OBJECTIVE To test the hypothesis that successful implementation of a care bundle designed to prevent nosocomial airway infection will be associated with decreased incidence of ventilator-associated tracheobronchitis. DESIGN Prospective pre- and post interventional. SETTING PICU at an academic medical center PATIENTS : All patients admitted to the PICU who received invasive mechanical vent...

References: 1. Zestos MM, Hoppen CN, Belenky WM, et al. Subglottic stenosis after surgery for congenital heart disease: a spectrum of severity. J Cardiothorac Vasc Anesth. 2005; 19(3): 367–369, indexed in Pubmed: 16130067. 2. Dalar L, Schuurmans MM, Eryuksel E, et al. Early tracheal stenosis causing extubation failure and prolonged ventilator dependency. Anaesth Intensive Care. 2013; 41(1): 108...

A variety of asynchronies between the patient’s respiratory efforts and programed ventilatory settings have been categorized. Reverse trigger is described as an inspiratory effort occurring after a ventilator-initiated breath may represent form entrainment. In other words, ventilator triggers muscular efforts. It often appears in repetitive, stereotyped pattern. occurs mechanically ventilated p...

BACKGROUND Mechanical ventilator circuits are commonly changed at 48-h intervals. This frequency may be unnecessary because ventilator-associated pneumonia often results from aspiration of pharyngeal secretions and not from the ventilator circuit. We compared the ventilator-associated pneumonia rates and costs associated with 48-h and 7-day circuit changes. METHODS Ventilator circuits were ch...

Patient-ventilator interaction is a key element in optimizing mechanical ventilation. The change from inspiration to expiration is a crucial point in the mechanically ventilated breath, and is termed "cycling." Patient-ventilator asynchrony may occur if the flow at which the ventilator cycles to exhalation does not coincide with the termination of neural inspiration. Ideally, the ventilator ter...

We determined the effect of varying ventilator tidal volume (VT) and inspiratory flow (V) on the inspiratory muscle work (WI) during assist-mode mechanical ventilation (AMV) in four healthy subjects. In another four subjects, under constant chemoreceptor input, we determined the responses of neuromuscular output as assessed by the mouth occlusion pressure (P0.1) to alteration in WI. During AMV,...

This study is aimed at identifying factors predicting tracheostomy requirement in children diagnosed with a posterior fossa medulloblastoma postoperatively. A retrospective chart review of all patients younger than 18 undergoing resection from 2012 to 2020 Namazi Hospital was conducted. Forty-five (26%) needed after the operation. The most common correlates were brainstem compression and absenc...