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Abstract
Weaning is the transitional period when a patient under mechanical ventilation (MV) transfers to unassisted spontaneous breathing. Failure in the discontinuation of ventilatory support is associated with an increase in the number of complications. The use of standardized guidelines to carry out weaning is already well established in general ICUs. The conditions most commonly seen in the coronary unit of care (CUC), such as acute myocardial ischemia, left ventricular dysfunction and after coronary artery bypass grafting surgery, however, cause completely different hemodynamic and circulatory alterations to those observed in other types of severely ill patients. The effects of mechanical ventilation and of weaning should therefore be tested specifically for these patients.
Highlights
Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction
In previous work we demonstrated that platelet-derived attributed to bacterial translocation (BT), and the aggravation of microparticles (MP) can induce endothelial and vascular smooth sepsis is related to the increased vascular permeability state that muscle cell apoptosis in septic patients through NADPH oxidase- potentates the BT index
The aim of this study is to evaluate the effects of hypertonic saline (HSS) 7.5% and lactated Ringer’s (LR) solutions on intestinal BT in rats that underwent intestinal obstruction and ischaemia (IO)
Summary
Clinical evidence suggests that bacterial translocation (BT) may not be the primary cause in the development of sepsis and multiple organ dysfunction. The evolution of intensive care and its results related to the survival of very critically ill patients produce a group of survivors characterized by complex co-morbidities and prolonged dependence on mechanical ventilation (more than 21 days). Methods A prospective, nonrandomized, observational and comparative study that compares effects on PPV of the VC with another three PC ventilatory settings applied in sedated and mechanically ventilated critically ill patients with an arterial catheter in place. The APACHE II score (26.1 ± 9.5 vs 17.7 ± 6.0, P = 0.000), mean SOFA score (10.55 ± 3.41 vs 3.52 ± 2.29, P < 0.001), use of a central catheter (87.5% vs 60.7%, P = 0.001), dialysis (21.4% vs 5.4%, P = 0.013), mechanical ventilation (91.1% vs 35.7%, P < 0.001) and presence of septic shock (32.1% vs 8.9%, P = 0.002) were associated with worse prognosis. Several complications are possible, making it necessary to provide an immediate, specialized, postoperatory intensive care treatment
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