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Not too much, not too little. Titrating flow rate to minimise inspiratory effort during helmet CPAP: A bench study.
Pulmonology
December 2025
Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei tintori, Monza, Italy.
Background: Non-invasive helmet respiratory support is suitable for several clinical conditions. Continuous-flow helmet CPAP systems equipped with HEPA filters have become popular during the recent Coronavirus pandemic. However, HEPA filters generate an overpressure above the set PEEP.
View Article and Find Full Text PDFEarly weaning from invasive mechanical ventilation via high-flow nasal oxygen versus conventional weaning in patients with hypoxemic respiratory failure: a prospective randomized controlled study.
Crit Care Sci
January 2025
Anaesthesiology and Critical Care, All India Institute of Medical Sciences - Jodhpur, India.
Objective: Although the efficacy of high-flow nasal oxygen therapy in delaying or avoiding intubation in patients with hypoxemic respiratory failure has been studied, its potential for facilitating early weaning from invasive mechanical ventilation remains unexplored.
Methods: In this randomized controlled trial, 80 adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation for > 48 hours were enrolled and divided into two groups: conventional weaning and early weaning via high-flow nasal oxygen. In the conventional weaning group, the spontaneous breathing trial was performed after the PaO2/FiO2 ratio was ≥ 200, whereas in the high-flow nasal oxygen group, the spontaneous breathing trial was conducted earlier when the PaO2/FiO2 ratio was 150 - 200.
Importance: Delirium is common after cardiac surgery and associated with adverse outcomes. Intraoperative benzodiazepines may increase postoperative delirium but restricting intraoperative benzodiazepines has not yet been evaluated in a randomized trial.
Objective: To determine whether an institutional policy of restricted intraoperative benzodiazepine administration reduced the incidence of postoperative delirium.
Optimizing Sedation Strategies in the Cardiac ICU: Induction, Maintenance and Weaning.
Curr Cardiol Rep
January 2025
Cardiovascular Division, University of Minnesota, 420 Delaware Street SE, MMC 508, Minneapolis, MN, 55455, USA.
Purpose Of Review: We aim to summarize the available literature guiding tailored sedation practices for specific conditions encountered in the Cardiovascular Intensive Care Unit (CICU).
Recent Findings: Data specific for the CICU population is lacking. Preclinical data and observational studies guide sedation approaches for specific pathologies that we have used to generate a guideline for sedative choice for various scenarios.
"Breaking the Bleed" Spontaneous Hemorrhage in an Emphysematous Bulla Complicated by Anticoagulation: A Case Report.
Cureus
December 2024
Internal Medicine, Mercy Health St. Vincent Medical Center, Toledo, USA.
We present a case of spontaneous hemorrhage in an emphysematous bulla, complicated by anticoagulation. Bullous emphysema is a well-recognized complication of chronic obstructive pulmonary disease (COPD), and a rare manifestation is hemorrhage into preexisting pulmonary bullae. A 69-year-old male patient presented to the emergency department with hemoptysis, shortness of breath, and productive cough.
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