Purpose- To evaluate whether spontaneous breathing trials (SBTs) are necessary when extubating critical care patients. Methods- A prospective, randomized, double-blind study was performed in adult patients supported by mechanical ventilation for at least 48 hours in the general intensive care unit of a teaching hospital. Patients ready for weaning were randomly assigned to either the SBT group ...

We have compared the differences between end-tidal PE'CO2 and arterial PaCO2 carbon dioxide partial pressures during general anaesthesia using either a cuffed oropharyngeal airway (COPA) or a tracheal tube (TT) in spontaneously breathing adult patients. After induction of anaesthesia, a COPA was inserted in 20 patients who were allowed to breathe spontaneously. When steady state was reached, PE...

The non-equilibrium fluctuation dissipation theorem is applied to predict how critically ill patients respond to treatment, based upon data currently collected by standard hospital monitoring devices. This framework is demonstrated on a common procedure in critical care: the spontaneous breathing trial. It is shown that the responses of groups of similar patients to the spontaneous breathing tr...

Introduction: Intraoral synechia is a rare congenital condition, generally associated with other maxillo-facial malformations. We present a neonate with congenital intraoral bilateral synechia without any other facial anomalies.   Case Report: In this paper, we present a 19-day-old male neonate with congenital intraoral bilateral synechia without any other facial anomalies. We review the litera...

Chest optimization, an evidence-based p rotocolguided multimodal chest physio therapy con sisting of bo dy positioning, sputu m mobilization, bronchodilation, an d lu ng hyperinflation, may be ro utinely adm inistered to venti latordependent patients with low cervical spinal cord injury (CSCI) for i mproving p ulmonary fu nctional o utcomes that facilitate weaning from mechanical ventilation. W...

It is often unclear when and how to wean patients from mechanical ventilation. We have devised an evidence-based protocol in which patients undergo a 30-minute trial of spontaneous breathing with a T tube or pressure support of 7 cm H2O. Those who can tolerate the trial are extubated, while those who cannot are reconnected to mechanical ventilation but undergo another trial every day until they...

The integrity of inspiratory and expiratory unidirectional valves is very important in the normal functioning of an anesthetic circle breathing system. We describe our experience of an emergency manipulation of a ceramic valve disk of a circle breathing system (Dräger Fabius GS, Dräger Medical Inc) that altered its characteristics and led to rebreathing only during spontaneous ventilation.

The spontaneous breathing trial (SBT)-relying on objective criteria assessed by the clinician-is the major diagnostic tool to determine if patients can be successfully extubated. However, little is known regarding the patient's subjective perception of autonomous breathing. PERREN, Andréas, et al. Patients' prediction of extubation success. Intensive Care Medicine , 2010, vol. 36, no. 12, p. 20...

BACKGROUND The maximum relaxation rate (MRR; percentage fall in pressure/10 ms) of oesophageal (POES) and transdiaphragmatic (PDI) pressure slows under conditions of loaded breathing, and has been measured previously in normal subjects. MRR has not been measured in intubated patients weaning from mechanical ventilation. METHODS Five postoperative patients who were expected to wean and nine pa...