Ventilator-associated pneumonia (VAP) is a pulmonary infection that occurs more than 48 hours after patients have been intubated and received mechanical ventilation. The incidence of VAP ranges from 6 to 52% and can reach 76% in some specific settings [1]. The incidence depends on several factors, the duration of mechanical ventilation, reintubation, supine position, advanced age and altered co...

Weaning from MV is the gradual removal of the ventilatory prosthesis, a different process to extubation, which involves removing the endotracheal tube (MacIntyre et al., 2001). The best moment to start weaning depends on multiple factors. Premature exhubation puts the patient at risk of reintubation and airway trauma. However, prolonged weaning exposes individuals to risk of hospital infection ...

TOPIC: Critical Care TYPE: Original Investigations PURPOSE: An unplanned extubation is a serious event in the intensive care unit (ICU). It has been associated with complications which may account for an increase morbidity and mortality. Understanding surrounding variables mechanisms at play that put intubated patient risk these events vital to prevent future extubation. This study was undertak...

Methods Observational study performed in a 17 beds medicalsurgical ICU. Time of study was 14 months. Consecutive mechanically ventilated patients with COPD and/or cardiac failure were included. The variables analyzed were age, sex, ICU diagnosis, APACHE II at admission in ICU, fluid balance, ICU length of stay, tracheotomy, rate of reintubation. We distinguish two strategies of extubation based...

RESULTS: 300 patients averaging 12.3 months were included. Cleft distribution included: Submucosal-1%, Veau 1–17.3%, Veau 2–38.3%, Veau 3–30.3%, Veau 4–13.0%. Pierre Robin (N=43) was the most prevalent syndrome/anomaly. 83% of patients received paralytic reversal and total narcotic dose averaged 0.19 mg/kg. 69 patients (23.0%) had an A.P.E., most frequently hypoventilation (10%) and airway obst...

RESULTS: 300 patients averaging 12.3 months were included. Cleft distribution included: Submucosal-1%, Veau 1–17.3%, Veau 2–38.3%, Veau 3–30.3%, Veau 4–13.0%. Pierre Robin (N=43) was the most prevalent syndrome/anomaly. 83% of patients received paralytic reversal and total narcotic dose averaged 0.19 mg/kg. 69 patients (23.0%) had an A.P.E., most frequently hypoventilation (10%) and airway obst...

features that appear frequently in intubated patients who may require later tracheostomy. Ventilator-associated pneumonia, low GCS, and the need for reintubation are possible risk factors for tracheostomy. Optimal time for tracheostomy varies with age and underlying pathology that lead to the need for it. The majority of the patients can be discharged from PICU post-tracheostomy; however, the m...

Introduction Reintubation has been shown, among many others, to be an independent risk factor for development of ventilator-associated pneumonia1 (VAP) which is a major cause of morbidity and mortality in ICUs. Selective Digestive Decontamination (SDD) is a tool that prevent infections in critically ill patients particularly VAP, that has been used mainly in Holland and in Spain. Despite of the...