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Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study

FERREIRA, Juliana C.; CHIPMAN, Daniel W.; KACMAREK, Robert M.
Fonte: SPRINGER Publicador: SPRINGER
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.69%
Objective: To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator. Design: Experimental bench study. Setting: The respiratory care laboratory of a university-affiliated teaching hospital. Subject: A computerized mechanical lung model, the IngMar ASL5000. Interventions: Ten mid-level ICU ventilators were compared to an ICU ventilator at two levels of lung model effort, three combinations of respiratory mechanics (normal, COPD and ARDS) and two modes of ventilation, volume and pressure assist/control. A total of 12 conditions were compared. Measurements and main results: Performance varied widely among ventilators. Mean inspiratory trigger time was < 100 ms for only half of the tested ventilators. The mean inspiratory delay time (time from initiation of the breath to return of airway pressure to baseline) was longer than that for the ICU ventilator for all tested ventilators except one. The pressure drop during triggering (Ptrig) was comparable with that of the ICU ventilator for only two ventilators. Expiratory Settling Time (time for pressure to return to baseline) had the greatest variability among ventilators. Conclusions: Triggering differences among these mid-level ICU ventilators and with the ICU ventilator were identified. Some of these ventilators had a much poorer triggering response with high inspiratory effort than the ICU ventilator. These ventilators do not perform as well as ICU ventilators in patients with high ventilatory demand.

Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients

Auxiliadora-Martins, M.; Menegueti, M.G.; Nicolini, E.A.; Alkmim-Teixeira, G.C.; Bellissimo-Rodrigues, F.; Martins-Filho, O.A.; Basile-Filho, A.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.6%
Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP...

Análise microbiológica e genético-molecular da biota orotraqueal de paciente crítico: subsídios na prevenção da pneumonia associada à ventilação mecânica; Microbiological and genetic molecular analysis of the orotracheal biota of critical patients: support in the prevention of mechanical ventilator-associated pneumonia.

Souza, Paula Regina de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 18/09/2009 PT
Relevância na Pesquisa
56.53%
A assistência em Unidade de Terapia Intensiva (UTI) é constantemente desafiada por infecções, que resultam no aumento da morbimortalidade, no tempo de internação e nos custos. Objetivos: avaliar os paciente críticos com tubo endotraqueal submetidos à ventilação mecânica na perspectiva clínica e microbiológica com a finalidade de determinar a dispersão de Staphylococcus aureus, Staphylococcus coagulase-negativa e Pseudomonas aeruginosa na assistência respiratória destes pacientes. Assim, analisou aspectos quantitativos, perfil de sensibilidade aos antibióticos, similaridade genética e formação de biofilme em tubo traqueal considerando a presença ou não de PAVM. Trata-se de um estudo observacional prospectivo realizado na UTI de um hospital de emergência no interior do Estado de São Paulo. A coleta de dados clínicos envolveu pacientes adultos com período 48 horas de intubação endotraqueal em ventilação mecânica mediante consentimento do responsável. As amostras foram procedentes da saliva, secreção traqueal e tubo traqueal dos referidos pacientes; e da luvas utilizadas na aspiração do tubo endotraqueal. Utilizou-se no processamento das amostras recursos clássicos e avançados da microbiologia como Enterobacterial Repetitive Intergenic Consensus Sequence (ERIC-PCR)...

Efeitos da lesão pulmonar induzida pela ventilação mecânica sobre o epitélio das vias aéreas de condução e sua influência no aparelho mucociliar: modelo experimental em coelhos; Effects of ventilator-induced lung injury on airway-ciliated epithelia and the influence on mucociliary transport system

