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Journal articles on the topic 'Mechanical ventilation'

To see the other types of publications on this topic, follow the link: Mechanical ventilation.

Author: Grafiati

Published: 4 June 2021

Last updated: 25 May 2024

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1

Nugent, Kenneth, and Gilbert Berdine. "Mechanical power during mechanical ventilation." Southwest Respiratory and Critical Care Chronicles 12, no. 50 (January 29, 2024): 16–23. http://dx.doi.org/10.12746/swrccc.v12i50.1275.

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Mechanical ventilation provides lifesaving support for patients with acute respiratory failure. However, the pressures and volumes required to maintain gas exchange can cause ventilator-induced lung injury. The current approach to mechanical ventilation involves attention to both tidal volume and airway pressures, in particular plateau pressures and driving pressures. The ventilator provides energy to overcome airway resistance and to inflate alveolar structures. This energy delivered to the respiratory system per unit time equals mechanical power. Calculation of mechanical power provides a composite number that integrates pressures, volumes, and respiratory rates. Increased levels of mechanical power have been associated with tissue injury in animal models. In patients, mechanical power can predict outcomes, such as ICU mortality, when used in multivariable analyses. Increases in mechanical power during the initial phase of ventilation have been associated with worse outcomes. Mechanical power calculations can be used in patients on noninvasive ventilation, and measurements of mechanical power have been used to compare ventilator modes. Calculation of mechanical power requires measurement of the area in a hysteresis loop. Alternatively, simplified formulas have been developed to provide this calculation. However, this information is not available on most ventilators. Therefore, clinicians will need to make this calculation. In summary, calculation of mechanical power provides an estimate of the energy requirements for mechanical ventilation based on a composite of factors, including airway resistance, lung elastance, respiratory rate, and tidal volume. Key words: mechanical ventilation, mechanical power, ventilator-induced lung injury, energy, work

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2

Pruitt, Bill, and Mary Catherine Hodges. "Mechanical ventilation." Nursing 54, no. 5 (April 19, 2024): 17–25. http://dx.doi.org/10.1097/01.nurse.0001009984.17145.03.

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Abstract: Mechanical ventilation is rarely a simple matter. Skill and knowledge are required to operate the ventilator modes, choose the optimal settings, and understand many monitored variables. Supporting the patient safely and effectively is the top priority in providing mechanical ventilation. This article discusses mechanical ventilation in adults.

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3

Cawley, Michael J. "Mechanical Ventilation." Journal of Pharmacy Practice 24, no. 1 (November 30, 2010): 7–16. http://dx.doi.org/10.1177/0897190010388145.

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Mechanical ventilation is a common therapeutic modality required for the management of patients unable to maintain adequate intrinsic ventilation and oxygenation. Mechanical ventilators can be found within various hospital and nonhospital environments (ie, nursing homes, skilled nursing facilities, and patient’s home residence), but these devices generally require the skill of a multidisciplinary health care team to optimize therapeutic outcomes. Unfortunately, pharmacists have been excluded in the discussion of mechanical ventilation since this therapeutic modality may be perceived as irrelevant to drug utilization and the usual scope of practice of a hospital pharmacist. However, the pharmacist provides a crucial role as a member of the multidisciplinary team in the management of the mechanically ventilated patient by verifying accuracy of prescribed medications, providing recommendations of alternative drug selections, monitoring for drug and disease interactions, assisting in the development of institutional weaning protocols, and providing quality assessment of drug utilization. Pharmacists may be intimidated by the introduction of advanced ventilator microprocessor technology, but understanding and integrating ventilator management with the pharmacotherapeutic needs of the patient will ultimately help the pharmacist be a better qualified and respected practitioner. The goal of this article is to assist the pharmacy practitioner with a better understanding of mechanical ventilation and to apply this information to improve delivery of pharmaceutical care.

