Objective: To delineate the incidence, outcome impact, and clinical predictors of prolonged mechanical ventilation (PMV) after adult aortic arch repair requiring deep hypothermic circulatory arrest (AAR-DHCA) Aims: (1) To determine the incidence of PMV after AAR–DHCA. (2) To determine whether PMV after AAR-DHCA is a multivariate predictor for mortality or length of stay in the intensive care un...

conclusions it was found that avoiding routine pivotal expertise, increasing consciousness of the nonphysical aspects of patients while providing treatment and presenting exclusive care, utilizing experienced icu nurses, and placing more emphasis on effective communication with patients in order to honor them as human beings can all enhance the holistic quality of care. results the four main th...

This paper reviews management strategies for patients undergoing prolonged mechanical ventilation (PMV). Topics covered include how to identify and correct barriers to weaning, the systematic approach to weaning trials, when to cease weaning trials and proceed with life-long support, managing the tracheostomy tube during PMV, and, finally, how to select a suitable mechanical ventilator for PMV.

In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since th...

Introduction Is There a Role for Screening Spirometry? Are Corticosteroids Useful in Late-Stage Acute Respiratory Distress Syndrome? Should Patients Be Able to Follow Commands Prior to Extubation? Are Sleep Studies Appropriately Done in the Home? Should Tracheostomy Be Performed as Early as 72 Hours in Patients Requiring Prolonged Mechanical Ventilation? Should Prone Positioning Be Routinely Us...

It has been 60 years since Bendixen, Hedley-White, and Laver described the progressive atelectasis resultant hypoxemia that resulted from prolonged mechanical ventilation. A proposed solution was to raise tidal volume (VT) those recommended by Radford’s nomogram for “proper ventilation” 10 -15 ml/ kg. less than four later Acute Respiratory Distress Syndrome (ARDS) first reported. Since then, cl...

We describe difficult weaning after prolonged mechanical ventilation in three tracheostomized children affected by respiratory virus infection. Although the spontaneous breathing trials were successful, the patients failed all extubations. Therefore a tracheostomy was performed and the weaning plan was begun. The strategy for weaning was the decrease of ventilation support combining pressure co...

BACKGROUND Prolonged chest tube duration is less well studied in patients who are supported by mechanical ventilation and have acquired pneumothorax. We investigated the impact of prolonged chest tube duration on patient outcomes and the risk factors associated with prolonged chest tube duration. METHODS This retrospective observational study included 106 ventilated subjects who had been trea...

INTRODUCTION Acute kidney injury (AKI) is associated with high mortality rates. New biomarkers that can identify subjects with early AKI (before the increase in serum creatinine) are needed to facilitate appropriate treatment. The purpose of this study was to test the role of serum cytokines as biomarkers for AKI and prolonged mechanical ventilation. METHODS This was a case-control study of c...

Displaced rib fractures as the result of blunt chest trauma impairs chest wall mechanics, causes severe pain, and results in prolonged mechanical ventilation. Rib fixation plates have been developed and manufactured for use in adult patients with improved outcomes over expectant management. The authors report the first case of rib fixation using titanium plates in a child after sustaining signi...