Decreasing mechanical ventilator support in medically fragile children with bronchopulmonary dysplasia: A step-by-step weaning protocol at a pediatric long term extended care facility

2015 ◽  
Vol 8 (2) ◽  
pp. 147-156 ◽  
Author(s):  
Swetha Suresh ◽  
Heather G. Huxol ◽  
Ronald L. Morton
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Care Facility ◽  
Mechanical Ventilator ◽  
Medically Fragile ◽  
Ventilator Support ◽  
Extended Care ◽  
Medically Fragile Children

Outcomes of long-term ventilator patients: a descriptive study

1997 ◽  
Vol 6 (2) ◽  
pp. 99-105 ◽  
Author(s):  
SL Douglas ◽  
BJ Daly ◽  
PF Brennan ◽  
S Harris ◽  
M Nochomovitz ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Care Facility ◽  
Systematic Research ◽  
Icu Patients ◽  
Sociodemographic Data ◽  
Extended Care ◽  
Long Term Ventilation ◽  
Prospective Longitudinal

BACKGROUND: Long-term ICU patients who require prolonged mechanical ventilation are a growing segment of the in-hospital population. Despite recognition that this population is costly to care for no systematic research has been done on the characteristics, outcomes, and disposition of these patients after they leave the hospital. OBJECTIVE: To describe clinical and sociodemographic characteristics and outcomes of ICU patients who require long-term (5 days or more) mechanical ventilation while in the hospital. METHODS: A prospective, longitudinal descriptive design was used to study 57 ICU patients who required 5 days or more of continuous mechanical ventilation while in the hospital. Clinical and sociodemographic data were collected at the time of enrollment. Patients were followed up for up to 6 months after discharge from the hospital to ascertain disposition and morality. RESULTS: On average, patients had a hospital stay of almost 6 weeks and required mechanical ventilation for approximately 4 weeks; 43.9% of the patients died in the hospital. None of the patients discharged from the hospital were able to return home initially without assistance. By 6 months after discharge, more than 50% of the original sample and died, 9% resided in an institution, and 33% were living at home. CONCLUSIONS: A large percentage of ICU patients who require 5 days or more of mechanical ventilation die in the hospital, and many of those who live spend considerable time in an extended-care facility before they are discharged to their homes. These likely outcomes of patients who require long-term ventilation should be discussed with patients and their families to assist them in making informed decisions.

“Music First”

GeroPsych ◽  
2018 ◽  
Vol 31 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Dane L. Shiltz ◽  
Tara T. Lineweaver ◽  
Tim Brimmer ◽  
Alex C. Cairns ◽  
Danielle S. Halcomb ◽  
...  
Keyword(s):  
Usual Care ◽  
Psychological Symptoms ◽  
Care Facility ◽  
Care Group ◽  
Music Listening ◽  
Term Care ◽  
Antipsychotic Medications ◽  
Risk Of Death ◽  
Extended Care ◽  
Individualized Music

Abstract. Existing research has primarily evaluated music therapy (MT) as a means of reducing the negative affect, behavioral, and/or cognitive symptoms of dementia. Music listening (ML), on the other hand, offers a less-explored, potentially equivalent alternative to MT and may further reduce exposure to potentially harmful psychotropic medications traditionally used to manage negative behavioral and psychological symptoms of dementia (BPSD). This 5-month prospective, naturalistic, interprofessional, single-center extended care facility study compared usual care (45 residents) and usual care combined with at least thrice weekly personalized ML sessions (47 residents) to determine the influence of ML. Agitation decreased for all participants (p < .001), and the ML residents receiving antipsychotic medications at baseline experienced agitation levels similar to both the usual care group and the ML patients who were not prescribed antipsychotics (p < .05 for medication × ML interaction). No significant changes in psychotropic medication exposure occurred. This experimental study supports ML as an adjunct to pharmacological approaches to treating agitation in older adults with dementia living in long-term care facilities. It also highlights the need for additional research focused on how individualized music programs affect doses and frequencies of antipsychotic medications and their associated risk of death and cerebrovascular events in this population.

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