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4

Mammel, Mark C., Janice P. Ophoven, Patrick K. Lewallen, Margaret J. Gordon, Marylyn C. Sutton, and Stephen J. Boros. "High-Frequency Ventilation and Tracheal Injuries." Pediatrics 77, no. 4 (April 1, 1986): 608–13. http://dx.doi.org/10.1542/peds.77.4.608.

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Recent reports linking serious tracheal injuries to various forms of high-frequency ventilation prompted this study. We compared the tracheal histopathology seen following standard-frequency, conventional mechanical ventilation with that seen following high-frequency, conventional mechanical ventilation, and two different forms of high-frequency jet ventilation. Twenty-six adult cats were examined. Each was mechanically ventilated for 16 hours. Seven received standard-frequency, conventional mechanical ventilation at 20 breaths per minute. Seven received high-frequency, conventional mechanical ventilation at 150 breaths per minute. Six received high-frequency jet ventilation at 250 breaths per minute via the Instrument Development Corporation VS600 jet ventilator (IDC). Six received high-frequency jet ventilation at 400 breaths per minute via the Bunnell Life Pulse jet ventilator (BLP). A semiquantitative histopathologic scoring system graded tracheal tissue changes. All forms of high-frequency ventilation produced significant inflammation (erosion, necrosis, and polymorphonuclear leukocyte infiltration) in the trachea in the region of the endotracheal tube tip. Conventional mechanical ventilation produced less histopathology than any form of high-frequency ventilation. Of all of the ventilators examined, the BLP, the ventilator operating at the fastest rate, produced the greatest loss of surface cilia and depletion of intracellular mucus. IDC high-frequency jet ventilation and high-frequency, conventional mechanical ventilation produced nearly identical histologic injuries. In this study, significant tracheal damage occurred with all forms of high-frequency ventilation. The tracheal damage seen with high-frequency, conventional mechanical ventilation suggests that ventilator frequency, not delivery system, may be responsible for the injuries.

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5

Daoud, Ehab, Jewelyn Cabigan, Gary Kaneshiro, and Kimiyo Yamasaki. "Split-ventilation for more than one patient, can it be done? Yes." Journal of Mechanical Ventilation 1, no. 1 (September 1, 2020): 1–7. http://dx.doi.org/10.53097/jmv.10002.

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Background: The COVID-19 pandemic crisis has led to an international shortage of mechanical ventilation. Due to this shortfall, the surge of increasing number of patients to limited resources of mechanical ventilators has reinvigorated the interest in the concept of split ventilation or co-ventilation (ventilating more than one patient with the same ventilator). However, major medical societies have condemned the concept in a joint statement for multiple reasons. Materials and Methods: In this paper, we will describe the history of the concept, what is trending in the literature about it and along our modification to ventilate two patients with one ventilator. We will describe how to overcome such concerns regarding cross contamination, re-breathing, safely adjusting the settings for tidal volume and positive end expiratory pressure to each patient and how to safely monitor each patient. Main results: Our experimental setup shows that we can safely ventilate two patients using one ventilator. Conclusion: The concept of ventilating more than one patient with a single ventilator is feasible especially in crisis situations. However, we caution that it has to be done under careful monitoring with expertise in mechanical ventilation. More research and investment are crucially needed in this current pandemic crisis.

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6

Cameron, P. D., and T. E. Oh. "Newer Modes of Mechanical Ventilatory Support." Anaesthesia and Intensive Care 14, no. 3 (August 1986): 258–66. http://dx.doi.org/10.1177/0310057x8601400306.

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Recent modes of ventilatory support aim to facilitate weaning and minimise the physiological disadvantages of intermittent positive pressure ventilation (IPPV). Intermittent mandatory ventilation (IMV) allows the patient to breathe spontaneously in between ventilator breaths. Mandatory minute volume ventilation (MMV) ensures that the patient always receives a preset minute volume, made up of both spontaneous and ventilator breaths. Pressure supported (assisted) respiration is augmentation of a spontaneous breath up to a preset pressure level, and is different from ‘triggering’, which is a patient-initiated ventilator breath. Other modes or refinements of IPPV include high frequency ventilation, expiratory retard, differential lung ventilation, inversed ratio ventilation, ‘sighs’, varied inspiratory flow waveforms and extracorporeal membrane oxygenation. While these techniques have useful applications in selective situations, IPPV remains the mainstay of managing respiratory failure for most patients.

