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INTRODUCTION Pressure-support ventilation, is widely used in critically ill patients; however, the relative contribution of patient's effort during assisted breathing is difficult to measure in clinical conditions. Aim of the present study was to evaluate the performance of ultrasonographic indices of diaphragm contractile activity (respiratory excursion(More)
Good communication between ICU staff and patients’ relatives may reduce the occurrence of post-traumatic stress disorder, anxiety or depression, and dissatisfaction with clinicians. An information brochure and website to meet relatives’ needs were designed to explain in technical yet simple terms what happens during and after an ICU stay, to legitimize(More)
A quantitative measure of the airway pressure–time tracing during passive inflation [stress index (SI)] has been suggested as an indicator of tidal lung recruitment and/or overinflation. If reliable, this simple index could help guide positive end-expiratory pressure (PEEP) and tidal volume selection. The compartment surrounding the lungs should impact(More)
Critically ill patients exhibit reduced melatonin secretion, both in nocturnal peaks and basal daytime levels. Oral melatonin supplementation may be useful for known sedative and antioxidant properties. Its early enteral absorption and daily pharmacokinetics were determined in two cohorts of six high-risk patients in this prospective trial. During their(More)
PURPOSE OF REVIEW Supporting patients with acute respiratory distress syndrome (ARDS) using a low tidal volume strategy is a standard practice in the ICU. Recruitment maneuvers can be used to augment other methods, like positive end-expiratory pressure and positioning, to improve aerated lung volume. Clinical practice varies widely, and optimal method and(More)
BACKGROUND Critically ill patients suffer from physiological sleep deprivation and have reduced blood melatonin levels. This study was designed to determine whether nocturnal melatonin supplementation would reduce the need for sedation in patients with critical illness. METHODS A single-center, double-blind randomized placebo-controlled trial was carried(More)
BACKGROUND A relevant innovation about sedation of long-term Intensive Care Unit (ICU) patients is the 'conscious target': patients should be awake even during the critical phases of illness. Enteral sedative administration is nowadays unusual, even though the gastrointestinal tract works soon after ICU admission. The enteral approach cannot produce deep(More)
OBJECTIVES Although pleural effusion reduces respiratory system compliance by restricting the lungs, the effusion volume is partially accommodated by chest wall expansion. The implications for these opposing volume changes on airway pressure monitoring in ventilated patients with pleural effusion are unreported. We investigated the interactions among(More)
The use of pulse pressure variation (PPV) and systolic pressure variation (SPV) is possible during controlled ventilation (MV). Even in acute respiratory failure, controlled MV tends to be replaced by assisted ventilatory support. We tested if PPV and SPV during flow triggered synchronized intermittent mechanical ventilation (SIMV) could be as accurate as(More)