Piccin, Vivien Schmeling
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/03/2010 PT
Relevância na Pesquisa
36.53%
A ventilação mecânica (VM) pode ser causa de lesão pulmonar sendo este fato reconhecido na literatura como Lesão Pulmonar Induzida pela Ventilação Mecânica (LPIV), onde alterações tanto fisiológicas quanto morfológicas são evidenciadas no pulmão. O objetivo desse trabalho foi avaliar a repercussão das forças envolvidas na ventilação mecânica através de diferentes mecanismos de LPIV sobre o sistema mucociliar pela análise funcional e histopatológica desse aparelho. Em um estudo controlado e randomizado vinte e sete coelhos machos da raça Nova Zelândia foram separados em quatro grupos. Nos primeiros trinta minutos foram submetidos à VM com volume corrente de 8 ml/kg peso, fluxo de 3 L/minuto, e pressão positiva expiratória final (PEEP) de 5 cm H2O e FIO2 de 0,4, sendo que o grupo Sham (n=6) foi ventilado por apenas 10 minutos. Os grupos Baixo Volume/BV (n=6; Vt 8, Ppico 17, Pmédia 9, PEEP 5, Fluxo 3), Alto Volume/AV (n=7; Vt 16, Ppico 27, Pmédia 12, PEEP 5, Fluxo 5) e Alta Pressão/AP (n=8; Vt 8, Ppico 30, Pmédia 20, PEEP 12, Fluxo 9) foram ventilados por mais 3 horas. A mecânica do sistema respiratório foi registrada pelo sistema Labview®. Foram acompanhados os valores de gasometria e sinais vitais. Amostras de tecido pulmonar foram coradas com H&E para análise de infiltrado inflamatório. Analisou-se a frequência de batimento ciliar (FBC)...

Hardware de ventilador pulmonar.; Hardware lung ventilator.

Silva, Alexandre Rodrigues da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 27/09/2011 PT
Relevância na Pesquisa
56.58%
Este trabalho visou mostrar o desenvolvimento de um ventilador pulmonar mecânico, focando principalmente na parte de hardware necessária para que este equipamento pudesse funcionar. Ventilação mecânica é a modalidade da medicina mais importante no cuidado a pacientes criticamente enfermos. O ventilador é um equipamento utilizado principalmente em unidades de terapia intensiva, que basicamente coloca uma mistura de ar e oxigênio para dentro do pulmão de um paciente incapacitado de fazer isto naturalmente, quer seja por força de uma doença que o impossibilita de fazê-lo, ou por uma cirurgia, a qual impossibilitou o movimento do músculo do diafragma para que o ar entrasse no pulmão naturalmente. Este projeto cobriu uma descrição abrangente sobre este ventilador, sua transformação de ar comprimido e oxigênio provenientes de um cilindro em uma mistura controlada de fluxos que entra no pulmão para a inspiração de um volume, ou para atingir uma pressão determinada, e a saída desta mistura, mantendo no pulmão uma pressão também controlada. Foi desenvolvido um protótipo de hardware e firmware para este aparelho, e o intuito foi mostrar o processo de transformação da ideia inicial e as necessidades de projeto em um aparelho testado e certificado para uso no mercado.; This work aimed to present the development of a pulmonary mechanical ventilator...

Efeitos fisiológicos da ventilação de alta frequência usando ventilador convencional em um modelo experimental de insuficiência respiratória grave; Physiological effects of high frequency ventilation with conventional ventilator in an experimental model of severe respiratory failure

Cordioli, Ricardo Luiz
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/07/2012 PT
Relevância na Pesquisa
36.62%
Introdução: A Síndrome do Desconforto Respiratório Agudo (SDRA) apresenta alta incidência e mortalidade em pacientes de terapia intensiva. A ventilação mecânica é o principal suporte para os pacientes que apresentam-se com SDRA, entretanto ainda existe muito debate sobre a melhor estratégia ventilatória a ser adotada, pois a ventilação mecânica pode ser lesiva aos pulmões e aumentar a mortalidade se mal ajustada. Um dos principais mecanismos de lesão pulmonar induzida pela ventilação é o uso de volumes correntes altos, havendo evidência na literatura que a utilização de volumes correntes menores fornece uma ventilação dita protetora, a qual aumenta a probabilidade de sobrevivência. Objetivo: Explorar se uma estratégia ventilatória de alta frequência com pressão positiva (HFPPV) realizada através de um ventilador mecânico convencional (Servo-300) é capaz de permitir uma maior redução do volume corrente e estabilização da PaCO2 em um modelo de SDRA severa, inicialmente ventilado com uma estratégia protetora. Métodos: Estudo prospectivo, experimental que utilizou oito porcos que foram submetidos a uma lesão pulmonar através de lavagem pulmonar com soro fisiológico e ventilação mecânica lesiva. Em seguida...

