Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics profiles, and it was associated with a lower V.
Background: The digital Auto-Trak™ system is a technology capable of automatically adjusting the triggering and cycling mechanisms during pressure support ventilation (PSV). Objective: To compare Auto-Trak with conventional settings in terms of patient-ventilator synchrony and discomfort. Methods: Twelve healthy volunteers underwent PSV via the mouth by breathing through an endotracheal tube. In the conventional setting, a pressure support of 8 cm H2O with flow cycling (25% peak inspiratory flow) and a sensitivity of 1 cm H2O was adjusted. In Auto-Trak the triggering and cycling were automatically set. Discomfort, effort of breathing, and the asynchrony index (AI) were assessed. In a complementary bench study, the inspiratory and expiratory time delays were quantified for both settings in three mechanical models: ‘normal', obstructive (COPD), and restrictive (ARDS), using the ASL 5000 simulator. Results: In the volunteer study the AI and the discomfort scores did not differ statistically between the two settings. In the bench investigation the use of Auto-Trak was associated with a greater triggering delay in the COPD model and earlier expiratory cycling in the ARDS model but with no asynchronic events. Conclusions: Use of the Auto-Trak system during PSV showed similar results in comparison to the conventional adjustments with respect to patient-ventilator synchrony and discomfort in simulated conditions of invasive mechanical ventilation.
Objetivo: analisar o conhecimento dos profissionais de saúde a respeito do uso da oxigenoterapia. Métodos: estudo quantitativo e transversal realizado em um Hospital Universitário da cidade de Fortaleza-CE. Participaram do estudo médicos, enfermeiros e fisioterapeutas. Para a coleta de dados utilizou-se um questionário semiestruturado contendo dados a respeito da formação acadêmica, tempo de experiência e conhecimento acerca da oxigenoterapia. Resultados: a amostra foi composta por 50 profissionais, com média de idade de 28,1 ± 10,9 anos, em sua maioria mulheres 80% (n = 40). Com relação à profissão, 44% (n = 22) possuem graduação em enfermagem, seguidas pela fisioterapia 32% (n = 16) e medicina 22% (n = 11). As indicações da oxigenoterapia com significância estatística são: hipoxemia, dessaturação e doença respiratória. Doença pulmonar obstrutiva crônica (DPOC), pneumotórax e hiperoxemia foram pontuadas como principais contraindicações, em relação aos efeitos adversos os mais prevalentes foram intoxicação, ressecamento e hipercapnia. O catéter nasal, máscara de Venturi, máscara com reservatório e macronebulização foram os tipos de oferta de oxigênio (O2) mais pontuados (p < 0,05). Conclusão: diante do exposto observamos que pode haver déficit em relação ao conhecimento dos profissionais de saúde a respeito do uso de oxigênio suplementar.
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