Abstract
Automatic pressure support reduction based on a targeted respiratory frequency or MRV is disposable in the TAENA ventilator for an automatic reduction of pressure support during weaning of patients in the intensive care unit (ICU). We studied 23 patients (63.52 years) in the postoperative period (14 cardiac, two thoracic and seven abdominal surgeries) in a prospective, randomized protocol comparing automatic pressure support weaning with the traditional manual reduction of pressure support to 5–7 cmH2O in our ICU. After arriving in the ICU after cardiac, thoracic or abdominal surgery, the patients were randomly assigned to traditional weaning consisting of manual reduction of pressure support (the pressure support was decreased every 30 min, keeping the RR/TV(L) < 80 until 5–7 cmH2O pressure support ventilation) or to the automatic pressure support reduction (MRV) with a respiratory frequency target of 20/min (the TAENA ventilator automatically decreased the pressure support ventilation level by 1 cmH2O every four respiratory cycles if the patient's RR was less than 16/min). Twelve patients were assigned to manual weaning whereas 11 patients were assigned to the automatic pressure support reduction weaning. The weaning mean time for the manual group was 3.18 hours while the weaning mean time for the automatic pressure support reduction group was 2.24 hours. There was no reintubation in both groups.
Highlights
Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI)
Patients and methods We evaluated in a cross-sectional and prospective study patients admitted in a chest pain unit (CPU), between March 1997 and May 2001, with diagnosis of acute aortic dissection (AAD)
Background data have shown that B-type natriuretic peptide (BNP) levels correlate with the severity and prognosis of heart failure, there are few studies regarding its levels in cardiac surgery patients
Summary
Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI). Few studies exist analysing the handling of acute respiratory insufficiency with invasive mechanical ventilation (IMV) and its correlation with mortality among the elderly intensive care unit (IUC) patient population. In Brazil, most patients with TBI are managed in general ICUs. The results of the treatment of patients admitted to nonspecialized ICUs must be compared with those obtained in neurosurgical ICUs. An acute confusional state (ACS) has been a frequent finding in patients undergoing cardiac surgery (CS), which, according to the literature, has resulted in a greater number of complications and in an increase in hospitalization and length of stay in the intensive care unit (ICU). The mortality of elderly patients who are admitted to intensive care units (ICU) has been the aim of some recent studies. Drugs that modulate such phenotypic alterations may be useful in the control of these and other clinical situations
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