Análise do suporte ventilatório mecânico durante anestesia e sua correlação com as complicações pulmonares pós-operatórias: um estudo observacional; Analysis of the mechanical ventilatory support in anesthesia and its correlation with the postoperative pulmonary complications: an observational study

Hirota, Adriana Sayuri
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 23/03/2005 PT
Relevância na Pesquisa
46.19%
Introdução: A formação de atelectasia durante a indução anestésica pode ser um dos fatores responsáveis pela ocorrência de complicações pulmonares pós-operatórias (CPP). A aplicação de pressão positiva expiratória ao final da expiração (PEEP), uso criterioso de altas frações inspiradas de oxigênio e a utilização de manobras de recrutamento alveolar no período intra-operatório são recursos utilizados para a prevenção de atelectasia em procedimentos anestésicos. O objetivo deste estudo foi avaliar o modelo de ventilação mecânica adotado em procedimentos anestésicos de longa duração e suas correlações com as complicações pulmonares pós-operatórias. Métodos: Foram avaliadas em estudo observacional as cirurgias com mais de cinco horas de duração. No início do procedimento anestésico, na sala de cirurgia e após o seu término, na unidade de terapia intensiva, os parâmetros ventilatórios utilizados foram anotados e correlacionados com os achados das radiografias torácicas e saturação periférica de oxigênio (SpO2) em ar ambiente. Resultados: Cento e vinte e um pacientes foram observados. O tempo total de anestesia 499,4 ± 159,8 minutos. O volume corrente (VC) determinado no período intraoperatório foi 8...

Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients

Auxiliadora-Martins,M.; Menegueti,M.G.; Nicolini,E.A.; Alkmim-Teixeira,G.C.; Bellissimo-Rodrigues,F.; Martins-Filho,O.A.; Basile-Filho,A.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2012 EN
Relevância na Pesquisa
36.6%
Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP...

Nursing actions for the prevention of ventilator-associated pneumonia

Gonçalves,Fernanda Alves Ferreira; Brasil,Virginia Visconde; Ribeiro,Luana Cássia Miranda; Tipple,Anaclara Ferreira Veiga
Fonte: Escola Paulista de Enfermagem, Universidade Federal de São Paulo Publicador: Escola Paulista de Enfermagem, Universidade Federal de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 EN
Relevância na Pesquisa
46.39%
OBJECTIVE: To identify prevention actions of the nursing team related to ventilator-associated pneumonia (VAP). METHOD: A cross-sectional, observational study conducted in an Intensive Care Unit of a teaching hospital in Goiania/GO. RESULTS: Hand hygiene occurred, mainly, after the procedures and most of care, such as elevating the head-of-bed, bronchial and oral hygiene, diet administration, also handlingmechanical ventilator circuits were not adequate and if experienced groups such as the one in the present study are not following the recommendations emerging from evidence, it may indicate that, for some reason, the learning is not being significant. CONCLUSION: Most recommendedmeasures to reduce VAP related to positioning the head-of-bed, bronchial and oral hygiene, administration of diet and handling mechanical ventilator circuit were not followed.

