Evolution of Mechanical Ventilation in Response to Clinical Research

Esteban, Andrés; Ferguson, Niall D.; Meade, Maureen O.; Frutos‐Vivar, Fernando; Apezteguía, Carlos; Brochard, Laurent; Raymondos, Konstantinos; Nin, Nicolás; Hurtado, Javier; Tomicić, Vinko; González, Marco; Elizalde, José; Nightingale, Peter; Abroug, Fékri; Pelosi, Paolo; Arabi, Yaseen M.; Moreno, Rui P.; Jibaja, Manuel; D’Empaire, Gabriel; Sandi, Fredi; Matamis, Dimitros; Montañez, Ana María; Anzueto, Antonio

doi:10.1164/rccm.200706-893oc

Cited by 591 publications

(401 citation statements)

References 26 publications

(23 reference statements)

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“…VALI tends to occur in conjunction with decreases in lung compliance during mechanical ventilation in adult ARDS patients. Although there has been some concern regarding how VALI not only extends the period of mechanical ventilation use but can also lead to increased mortality,192 this increase arises from elevations in tidal volume and airway pressure during mechanical ventilation, and as such, it is expected that both can be controlled by limiting plateau pressure 193. However, the results of limiting plateau pressure are not all beneficial; lower plateau pressure may also lead to adverse events such as hypercapnia 194.…”

Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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“…La existencia de DDIV empeora el pronóstico y se asocia a un fracaso en la extubación, con un aumento de los días de VM 7,8,9,10,11,12 y de la mortalidad 13,1415,16 . No obstante, en la actualidad no se realiza una monitorización rutinaria de la función diafragmática en muchas Unidades, por lo que cabe pensar que esta entidad se encuentra sistemáticamente infradiagnosticada 17 .…”

Section: Introductionunclassified

Disfunción diafragmática: una realidad en el paciente ventilado mecánicamente

Dot

Samper

Masclans

2017

Archivos de Bronconeumología

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3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 1 ResumenLa afectación muscular del paciente crítico está presente en la mayoría de pacientes que ingresan en el Servicio de Medicina Intensiva (SMI). La alteración, en particular, del músculo diafragmático, inicialmente englobada en esta categoría, se ha diferenciado en los últimos años y se ha demostrado la existencia de una disfunción muscular propia de los pacientes sometidos a ventilación mecánica. En este subgrupo de pacientes, encontramos una disfunción muscular que aparece de manera precoz después del inicio de la ventilación mecánica y que se relaciona, principalmente, con el uso de modalidades control, la presencia de sepsis y/o de fracaso multiorgánico. Aunque se desconoce la etiología concreta que desencadena el proceso, el músculo presenta procesos de estrés oxidativo y alteración mitocondrial, que provocan un desequilibrio en la síntesis proteica, con el resultado de atrofia y alteración de la contractilidad y, como consecuencia, una menor funcionalidad. No fue, de hecho, hasta 2004 cuando Vassilakopoulos et al describieron el término "Disfunción diafragmática asociada a ventilación mecánica" que junto a la lesión por sobre distensión pulmonar y por barotrauma, representan un reto en el día a día de los pacientes ventilados.La disfunción diafragmática tiene influencia en el pronóstico, retardando la extubación, aumentando la estancia hospitalaria y afectando la calidad de vida de estos pacientes en los años siguientes al alta hospitalaria. La ecografía, como técnica no invasiva y accesible en la mayoría de Unidades, podría ser de utilidad en el diagnóstico precoz para iniciar, de forma avanzada, la rehabilitación e influir positivamente en el pronóstico de estos enfermos.Palabras clave: Diafragma, disfunción diafragmática, ventilación mecánica, ecografía. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2 *Manuscrito (sin información de autores) AbstractThe critical patient muscle involvement is present in most patients admitted to the intensive care unit (ICU). Specifically the diaphragmatic muscle alteration, initially considered in this category, has been differentiated in recent years, and it has been demonstrated the existence of this muscular dysfunction during mechanical ventilation. In this subgroup of patients, we found that this muscle dysfunction appears at an early stage after the start of mechanical ventilation, which is mainly related to the use of modalities control, and also in presence of sepsis and/or multi-organ failure. Although the specific etiology that triggers the processes unknown, the muscle has processes oxidative stress and mitochond...

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“…Mechanical ventilation is a widely used therapy in intensive care units (ICUs) for acute respiratory failure [1].…”

Section: Introductionmentioning

confidence: 99%

NAVA enhances tidal volume and diaphragmatic electro-myographic activity matching: a Range90 analysis of supply and demand

Moorhead

Piquilloud²,

Lambermont

et al. 2012

J Clin Monit Comput

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Evolution of Mechanical Ventilation in Response to Clinical Research

Abstract: The strong concordance of predicted and observed practice changes suggests that randomized trial results have advanced mechanical ventilation practices internationally.

Cited by 591 publications

References 26 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Disfunción diafragmática: una realidad en el paciente ventilado mecánicamente

NAVA enhances tidal volume and diaphragmatic electro-myographic activity matching: a Range90 analysis of supply and demand

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