Ventilator Management Strategies for Critical Care

2001 ◽  
Keyword(s):  
Critical Care ◽  
Management Strategies ◽  
Ventilator Management

scholarly journals The correlation of respiratory system compliance and mortality in COVID-19 acute respiratory distress syndrome: do phenotypes really exist?

2021 ◽  
Vol 8 (2) ◽  
pp. 67-74
Author(s):  
Rachel L. Choron ◽  
Stephen A. Iacono ◽  
Alexander Cong ◽  
Christopher G. Bargoud ◽  
Amanda L. Teichman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory System ◽  
Management Strategies ◽  
Respiratory System Compliance ◽  
Risk Of Death ◽  
Mortality Difference ◽  
Ventilator Management ◽  
Observational Cohort ◽  
Multivariable Regression ◽  
The Mean

Background: Recent literature suggests respiratory system compliance (Crs) based phenotypes exist among COVID-19 ARDS patients. We sought to determine whether these phenotypes exist and whether Crs predicts mortality. Methods: A retrospective observational cohort study of 111 COVID-19 ARDS patients admitted March 11-July 8, 2020. Crs was averaged for the first 72-hours of mechanical ventilation. Crs<30ml/cmH2O was defined as poor Crs(phenotype-H) whereas Crs≥30ml/cmH2O as preserved Crs(phenotype-L). Results: 111 COVID-19 ARDS patients were included, 40 phenotype-H and 71 phenotype-L. Both the mean PaO2/FiO2 ratio for the first 72-hours of mechanical ventilation and the PaO2/FiO2 ratio hospital nadir were lower in phenotype-H than L(115[IQR87] vs 165[87], p=0.016), (63[32] vs 75[59], p=0.026). There were no difference in characteristics, diagnostic studies, or complications between groups. Twenty-seven (67.5%) phenotype-H patients died vs 37(52.1%) phenotype-L(p=0.115). Multivariable regression did not reveal a mortality difference between phenotypes; however, a 2-fold mortality increase was noted in Crs<20 vs >50ml/cmH2O when analyzing ordinal Crs groups. Moving up one group level (ex. Crs30-39.9ml/cmH2O to 40-49.9ml/cmH2O), was marginally associated with 14% lower risk of death(RR=0.86, 95%CI 0.72, 1.01, p=0.065). This attenuated (RR=0.94, 95%CI 0.80, 1.11) when adjusting for pH nadir and PaO2/FiO2 ratio nadir. Conclusion: We identified a spectrum of Crs in COVID-19 ARDS similar to Crs distribution in non-COVID-19 ARDS. While we identified increasing mortality as Crs decreased, there was no specific threshold marking significantly different mortality based on phenotype. We therefore would not define COVID-19 ARDS patients by phenotypes-H or L and would not stray from traditional ARDS ventilator management strategies.

Blood Management Strategies for Critical Care Patients

2003 ◽  
Vol 23 (6) ◽  
pp. 34-41
Author(s):  
Sharon Vernon ◽  
Gail M. Pfeifer
Keyword(s):  
Critical Care ◽  
Management Strategies ◽  
Blood Management ◽  
Critical Care Patients

Impact of Critical Care Air Transport Team (CCATT) ventilator management on combat mortality

2018 ◽  
Vol 84 (1) ◽  
pp. 157-164 ◽  
Author(s):  
Joseph K. Maddry ◽  
Alejandra G. Mora ◽  
Shelia C. Savell ◽  
Crystal A. Perez ◽  
Phillip E. Mason ◽  
...  
Keyword(s):  
Critical Care ◽  
Air Transport ◽  
Transport Team ◽  
Ventilator Management

A Survey of Airway and Ventilator Management Strategies in North American Pediatric Burn Units

2004 ◽  
Vol 25 (5) ◽  
pp. 435-440 ◽  
Author(s):  
Geoffrey M. Silver ◽  
Carter Freiburg ◽  
Marcia Halerz ◽  
Jonathan Tojong ◽  
Kathy Supple ◽  
...  
Keyword(s):  
North American ◽  
Management Strategies ◽  
Burn Units ◽  
Ventilator Management
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