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7

Kolandaivelu, Kumaran, and Chi-Sang Poon. "A miniature mechanical ventilator for newborn mice." Journal of Applied Physiology 84, no. 2 (February 1, 1998): 733–39. http://dx.doi.org/10.1152/jappl.1998.84.2.733.

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Kolandaivelu, Kumaran, and Chi-Sang Poon.A miniature mechanical ventilator for newborn mice. J. Appl. Physiol. 84(2): 733–739, 1998.—Transgenic/knockout mice with predefined mutations have become increasingly popular in biomedical research as models of human diseases. In some instances, the resulting mutation may cause cardiorespiratory distress in the neonatal or adult animals and may necessitate resuscitation. Here we describe the design and testing of a miniature and versatile ventilator that can deliver varying ventilatory support modes, including conventional mechanical ventilation and high-frequency ventilation, to animals as small as the newborn mouse. With a double-piston body chamber design, the device circumvents the problem of air leakage and obviates the need for invasive procedures such as endotracheal intubation, which are particularly important in ventilating small animals. Preliminary tests on newborn mice as early as postnatal day 0 demonstrated satisfactory restoration of pulmonary ventilation and the prevention of respiratory failure in mutant mice that are prone to respiratory depression. This device may prove useful in the postnatal management of transgenic/knockout mice with genetically inflicted respiratory disorders.

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8

Wendel Garcia, Pedro David, Daniel Andrea Hofmaenner, Silvio D. Brugger, Claudio T. Acevedo, Jan Bartussek, Giovanni Camen, Patrick Raphael Bader, et al. "Closed-Loop Versus Conventional Mechanical Ventilation in COVID-19 ARDS." Journal of Intensive Care Medicine 36, no. 10 (June 8, 2021): 1184–93. http://dx.doi.org/10.1177/08850666211024139.

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Background: Lung-protective ventilation is key in bridging patients suffering from COVID-19 acute respiratory distress syndrome (ARDS) to recovery. However, resource and personnel limitations during pandemics complicate the implementation of lung-protective protocols. Automated ventilation modes may prove decisive in these settings enabling higher degrees of lung-protective ventilation than conventional modes. Method: Prospective study at a Swiss university hospital. Critically ill, mechanically ventilated COVID-19 ARDS patients were allocated, by study-blinded coordinating staff, to either closed-loop or conventional mechanical ventilation, based on mechanical ventilator availability. Primary outcome was the overall achieved percentage of lung-protective ventilation in closed-loop versus conventional mechanical ventilation, assessed minute-by-minute, during the initial 7 days and overall mechanical ventilation time. Lung-protective ventilation was defined as the combined target of tidal volume <8 ml per kg of ideal body weight, dynamic driving pressure <15 cmH2O, peak pressure <30 cmH2O, peripheral oxygen saturation ≥88% and dynamic mechanical power <17 J/min. Results: Forty COVID-19 ARDS patients, accounting for 1,048,630 minutes (728 days) of cumulative mechanical ventilation, allocated to either closed-loop (n = 23) or conventional ventilation (n = 17), presenting with a median paO2/ FiO2 ratio of 92 [72-147] mmHg and a static compliance of 18 [11-25] ml/cmH2O, were mechanically ventilated for 11 [4-25] days and had a 28-day mortality rate of 20%. During the initial 7 days of mechanical ventilation, patients in the closed-loop group were ventilated lung-protectively for 65% of the time versus 38% in the conventional group (Odds Ratio, 1.79; 95% CI, 1.76-1.82; P < 0.001) and for 45% versus 33% of overall mechanical ventilation time (Odds Ratio, 1.22; 95% CI, 1.21-1.23; P < 0.001). Conclusion: Among critically ill, mechanically ventilated COVID-19 ARDS patients during an early highpoint of the pandemic, mechanical ventilation using a closed-loop mode was associated with a higher degree of lung-protective ventilation than was conventional mechanical ventilation.

