reasonable coverage of these specialized service capacities by the survey is likely, the number reported could still be biased by underreporting by non-response. Both the broad variation of number of "beds" for prolonged weaning per unit and their unequal geographical distribution across federal states (per capita rate) warrant a more refined follow-up survey that will provide insights into reasons for the observed pattern of variation for these specialized hospital capacities.
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http://dx.doi.org/10.1186/s42466-020-00065-1 | DOI Listing |
BMC Pediatr
January 2025
Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Background: Consequences of lung injury and inflammation in preterm infants with bronchopulmonary dysplasia (BPD) contribute to prolonged oxygen requirements. Home oxygen therapy (HOT) is an alternative way of respiratory support in infant with BPD. However, there is no consensus on weaning guidelines.
View Article and Find Full Text PDFRespir Med
January 2025
Department of Pulmonology and Respiratory Medicine, Lung Center Stuttgart - Schillerhoehe Lung Clinic, affiliated to the Robert-Bosch-Hospital GmbH, Auerbachstrasse 110, 70376, Stuttgart, Germany; Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich, Germany.
Introduction: Evidence suggests that mechanical power (MP) normalized to dynamic compliance, which equals power density, may help identify prolonged ventilated patients at risk for spontaneous breathing trial (SBT) failure. This study compared MP density with traditional spontaneous breathing indexes to predict a patient's capacity to sustain a short trial of unassisted breathing.
Methods: A prospective observational study on 186 prolonged ventilated, tracheotomized patients.
JTCVS Open
December 2024
Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Objective: Prolonged mechanical ventilation after cardiac surgery significantly increases morbidity and mortality. The aim of this study is to establish the role of diaphragmatic pacing to decrease mechanical ventilation burden in high-risk patients undergoing cardiac surgery.
Methods: This is a prospective, randomized trial of temporary diaphragmatic pacing electrode use in patients undergoing cardiac surgery (NCT04899856).
J Cardiothorac Surg
January 2025
Department of Anesthesiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
Background: Near-infrared spectroscopy (NIRS) enables a non-invasive measurement of tissue oxygen saturation (StO) in regions illuminated by near-infrared lights. Vascular occlusion test (VOT) serves as a model to artificially induce forearm ischemia-reperfusion. The combination of StO monitoring and VOT allows for dynamic evaluation of the balance between oxygen delivery and consumption in tissue, as well as the functional reserve of microcirculation.
View Article and Find Full Text PDFIntensive Care Med
January 2025
Critical Care Medicine, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.
Purpose: Predicting extubation failure remains a clinical challenge. This study aimed to determine diagnostic accuracy of models used at the bed side.
Methods: Post hoc analysis of 2341 patients at all risk included in five multicenter randomized trials.
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