Objective: To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. Methods: This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and wer...

BACKGROUND Mortality increases when extubations fail. Although predictors of extubation failure have been evaluated, physicians' reasoning to extubate a patient has received minimal attention. We hypothesized that the accuracy and reliability of physicians' extubation decisions are low. METHODS We sent surveys to 55 physicians in the divisions of pulmonary and critical care medicine of 3 teac...

OBJECTIVES Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH2O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomo...

PURPOSE OF REVIEW To discuss the recent literature concerning the use of noninvasive ventilation for hypoxemic acute respiratory failure. RECENT FINDINGS The benefits of noninvasive ventilation for patients with hypoxemic acute respiratory failure are unclear. In immunocompromised patients and following thoracic surgery, there is a strong rationale for using noninvasive ventilation to treat a...

BACKGROUND AND OBJECTIVES Weaning patients from mechanical ventilation is a challenge in the intensive care unit (ICU) practice and is related to some complications. One of these is the pos-extubation laryngospasm, an event that can be anticipated for the cuff leak test (CLT). The objective was demonstrate that the CLT is a simple, reliable and low costs method to available the presence of obst...

Received February 15, 2007 Abstract Bubble continuous positive airway pressure (CPAP) was introduced more than 30 years ago for infants with respiratory distress. With this, there had been reports of decreased incidence of mechanical ventilation and chronic lung disease among the premature, as well as less failure of extubation. This report described how this treatment modality was adopted loca...

a normal life span. It has recently been shown that CCHS confers risk for adverse neurocognitive outcome [3]. Visuoperceptual reasoning and clerical/ visuographic speed appear particularly vulnerable. In this issue of IMAJ, Cohen-Cymberknoh and colleagues [4] present an interesting and unusual case of a 12 year old girl with late-onset CCHS that was suspected and diagnosed only after she failed...

Background Although invasive mechanical ventilation (IMV) has contributed to the survival of preterm infants with extremely low birth weight (ELBW), it is also associated unsatisfactory clinical outcomes when used for prolonged periods. This study aimed identify factors that may be decisive extubation success in very (VLBW) and (ELBW) infants. Methods The cohort included gestational age (GA) &l...

Introduction  Mechanical ventilation may be lifesaving intervention,It can be associated with complications,Thus,successful weaning is constitutive.One of the factors which is  important in successful weaning is  method of weaning. It is shown that  weaning is conducted successfully by using Spontaneous Breathing Trial (SBT) through T-piece and pressure support (PS) ventilation.But few studies ...

We have read the research by Kapnadak et al [1] with great interest. In this article, the authors evaluate the differences in clinical outcomes relative to a high, intermediate, or low percentage of failed planned extubation. They describe that the best percentage of failed planned extubation is located in the intermediate range (7%-15%) because, in this range, more ventilator-free days and int...