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9

Hammouda, Eman Yasser, Hanaa Hussein Ahmed, Amr A. Moawad, and Nahed Attia Kandeel. "Weaning success among COPD patients following ventilator care bundle application." Clinical Nursing Studies 10, no. 1 (March 1, 2022): 1. http://dx.doi.org/10.5430/cns.v10n1p1.

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Objective: Several studies evaluated the effectiveness of the ventilator care bundle in reducing the occurrence of ventilatorassociated pneumonia. The ventilator care bundle efficacy in early mechanical ventilation weaning has not been adequately assessed. The study aimed to investigate the weaning success among chronic obstructive pulmonary disease (COPD) patients following ventilator care bundle application.Methods: This study is quasi-experimental, recruiting 80 mechanically ventilated COPD patients (40 patients for each bundle and control group). It was conducted at the respiratory intensive care units (ICUs) at Mansoura University Hospital, Egypt. Data were collected using a mechanically ventilated patient (MVP) assessment tool, a ventilator care bundle compliance checklist, and MVP evaluation tools based on the Burns’ Wean Assessment Program (BWAP) checklist and the patient’s ventilation indicators.Results: The results revealed that almost 75% of the bundle group was successfully weaned from invasive mechanical ventilation at the first attempt of the spontaneous breathing trial compared with 32.5% of the control group. The ventilation duration and length of ICU stay were reduced in the bundle compared with the control group.Conclusions: The bundle group demonstrated higher weaning scores than the control group. Therefore, we recommend the integration of the ventilator care bundle in the weaning trial of MVPs to accelerate weaning and reduce the duration of mechanical ventilation.

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10

Radke, Oliver. "Monitoring Mechanical Ventilation Using Ventilator Waveforms." Anesthesia & Analgesia 128, no. 1 (January 2019): e6. http://dx.doi.org/10.1213/ane.0000000000003896.

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11

Lozano-Zahonero, Sara, Matthias Schneider, Sashko Spassov, and Stefan Schumann. "A novel mechanical ventilator providing flow-controlled expiration for small animals." Laboratory Animals 54, no. 6 (February 19, 2020): 568–75. http://dx.doi.org/10.1177/0023677220906857.

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For investigating the effects of mechanical ventilation on the respiratory system, experiments in small mammal models are used. However, conventional ventilators for small animals are usually limited to a specific ventilation mode, and in particular to passive expiration. Here, we present a computer-controlled research ventilator for small animals which provides conventional mechanical ventilation as well as new type ventilation profiles. Typical profiles of conventional mechanical ventilation, as well as flow-controlled expiration and sinusoidal ventilation profiles can be generated with our new ventilator. Flow control during expiration reduced the expiratory peak flow rate by 73% and increased the mean airway pressure by up to 1 mbar compared with conventional ventilation without increasing peak pressure and end-expiratory pressure. Our new ventilator for small animals allows for the application of various ventilation profiles. We could analyse the effects of applying conventional ventilation profiles, pressure-controlled ventilation and volume-controlled ventilation, as well as the novel flow-controlled ventilation profile. This new approach enables studying the mechanical properties of the respiratory system with an increased freedom for choosing independent ventilation parameters.

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12

Richless, CI. "Current trends in mechanical ventilation." Critical Care Nurse 11, no. 3 (March 1, 1991): 41–53. http://dx.doi.org/10.4037/ccn1991.11.3.41.

