Mas de ventilación mecánica/More on mechanical ventilation

En algunos envios podrá notar que se incluye el hiperlik de los PDFs. Esto le facilita ampliar la información sobre los autores y las revistas con tan solo hacer click sobre los datos incluidos. In some e-mails you may notice that the hyperlinks are included. This makes it easy more information about the authors and journals just clicking on the data included. Em alguns e-mails que você perceber que podem os hiperlinks estão incluídos. Isto torna mais fácil obter mais informações sobre os autores e periódicos apenas clicando sobre os dados incluídos. در برخی از ایمیل شما متوجه است که ممکن است لینک گنجانده شده است. این باعث می شود آن را آسان اطلاعات بیشتر در مورد نویسندگان و مجلات تنها با کلیک کردن بر روی داده ها گنجانده شده است. Beneficios de la ventilación protectora. Viendo más allá de UCI Benefits of lung-protective ventilation: looking beyond the ICU. Gupta N, Yende S. Crit Care. 2014 Sep 25;18(5):530. doi: 10.1186/s13054-014-0530-0. PDF Avances recientes en ventilación mecánica en pacientes sin ARDS Recent advances in mechanical ventilation in patients without acute respiratory distress syndrome. Serpa Neto A, Filho RR, Rocha LL, Schultz MJ. F1000Prime Rep. 2014 Dec 1;6:115. doi: 10.12703/P6-115. eCollection 2014. Abstract While being an essential part of general anesthesia for surgery and at times even a life-saving intervention in critically ill patients, mechanical ventilation has a strong potential to cause harm. Certain ventilation strategies could prevent, at least to some extent, the injury caused by this intervention. One essential element of so-called 'lung-protective' ventilation is the use of lower tidal volumes. It is uncertain whether higher levels of positive end-expiratory pressures have lung-protective properties as well. There are indications that too high oxygen fractions of inspired air, or too high blood oxygen targets, are harmful. Circumstantial evidence further suggests that spontaneous modes of ventilation are to be preferred over controlled ventilation to prevent harm to respiratory muscle. Finally, the use of restrictive sedation strategies in critically ill patients indirectly prevents ventilation-induced injury, as daily spontaneous awakening and breathing trials and bolus instead of continuous sedation are associated with shorter duration of ventilation and shorten the exposure to the injurious effects of ventilation. PDF Enfoques para la ventilación en cuidados intensivos. Approaches to ventilation in intensive care. Spieth PM, Koch T, Gama de Abreu M. Dtsch Arztebl Int. 2014 Oct 17;111(42):714-20. doi: 10.3238/arztebl.2014.0714. Abstract BACKGROUND: Mechanical ventilation is a common and often life-saving intervention in intensive care medicine. About 35% of all patients in intensive care are mechanically ventilated; about 15% of these patients develop a ventilation-associated pneumonia. The goal of ventilation therapy is to lessen the work of respiration and pulmonary gas exchange and thereby maintain or restore an adequate oxygen supply to the body's tissues.Mechanical ventilation can be carried out in many different modes; the avoidance of ventilation-induced lung damage through protective ventilationstrategies is currently a major focus of clinical interest. METHOD: This review is based on pertinent articles retrieved by a selective literature search. RESULTS: Compared to conventional lung-protecting modes of mechanical ventilation, the modern modes of ventilation presented here are further developments that optimize lung protection while improving pulmonary function and the synchrony of the patient with the ventilator. In high-frequencyventilation, tidal volumes of 1-2 mL/kgBW (body weight) are given, at a respiratory rate of up to 12 Hz. Assisted forms of spontaneous respiration are also in use, such as proportional assist ventilation (PAV), neurally adjusted ventilatory assist (NAVA), and variable pressure-support ventilation. Computer-guided closed-loop ventilation systems enable automated ventilation; according to a recent meta-analysis, they shorten weaning times by 32% . CONCLUSION: The currently available scientific evidence with respect to clinically relevant endpoints is inadequate for all of these newer modes ofventilation. It appears, however, that they can lower both the invasiveness and the duration of mechanical ventilation, and thus improve the care of patients who need ventilation. Randomized trials with clinically relevant endpoints must be carried out before any final judgments can be made. PDF

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