Ventilator-associated pneumonia (VAP) is a common and serious complication of mechanical ventilation via an artificial airway. As with all nosocomial infections, VAP increases costs, morbidity, and mortality in the intensive care unit (ICU). VAP prevention is a multifaceted priority of the intensive care team, and can include the use of specialized artificial airways and heat-and-moisture excha...

INTRODUCTION This study aimed to evaluate the pupillary dilatation reflex (PDR) during a tetanic stimulation to predict insufficient analgesia before nociceptive stimulation in the intensive care unit (ICU). METHODS In this prospective non-interventional study in a surgical ICU of a university hospital, PDR was assessed during tetanic stimulation (of 10, 20 or 40 mA) immediately before 40 end...

BACKGROUND Relationships between plasma morphine concentrations and neonatal responses to endotracheal tube (ETT) suctioning are unknown in preterm neonates. METHODS Ventilated preterm neonates (n=898) from 16 centres were randomly assigned to placebo (n=449) or morphine (n=449). After an i.v. loading dose (100 microg kg(-1)), morphine infusions [23-26 weeks postmenstrual age (PMA) 10 microg ...

BACKGROUND Critically ill patients under mechanical ventilation require frequent suctioning of airway secretion. Closed suction permits suctioning without disconnection from ventilator; so it might decrease hypoxemia and infection rate. OBJECTIVES This study aimed to evaluate the effect of closed tracheal suction system (CTSS) versus open tracheal suction system (OTSS). PATIENTS AND METHODS...

Suctioning intubated patients aids in removing secretions and maintaining a patent airway, while promoting optimal ventilation and oxygenation. The development of guidelines by Brooks et al supports clinical decision making by taking into consideration both the benefits and complications associated with the procedure. Recommendations for preoxygenation, hyperoxygenation, hyperinflation plus met...