Ventilator-associated pneumonia in an adult clinical-surgical intensive care unit of a Brazilian university hospital: incidence, risk factors, etiology, and antibiotic resistance

Rocha,Laura de Andrade da; Vilela,Carolina Assis Pereira; Cezário,Renata Cristina; Almeida,Alair Benedito; Gontijo Filho,Paulo
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2008 EN
Relevância na Pesquisa
36.5%
The objective of this study was to evaluate clinical characteristics, etiology, and resistance to antimicrobial agents, among patients with ventilator-associated pneumonia (VAP). A case study vs. patients control under mechanical ventilation and hospitalized into clinical-surgical adults ICU of HC-UFU was performed from March/2005 to March/2006. Patients under ventilation for over 48 h were included in the study including 84 with diagnosis of VAP, and 191 without VAP (control group). Laboratory diagnosis was carried out through quantitative microbiological evaluation of tracheal aspirate. The identification of pathogens was performed by classical microbiological tests, and the antibiotics sensitivity spectrum was determined through the CLSI technique. VAP incidence rate over 1,000 days of ventilation was 24.59. The mean (± SD) duration of mechanical ventilation prior to VAP diagnosis was 23.2 ± 17.2 days. By multivariate analysis the risk factors predisposing for VAP were: mechanical ventilation time and mechanical ventilation > seven days, tracheostomy and use of > three antibiotics. Mortality rate was high (32.1 %) but lower than that of the control group (46.5%). Major pathogens were identified in most of patients (95.2%) and included: Pseudomonas aeruginosa (29%)...

Noninvasive mechanical ventilation in the treatment of acute cardiogenic pulmonary edema

Park,Marcelo; Lorenzi-Filho,Geraldo
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2006 EN
Relevância na Pesquisa
46.12%
Current literature was searched by using the MEDLINE database to find consistent evidence regarding the use of noninvasive mechanical ventilation in patients with acute cardiogenic pulmonary edema. 18 studies demonstrating that noninvasive ventilation applied by continuous positive airway pressure (CPAP) or bilevel positive airway pressure (bilevel-PAP) is safe, and that the two approaches have similar effects and are effective in preventing endotracheal intubation in patients with respiratory distress of cardiac origin, were found. The results support the concept that positive intrathoracic positive pressure must be seen as a nonpharmacological form of treatment of acute pulmonary edema rather than only a supportive measure.

Mechanical ventilation and the total artificial heart: optimal ventilator trigger to avoid post-operative autocycling - a case series and literature review

Shoham, Allen B; Patel, Bhavesh; Arabia, Francisco A; Murray, Michael J
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 17/05/2010 EN
Relevância na Pesquisa
36.5%
Many patients with end-stage cardiomyopathy are now being implanted with Total Artificial Hearts (TAHs). We have observed individual cases of post-operative mechanical ventilator autocycling with a flow trigger, and subsequent loss of autocycling after switching to a pressure trigger. These observations prompted us to do a retrospective review of all TAH devices placed at our institution between August 2007 and May 2009. We found that in the immediate post-operative period following TAH placement, autocycling was present in 50% (5/10) of cases. There was immediate cessation of autocycling in all patients after being changed from a flow trigger of 2 L/minute to a pressure trigger of 2 cm H2O. The autocycling group was found to have significantly higher CVP values than the non-autocycling group (P = 0.012). Our data suggest that mechanical ventilator autocycling may be resolved or prevented by the use of a pressure trigger rather than a flow trigger setting in patients with TAHs who require mechanical ventilation.

Very Low Birth Weight Infant Necessitating Nissen Fundoplication for Weaning off the Mechanical Ventilator

Varal, İpek Güney; Köksal, Nilgün; Özkan, Hilal; Doğan, Pelin; Bağcı, Onur; Doğruyol, Hasan; Gürpınar, Arif
Fonte: EL-MED-Pub Publicador: EL-MED-Pub
Tipo: Artigo de Revista Científica
Publicado em 21/05/2014 EN
Relevância na Pesquisa
46.4%
Gastro-esophageal reflux (GER) is one of the common problems of neonatal intensive care units. Although this condition does not always need to be treated, it occasionally causes clinically serious consequences. Initial management is medical; however, in some cases surgery might be required. A premature neonate with birth weight of 1370 grams was managed in our ICU. The patient was mechanical ventilator dependent due to GER. The patient needed Nissen fundoplication for successfully weaning off the ventilator.

