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Ventilator Management
Jun 22, 2018

Intubation, with subsequent mechanical ventilation, is a common life-saving intervention in the emergency department (ED). Given the increasing length of stay of ventilated patients in EDs, it is necessary for emergency practitioners to have a good understanding of techniques to optimize mechanical ventilation and minimize complications.

Many different strategies of positive-pressure ventilation are available; these are based on various permutations of triggered volume-cycled and pressure-cycled ventilations and are delivered at a range of rates, volumes, and pressures. Poor ventilatory management can inflict serious pulmonary and extrapulmonary damage that may not be immediately apparent.

The findings of this systematic review suggest that HFO was a promising treatment for ALI and ARDS prior to the uptake of current lung protective ventilation strategies. These findings may not be applicable with current conventional care, pending the results of large multi-centre trials currently underway.

Mechanical ventilation is an effective means of life support and respiratory therapy, has been widely applied in clinic fields. Especially in recent years, the construction of the emergency in two level of first-class hospital and ICU established, ventilator applications gain popularity. Ventilator alarm is a frequent problem in mechanical ventilation, if handled improperly, not only affect the ventilator's using, but also endanger the patient's life. So correct judgment and timely remove alarm is very important. Clinical medical staff who are not very familiar with ventilator application will feel the tension and pressure on ventilator alarm, even feel be at a loss, they can not be quickly make sure the reasons and perform the correct treatment.This paper analyzes the reasons of ventilator alarm in order to help doctors and nurses to handle the common reasons,and further improve the success rate of resuscitation of critically ill patients.

Antibiotic treatment of clinically diagnosed VAP was associated with lower overall survival than withholding treatment. Antibiotic treatment of VAP diagnosed by invasive (PSB) or semi-invasive (pBAL) techniques was associated with better survival than withholding treatment, although withholding antibiotic therapy was favored as the mortality rate of antibiotic-treated VAP approached 70%. Invasive or semi-invasive diagnostic techniques should be used to diagnose VAP, guide therapy, and thereby potentially improve survival. A prospective, randomized trial assessing outcome according to diagnostic technique is needed.

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