Mechanical Ventilation

Double cycling with breath-stacking during partial support ventilation in ARDS: Just a feature of natural variability?

Abstract Background Double cycling with breath-stacking (DC/BS) during controlled mechanical ventilation is considered potentially injurious, reflecting a high respiratory drive. During partial ventilatory support, its occurrence might be attributable to physiological variability of breathing patterns, reflecting the response of the mode without carrying specific risks. Methods This secondary analysis of a crossover study evaluated DC/BS […]

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Double cycling with breath-stacking during partial support ventilation in ARDS: Just a feature of natural variability? Read Post »

Circulatory

Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal

Summary of “Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal” Abstract Extracorporeal carbon dioxide removal (ECCO₂R) is an emerging technique designed to facilitate lung-protective ventilation and reduce the work of breathing by removing CO₂ from venous blood. Operating at lower blood flows than extracorporeal membrane oxygenation (ECMO), ECCO₂R reduces procedural invasiveness but remains

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Miscellaneous

Physiology and pathophysiology of mucus and mucolytic use in critically ill patients

Abstract Airway mucus is a highly specialised secretory fluid which functions as a physical and immunological barrier to pathogens whilst lubricating the airways and humifying atmospheric air. Dysfunction is common during critical illness and is characterised by changes in production rate, chemical composition, physical properties, and inflammatory phenotype. Mucociliary clearance, which is determined in part

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Physiology and pathophysiology of mucus and mucolytic use in critically ill patients Read Post »

Respiratory

Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

Abstract Background and Objective: Acute respiratory distress syndrome (ARDS) is a severe, life-threatening medical condition characterized by poor oxygenation due to non-compliant lungs secondary diffuse alveolar damage. Encouragingly, the incidence of ARDS has declined steadily recently, attributed mainly to implementation of keystone guidelines and continuous research efforts. Mechanical ventilation is the cornerstone of supportive care for

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Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review Read Post »

Mechanical Ventilation, Respiratory

Beyond the Lungs: Extrapulmonary Effects of Non-Invasive and Invasive Ventilation Strategies

Abstract Background/Objectives: Non-invasive respiratory support and invasive mechanical ventilation are critical interventions that can induce significant changes not only in the lungs but also in extra-pulmonary organs, which are often overlooked. Understanding the extra-pulmonary effects of non-invasive respiratory support and invasive mechanical ventilation is crucial since it can help prevent or mitigate complications and improve

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Beyond the Lungs: Extrapulmonary Effects of Non-Invasive and Invasive Ventilation Strategies Read Post »

Respiratory

A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management

Abstract Acute respiratory distress syndrome (ARDS) is a severe complication of critical illness, characterized by bilateral lung infiltrates and hypoxemia. Its clinical and pathophysiological heterogeneity poses challenges for both diagnosis and treatment. This review outlines the evolution of ARDS definitions, discusses the underlying pathophysiology of ARDS, and examines the clinical implications of its heterogeneity. Traditional

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A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management Read Post »

Respiratory

Rapidly improving ARDS differs clinically and biologically from persistent ARDS

Abstract Background Rapidly improving acute respiratory distress syndrome (RIARDS) is an increasingly appreciated subgroup of ARDS in which hypoxemia improves within 24 h after initiation of mechanical ventilation. Detailed clinical and biological features of RIARDS have not been clearly defined, and it is unknown whether RIARDS is associated with the hypoinflammatory or hyperinflammatory phenotype of ARDS.

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Rapidly improving ARDS differs clinically and biologically from persistent ARDS Read Post »

Respiratory

Patient-Self Inflicted Lung Injury (P-SILI): An Insight into the Pathophysiology of Lung Injury and Management

Abstract Acute respiratory distress syndrome (ARDS) is a heterogeneous group of disease entities that are associated with acute hypoxic respiratory failure and significant morbidity and mortality. With a better understanding and phenotyping of lung injury, novel pathophysiologic mechanisms demonstrate the impact of a patient’s excessive spontaneous breathing effort on perpetuating lung injury. Patient self-inflicted lung

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Patient-Self Inflicted Lung Injury (P-SILI): An Insight into the Pathophysiology of Lung Injury and Management Read Post »

Miscellaneous

A review of gut failure as a cause and consequence of critical illness

Abstract In critical illness, all elements of gut function are perturbed. Dysbiosis develops as the gut microbial community loses taxonomic diversity and new virulence factors appear. Intestinal permeability increases, allowing for translocation of bacteria and/or bacterial products. Epithelial function is altered at a cellular level and homeostasis of the epithelial monolayer is compromised by increased

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A review of gut failure as a cause and consequence of critical illness Read Post »

Respiratory

Limitations of SpO2 / FiO2-ratio for classification and monitoring of acute respiratory distress syndrome—an observational cohort study

Abstract Background The ratio of pulse-oximetric peripheral oxygen saturation to fraction of inspired oxygen (SpO2/FiO2) has been proposed as additional hypoxemia criterion in a new global definition of acute respiratory distress syndrome (ARDS). This study aims to evaluate the clinical and theoretical limitations of the SpO2/FiO2-ratio when using it to classify patients with ARDS and

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Limitations of SpO2 / FiO2-ratio for classification and monitoring of acute respiratory distress syndrome—an observational cohort study Read Post »

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