The effects of mechanical ventilation on the development of Acute Respiratory Distress Syndrome

Jia, Xiaoming, M. Eng. Massachusetts Institute of Technology
Fonte: Massachusetts Institute of Technology Publicador: Massachusetts Institute of Technology
Tipo: Tese de Doutorado Formato: 76 p.
ENG
Relevância na Pesquisa
36.72%
Acute Respiratory Distress Syndrome (ARDS) is a severe lung illness characterized by inflammation and fluid accumulation in the respiratory system. Historically, ARDS and other forms of respiratory failure have been treated using mechanical ventilation to help maintain gas exchange in the lungs. However, clinical investigators are beginning to discover the adverse effects of mechanical ventilation if it is not applied properly. Specifically, excessive ventilator volumes and pressures may exacerbate existing lung injury and increase hospital mortality. Furthermore, aggressive ventilation may cause lung injury and trigger an inflammatory response that is characteristic of ARDS. These findings have alarmed the critical care community, and many studies have been conducted to find mechanical ventilator settings that reduce mortality in patients with ARDS. However, there have been no firm recommendations on the optimal settings for patients who require ventilator therapy for reasons apart from respiratory failure. In this thesis, we retrospectively examine a large medical database (MIMIC-II) to study the relationship between mechanical ventilation and the development of ARDS. Specifically, our goals are to (1) find patients who did not have ARDS at the beginning of mechanical ventilation but who later developed the disease; (2) identify physiologic and ventilator-associated risk factors for ARDS; and (3) develop a text analysis algorithm to automatically extract clinical findings from radiology (chest x-ray) reports. Our findings suggest that acute respiratory distress syndrome is a relatively common illness in patients who require mechanical ventilation in the ICU (152 of 789 without ARDS at the outset eventually developed the disease).; (cont.) High plateau pressure (odds ratio 1.5 per 6.3 cmH20...

Relationship between monitored elements and prescribed ventilator setting modifications in critically ill children

Eddington, Kay Allen
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
EN
Relevância na Pesquisa
46.64%
Les pédiatres intensivistes ont plusieurs éléments disponibles pour guider leurs décisions par rapport à la ventilation mécanique. Par contre, aucune étude prospective ne décrit les éléments auxquels les intensivistes se réfèrent pour modifier les paramètres du respirateur. Objectifs : Décrire la pratique actuelle de la modification des paramètres du respirateur aux soins intensifs du CHU Sainte-Justine, un hôpital pédiatrique tertiaire. Hypothèse : 80% des modifications des paramètres du respirateur influant sur l’épuration du CO2 sont liées à l’analyse de la PCO2 ou du pH et 80% des modifications des paramètres d’oxygénation sont liés à l’analyse de l’oxymétrie de pouls. Méthodes : En se servant d’un logiciel de recueil de données, les soignants ont enregistré un critère de décision primaire et tous les critères de décision secondaires menant à chaque modification de paramètre du respirateur au moment même de la modification. Résultats : Parmi les 194 modifications des paramètres du respirateur influant sur l’épuration du CO2, faites chez vingts patients, 42.3% ±7.0% avaient pour critère primaire la PCO2 ou le pH sanguin. Parmi les 41 modifications de la pression expiratoire positive et les 813 modifications de la fraction d’oxygène inspirée...

Dynamic selection of models for a ventilator-management advisor.

