a 21-year old man with cervical spinal cord damage due to diving was admitted in the icu. tracheostomy was performed due to prolonged mechanical ventilation. left lung atelectasis happened frequently. because of the difficulty of bronchoscopy and failing of recruitment, using a double lumen, two tracheal tubes were guided into the left and right lungs through the tracheostomy stoma site. after ...

results there were 80 successful and 44 unsuccessful as well as 72 successful and 8 unsuccessful weaning cases in the first and second phase of the study, respectively. the area under the roc curves for iwi was 0.967, with standard error of 0.020, 95% confidence interval of 0.899 to 0.993 and significance level of p = 0.001, se = 94.59, sp = 66.67, ppv = 97.22, npv = 50, da = 92.5 and likelihoo...

Improving Intensive Care Unit (ICU) outcomes by reducing ventilator associated complications and ventilator days may warrant re-engineering the weaning process.1 Alternative methods which assist clinicians in organizing and implementing accurate weaning processes may shorten the duration of ventilator dependence and positively impact ICU outcomes.2 Knowledge based weaning (KBW) provides an alte...

Most patients staying in the intensive care unit (ICU) require respiratory support through a ventilator. Since prolonged mechanical ventilation and weaning from the ventilator without criteria or at the inappropriate time can result in many complications, it is required that patients be weaned off the ventilator as soon as possible. This study was conducted to investigate a few standard tools t...

Objectives: The objectives of this post hoc analysis was to describe the characteristics of cardiopulmonary indicators among patients with normal ventilator weaning response and dysfunctional ventilator weaning response after coronary artery bypass graft surgery, and to find the differences in characteristics of cardiopulmonary indicators between patients with normal ventilator weaning response...

BACKGROUND Mechanical ventilation (MV) is a key component in the care of critically ill and injured patients. Weaning from MV constitutes a major challenge in intensive care units (ICUs). Any delay in weaning may increase the number of complications and leads to greater expense. Nurse-led, protocol-directed weaning has become popular, but it remains underused. The aim of this study was to ident...

BACKGROUND Approximately ten percent of patients placed on mechanical ventilation during acute illness will require long-term ventilator support. Unfortunately, despite rehabilitation, some will never be liberated from the ventilator. A method of predicting weaning outcomes for these patients could help conserve resources and minimize frustrating failed weaning attempts for this population. The...

BACKGROUND Weaning is typically regarded as a process of discontinuing mechanical ventilation in the daily practice of an intensive care unit (ICU). Among the ICU patients, 39%-40% need mechanical ventilator for sustaining their lives. The predictive rate of successful weaning achieved only 35-60% for decisions made by physicians. Clinical decision support systems (CDSSs) are promising in enhan...

OBJECTIVE We sought to determine whether the utilization of a respiratory therapist (RT) driven mechanical ventilation weaning protocol is associated with improvement in clinical outcomes in subjects with simple versus difficult weaning. METHODS This was a retrospective analysis of prospectively collected data obtained during a quality improvement project. We collected data on 803 consecutive...

Abstract Background Patient-ventilator asynchrony is a common problem in mechanically ventilated patients. It associated with adverse effects including increased work of breathing, patient discomfort, need for sedation, prolonged mechanical ventilation, weaning difficulties, and failure. The purpose the present was to describe patient-ventilator its impact on outcomes chronic obstructive pulmon...