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The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group.
It is concluded that VAP prolongs ICU length of stay and may increase the risk of death in critically ill patients and the attributable risk of VAP appears to vary with patient population and infecting organism.
Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure
This document provides European Respiratory Society/American Thoracic Society and ERS/ATS evidence-based recommendations for the use of noninvasive ventilation in acute respiratory failure based on the most current literature.
A randomized crossover study of an oral appliance vs nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea.
It is concluded that OA is an effective treatment in some patients with mild-moderate OSA and is associated with fewer side effects and greater patient satisfaction than N-CPAP.
Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting
Over the past two decades, the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure by mask has increased substantially for acutely ill patients.
A retrospective review of a large cohort of patients undergoing the process of withholding or withdrawal of life support.
WD/WHLS was the most common cause of death in academic ICUs and poor patient prognosis was considered the most important factor in deciding on WDLS, however, in contrast to other studies, future quality of life was not as frequently cited a reason for WDLS and larger amounts of morphine were used during WDLS.
Patients readmitted to the intensive care unit during the same hospitalization: clinical features and outcomes.
Patients with GI and neurologic diseases are at greatest risk of requiring ICU readmission, and respiratory diseases are the major reason for readmission due to new complications.
Which Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Benefit from Noninvasive Positive-Pressure Ventilation?
A meta-analysis of 15 trials found that adding NPPV to standard care reduced rates of endotracheal intubation, length of hospital stay, and in-hospital mortality rates in patients with severe exacerbations but not in those with milder exacerbations.
Evidence-Based Clinical Practice Guideline for the Prevention of Ventilator-Associated Pneumonia
The methods used to create the VAP Prevention Guideline Panel, an evidence-based clinical practice guideline for the prevention of VAP, and the recommendations generated are described.
Noninvasive positive-pressure ventilation for postextubation respiratory distress: a randomized controlled trial.
The addition of NPPV to standard medical therapy does not improve outcome in heterogeneous groups of patients who develop respiratory distress during the first 48 hours after extubation.
Clinical characteristics, sepsis interventions and outcomes in the obese patients with septic shock: an international multicenter cohort study
The obesity paradox (lower mortality in the obese) documented in other populations is also observed in septic shock, and may be related in part to differences in patient characteristics.