Rutledge, G. W.
Fonte: American Medical Informatics Association Publicador: American Medical Informatics Association
Tipo: Artigo de Revista Científica
Publicado em //1993 EN
Relevância na Pesquisa
36.52%
A ventilator-management advisor (VMA) is a computer program that monitors patients who are treated with a mechanical ventilator. A VMA implements a patient-specific physiologic model to interpret patient data and to predict the effects of alternative control settings for the ventilator. Because a VMA evaluates its physiologic model repeatedly during each cycle of data interpretation, highly complex models may require more computation time than is available in this time-critical application. On the other hand, less complex models may be inaccurate if they are unable to represent a patient's physiologic abnormalities. For each patient, a VMA should select a model that balances the tradeoff of prediction accuracy and computation-time complexity. I present a method to select models that are at an appropriate level of detail for time-constrained decision tasks. The method is based on a local search in a graph of models (GoM) for a model that maximizes the tradeoff of computation-time complexity and prediction accuracy. For each model under consideration, a belief network computes a probability of model adequacy given the qualitative prior information, and the goodness of fit of the model to the data provides a measure of the conditional probability of adequacy given the quantitative observations. I apply this method to the problem of model selection for a VMA. I describe an implementation of a graph of physiologic models that range in complexity from VentPlan...

Uso da ventilação não invasiva no tratamento de pacientes com edema agudo de pulmão cardiogênico; Noninvasive mechanical ventilation in the treatment of acute cardiogenic pulmonary edema

Park, Marcelo; Lorenzi-Filho, Geraldo
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/06/2006 ENG
Relevância na Pesquisa
46.12%
Pesquisamos a literatura atual usando a base de dados MEDLINE para encontrar evidências consistentes sobre o uso da ventilação não invasiva em pacientes com edema agudo de pulmão cardiogênico. Foram encontrados 18 estudos demonstrando que a ventilação não invasiva aplicada por CPAP ou bilevel-PAP é segura, tem efeitos similares e é efetiva em reduzir a necessidade de intubação traqueal em pacientes com desconforto respiratório de origem cardíaca. Os resultados reforçam o conceito que a pressão positiva intratorácica deve ser considerada um forma não farmacológica de tratamento do edema agudo de pulmão cardiogênico e não simplesmente uma medida de suporte.; Current literature was searched by using the MEDLINE database to find consistent evidence regarding the use of noninvasive mechanical ventilation in patients with acute cardiogenic pulmonary edema. 18 studies demonstrating that noninvasive ventilation applied by continuous positive airway pressure (CPAP) or bilevel positive airway pressure (bilevel-PAP) is safe, and that the two approaches have similar effects and are effective in preventing endotracheal intubation in patients with respiratory distress of cardiac origin, were found. The results support the concept that positive intrathoracic positive pressure must be seen as a nonpharmacological form of treatment of acute pulmonary edema rather than only a supportive measure.

Parameter estimation of an artificial respiratory system under mechanical ventilation following a noisy regime

Victor Júnior,Marcus Henrique; Forgiarini Junior,Luiz Alberto; Kinjo,Toru Miyagi; Amato,Marcelo Britto Passos; Yoneyama,Takashi; Tanaka,Harki
Fonte: Sociedade Brasileira de Engenharia Biomédica Publicador: Sociedade Brasileira de Engenharia Biomédica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
Relevância na Pesquisa
56.53%
Abstract Introduction: This work concerns the assessment of a novel system for mechanical ventilation and a parameter estimation method in a bench test. The tested system was based on a commercial mechanical ventilator and a personal computer. A computational routine was developed do drive the mechanical ventilator and a parameter estimation method was utilized to estimate positive end-expiratory pressure, resistance and compliance of the artificial respiratory system. Methods The computational routine was responsible for establishing connections between devices and controlling them. Parameters such as tidal volume, respiratory rate and others can be set for standard and noisy ventilation regimes. Ventilation tests were performed directly varying parameters in the system. Readings from a calibrated measuring device were the basis for analysis. Adopting a first-order linear model, the parameters could be estimated and the outcomes statistically analysed. Results Data acquisition was effective in terms of sample frequency and low noise content. After filtering, cycle detection and estimation took place. Statistics of median, mean and standard deviation were calculated, showing consistent matching with adjusted values. Changes in positive end-expiratory pressure statistically imply changes in compliance...

