Study protocol. Study protocol. Subjects with hemodynamic, respiratory, and neurologic stability and positive predictive index were randomized to 3 groups.

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Ventilatory Parameters

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Emídio Lima MD, PhD. Mortality Increases with the Duration of Mechanical Ventilation and Weaning Failure.

1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license.

APPROACH TO ASSESSMENT AND WEANING OFF THE MECHANICAL VENTILATOR AT THE BEDSIDE DR. MUNIRA DILAWER GHEEWALA.

Weaning From Mechanical Ventilation

Effect of nasal positive expiratory pressure (PEP) on 6-min walk test (6MWT) distance and pre- to post-exercise increase in lung volumes in each individual.

Weaning From The Ventilator

Meets all Extubation Criteria

The changes in peak flow and inspiratory time between a minimum rise time (first 2 breaths) and a maximum rise time (last 2 breaths), with the Servo-i.

Airway pressure and flow waveforms during constant flow volume control ventilation, illustrating the effect of an end-inspiratory breath-hold. Airway pressure.

Mask fit process. Mask fit process. The mask fit process begins with 3-dimensional surface images of the subject's face (A). Three-dimensional scans are.

Example ventilator screen during nasal neurally adjusted ventilatory assist in a premature neonate (23 weeks gestational age, 560 g) with respiratory distress.

Representative images of 5 subjects are shown.

Trigger delays and leaks.

Picture of bubble PEP devices.

Flow chart of pressure support test and spontaneous breathing trial (SBT). Flow chart of pressure support test and spontaneous breathing trial (SBT). The.

Running title: NAVA may reduce weaning duration from mechanical ventilation A randomized controlled trial to compare Neurally adjusted ventilatory assist.

Noninvasive ventilation-neurally adjusted ventilatory assist (NIV-NAVA) where each patient effort is captured but support is insufficient (maximum electrical.

A: Pressure (green) and volume (black)/time curve in airway pressure release ventilation (APRV). A: Pressure (green) and volume (black)/time curve in airway.

Asynchrony index at baseline and following optimization of pressure support (PS) level (A), and following optimization of mechanical inspiratory time (mechanical.

Likert-scale agreement ratings regarding the use of extubation readiness parameters by pediatric critical care physicians. Likert-scale agreement ratings.

Simulated screenshot of flow starvation in volume control continuous mandatory ventilation. Simulated screenshot of flow starvation in volume control continuous.

Indications for ventilation in adults

Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, Area Under the Curve, and 95% CIs for the 0, 10, 25, 50, and 100 SatSeconds.

Representative tracings of transcutaneous CO2 (PtcCO2), Spo2, and heart rate during an apnea test designed to raise Paco2 to 100 mm Hg. At baseline, PtcCO2.

A: Machine-triggered intermittent mandatory ventilation (IMV) with inadequate patient triggering of mandatory breaths. A: Machine-triggered intermittent.

Trigger and synchronization windows.

Algorithm of the typical evolution of disease in patients with progressive neuromuscular disorders (gray boxes) and assessments and interventions that.

Ineffective efforts and operation of apnea ventilation during pressure control continuous spontaneous ventilation (PC-CSV). Ineffective efforts and operation.

Asynchrony index (%) during invasive and noninvasive ventilation (NIV) relative to leak level. Asynchrony index (%) during invasive and noninvasive ventilation.

Asynchrony index (%) during invasive and noninvasive ventilation (NIV) relative to body weight. Asynchrony index (%) during invasive and noninvasive ventilation.

This tracing depicts 30 seconds of information.

Graphic representation of a dynamic airway pressure scalar during volume control ventilation with a constant inspiratory flow. Graphic representation of.

Effect of respiratory mechanics on cycling of pressure support from inhalation to exhalation. Effect of respiratory mechanics on cycling of pressure support.

Negative pressures calculated with the Rosen and Hillard formula

We connected the supplemental oxygen supply at 3 places: near the ventilator, near the exhalation valve, and on the nasal mask port. We connected the supplemental.

Change in mean pulmonary arterial pressure after a 5-min inhalation of the Rho kinase inhibitor Y in rats with hypoxic pulmonary hypertension, with.

Control circuit for a servo targeting scheme (eg, Proportional Assist Ventilation). Control circuit for a servo targeting scheme (eg, Proportional Assist.

Inspiratory time in excess (TIex) with the 10 ventilators tested under 3 conditions: in the absence of leaks and with the NIV algorithm deactivated (L0NIV0),

Change in trigger delay during invasive (A) and noninvasive ventilation (B) with variable leak. Change in trigger delay during invasive (A) and noninvasive.