EPIDEMIOLOGY OF POLYTRAUMA PATIENTS WITH VENTILATOR-ASSOCIATED PNEUMONIA IN THE INTENSIVE CARE UNIT OF EVANGÉLICO UNIVERSITY HOSPITAL FROM CURITIBA; PERFIL EPIDEMIOLÓGICO DOS PACIENTES POLITRAUMATIZADOS COM PNEUMONIA ASSOCIADA À VENTILAÇÃO MECÂNICA NA UNIDADE DE TERAPIA INTENSIVA DO HOSPITAL UNIVERSITÁRIO EVANGÉLICO DE CURITIBA

Marques, Matheus Lenci; Faculdade Evangélica do Paraná; Musial, Vinícius Panichi; Faculdade Evangélica do Paraná; Cordeiro, Alessandra Amatuzzi; Pontifícia Universidade Católica do Paraná - PUCPR; Kuzmicz, Marcelo; Faculdade Evangélica do Paraná
Fonte: Setor de Ciência da Saúde - Universidade Federal do Paraná Publicador: Setor de Ciência da Saúde - Universidade Federal do Paraná
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Avaliado pelos pares; Estudo Epidemiológico; Research Formato: application/pdf
Publicado em 01/03/2014 POR
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36.62%
Abstract: Purpose: Demonstrate the epidemiological profile of polytrauma patients who developed ventilator-associated pneumonia in the intensive care unit of Evangélico University Hospital from Curitiba. Material and Method: Were assessed patients who developed ventilator-associated pneumonia in the period of March 2012 through September 2012. Were surveyed several factors that could influence the occurrence of the ventilator-associated pneumonia, such as gender, age, comorbidities, duration of mechanical ventilation and length of hospitalization. Results: Forty patients aged between 18 and 73 years, with 28 (70%) males and 12 (30%) female were evaluated in this study. The hospitalization of the patients in the ICU ranged from a minimum of 4 days to a maximum of 111 days with a mean of 19.1 days, the duration of mechanical ventilation ranged from 4 to 111 days with an average of 16 days. Conclusion: The epidemiological profile of polytrauma patients that develops ventilator-associated pneumonia in Evangélico University Hospital from Curitiba demon-strate that this kind of infection predominates in male patients with a mean age of 36 years, smokers, who already make use of mechanical ventilation for at least 16 days and also that infection begins on average in the sixth day following the patient intubation. ; Resumo: Objetivo: demonstrar o perfil epidemiológico dos pacientes politraumatizados que desenvolveram pneumonia associada à ventilação mecânica na unidade de terapia intensiva do Hospital Universitário Evangélico de Curitiba Materi-al e Método: Foram avaliados os pacientes que desenvolveram pneumonia associada à ventilação mecânica no período de março de 2012 até setembro de 2012...

Nosocomial ventilator-associated pneumonia in Cuban intensive care units: bacterial species and antibiotic resistance

Medell,Manuel; Hart,Marcia; Duquesne,Amílcar; Espinosa,Fidel; Valdés,Rodolfo
Fonte: Medical Education Cooperation with Cuba Publicador: Medical Education Cooperation with Cuba
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 EN
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INTRODUCTION: Nosocomial pneumonia associated with use of mechanical ventilators is one of the greatest challenges confronted by intensivists worldwide. The literature associates several bacteria with this type of infection; most common in intensive care units are Acinetobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and some of the Enterobacteriaceae family. OBJECTIVES: To identify the causal agents of nosocomial ventilatorassociated pneumonia in patients receiving mechanical ventilation in the intensive care units of Havana's Hermanos Ameijeiras Clinical-Surgical Teaching Hospital in 2011, and to characterize their antibiotic resistance. METHODS: A cross-sectional descriptive study was conducted using hospital administrative data of quantitative cultures from positive tracheal aspirates for January through December, 2011. Records were analyzed from 77 intensive care unit patients who developed nosocomial ventilator-associated pneumonia. Variables examined were age and sex, and pathogens identified from culture of tracheal aspirate and related antibiotic susceptibility. RESULTS: Species most frequently isolated were: Acinetobacter baumannii in 53 patients (68.8%), Pseudomonas aeruginosa in 34 patients (44.2%)...