Venn diagram illustrating how the mode taxonomy can be viewed in terms of discriminating features and defining features. Venn diagram illustrating how.

A: Pressure ulcer on the left cheek of a patient after 1 week of prone positioning using a commercially available endotracheal tube (ETT) holder. A: Pressure.

Kaplan-Meier curve for the probability of noninvasive ventilation (NIV) failure relative to continuous use of NIV and stratified for Acute Physiology and.

Total drug dose by device and condition while delivering 1 mL of ribavirin (5 min for the small-particle aerosol generator [SPAG] or 2 min for the vibrating.

Experimental setup of particle distribution using the 8-stage Andersen cascade impactor and in vitro module using an absolute filter. Experimental setup.

The cause of asynchrony during volume-targeted ventilation and total asynchrony index. The cause of asynchrony during volume-targeted ventilation and total.

Survival of subjects listed for heart transplantation with different spirometric ventilatory patterns. Survival of subjects listed for heart transplantation.

Graphical representation of the locations where spontaneous breaths may occur during the airway pressure (Paw) release ventilation ventilatory cycle. Graphical.

Mean inspiratory work of breathing during assisted breaths and spontaneous breaths across the spectrum of ventilatory support continuous mandatory ventilation.

Survival of subjects listed for heart transplantation with and without spirometry. Survival of subjects listed for heart transplantation with and without.

Schematic of mechanisms behind the better recruitment of alveoli with spontaneous breathing. Schematic of mechanisms behind the better recruitment of alveoli.

Plots of alveolar PO2, hemoglobin saturation, and alveolar PCO2 as a function of alveolar ventilation in a normal subject at sea level (inspired oxygen.

Components of a patient-triggered mechanical breath.

FEV1 and FVC for the control group (without noninvasive ventilation [NIV]), NIV with an inspiratory pressure (IPAP) of 15 cm H2O and expiratory pressure.

Indications for ventilation in children and adolescents

Correlation between maximum inspiratory pressure and inspiratory load compensation (ILC) ventilatory variables in the 16 difficult-to-wean subjects, prior.

PaO2/FIO2, leukocyte count, and C-reactive protein during the first 10 days after out-of-hospital cardiac arrest, in subjects with or without early-onset.

Ventilation protocol. Ventilation protocol. The PEEP group raised peak inspiratory pressure (PIP) through 5-cm H2O PEEP increments every 2 min while keeping.

A: Work of breathing before and after nebulized terbutaline delivered via standard nebulization method versus delivered during continuous positive airway.

The changes in peak flow and inspiratory time between a minimum rise time (first 2 breaths) and a maximum rise time (last 2 breaths), with the Servo-i.

Number of ventilator starts (including both noninvasive ventilation [NIV] and invasive mechanical ventilation subjects) based on age and etiology of ARF.

Representative tidal volume (VT) and breathing frequency (f) patterns of subjects with COPD and normal subjects during cardiopulmonary exercise testing.

Progression of spontaneous breathing trials administered during inspiratory muscle strength training study interventions. Progression of spontaneous breathing.

For inspiratory load compensation testing, this threshold positive expiratory pressure (PEP) training device was inverted and connected to a respiratory.

Receiver operator characteristic curve of CURB-65 (confusion, urea, respiratory rate, blood pressure and age > 65), pneumonia severity index (PSI), nursing.

Percent of extremely-low-birth-weight (ELBW) babies alive and off mechanical ventilation at 7 days, and median days on mechanical ventilation for ELBW.

Total dynamic dead space (VD/VT) in bilevel versus pressure-support and pressure-assist noninvasive ventilation (NIV) face masks. └: Respironics BIPAP.

Coefficients of variation across ventilation modes and ARDS categories for each combination of effort and breathing frequency. Coefficients of variation.

Minute-by-minute means of breathing variables during the spontaneous breathing trial for the groups of subjects with trial success (n = 32) and failure.

Effects of an automated endotracheal-tube-compensation system on a pressure-support breath. Effects of an automated endotracheal-tube-compensation system.

Presentation transcript:

Study protocol. Study protocol. Subjects with hemodynamic, respiratory, and neurologic stability and positive predictive index were randomized to 3 groups (T-tube, pressure support ventilation [PSV], and proportional assist ventilation plus [PAV+]) to perform a spontaneous breathing trial (SBT). The subjects who showed no signs of intolerance were extubated. Those who failed the SBT were assessed the following day. VADs = vasoactive drugs; MIP = maximum inspiratory pressure; RSBI = rapid shallow breathing index; HR = heart rate; NIV = noninvasive ventilation. Sandy Nogueira Teixeira et al. Respir Care 2015;60:1527-1535 (c) 2012 by Daedalus Enterprises, Inc.