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It is increasingly evident that there is little data available to compare the use of various modes of mechanical ventilation or to assess their application. It is difficult to compare the new modes of mechanical ventilation with the conventional modes because of a similar lack of clinical data. The challenge for future research in the area of ventilator technology is to generate controlled clinical studies to support its application. With the increased impact of financial constraints on healthcare, research will also need to examine the economic issues related to the application of newer modes of mechanical ventilation. The critical care nurse will be faced with the continued challenge of being knowledgeable regarding the current trends in ventilatory support and their potential advantages and disadvantages, while keeping in perspective those areas where clinical research is lacking. Possibilities for future nursing research related to mechanical ventilation are endless. The application and refinement of assessment parameters to evaluate the impact of nursing interventions on mechanically ventilated patients should be a key focus. The growing use of SVO2 monitoring in conjunction with other assessment parameters may prove to be useful tools to measure the impact of interventions such as suctioning, positioning, muscle reconditioning, weaning techniques, and comfort measures on mechanically ventilated patients.

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13

NIKOLAOU (Χ. ΝΙΚΟΛΑΟΥ), Ch, I. SAVVAS (Ι. ΣΑΒΒΑΣ), and A. PAPASTEFANOU (Α. ΠΑΠΑΣΤΕΦΑΝΟΥ). "Mechanical ventilation. Part I: Physiology and pathophysiology." Journal of the Hellenic Veterinary Medical Society 61, no. 1 (November 13, 2017): 61. http://dx.doi.org/10.12681/jhvms.14878.

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Despite the fact that mechanical ventilation is an integral part of anaesthesia practice, its widespread use in veterinary medicine has yet to be established. The increasing needs and advances in animal pain management, being associated with anaesthetic protocols that can cause hypoventilation, make the use of mechanical ventilation more necessary than ever. Although mechanically ventilating the patient is not pivotal in a substantial number of surgical techniques, inability to do so precludes certain anaesthetic protocols from being used, making the choice of the drugs to be employed troubleshooting. Successful mechanical ventilation requires a thorough understanding of the physiology and pathophysiology of respiration, as well as the way mechanical ventilation affects them. Before any attempt to describe mechanical ventilation, a glossary of technical terms has to be accepted, as long as consensus between the authors has not been found in the literature. Lung elasticity, resistance to flow, inspiration time and the ratio of inspiration to expiration time interact during mechanical ventilation affecting the final result on the patient. Volutrauma, barotrauma, ventilation-perfusion mismatch and cardiac output decrease are some of the adverse effects of mechanical ventilation. The choice of whether or not to use automatic ventilators, the choice of the right equipment and setting the variables correctly on the control panel need a thorough understanding of patient pathology. This article reviews respiration under normal and pathologic conditions and the effects mechanical ventilation exerts on different organ systems. Guidelines for the application of mechanical ventilation under various pathologic conditions are provided.

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14

Rathod, Bipin, Sunil Mhaske, Liza Bulsara, and Vishnu Kadam. "Neonatal Mechanical Ventilation: Indications and Outcome." Indian Journal of Maternal-Fetal and Neonatal Medicine 3, no. 2 (2016): 81–86. http://dx.doi.org/10.21088/ijmfnm.2347.999x.3216.4.

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15

Kondili, Eumorfia, Demosthenes Makris, Dimitrios Georgopoulos, Nikoletta Rovina, Anastasia Kotanidou, and Antonia Koutsoukou. "COVID-19 ARDS: Points to Be Considered in Mechanical Ventilation and Weaning." Journal of Personalized Medicine 11, no. 11 (October 28, 2021): 1109. http://dx.doi.org/10.3390/jpm11111109.

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The COVID-19 disease can cause hypoxemic respiratory failure due to ARDS, requiring invasive mechanical ventilation. Although early studies reported that COVID-19-associated ARDS has distinctive features from ARDS of other causes, recent observational studies have demonstrated that ARDS related to COVID-19 shares common clinical characteristics and respiratory system mechanics with ARDS of other origins. Therefore, mechanical ventilation in these patients should be based on strategies aiming to mitigate ventilator-induced lung injury. Assisted mechanical ventilation should be applied early in the course of mechanical ventilation by considering evaluation and minimizing factors associated with patient-inflicted lung injury. Extracorporeal membrane oxygenation should be considered in selected patients with refractory hypoxia not responding to conventional ventilation strategies. This review highlights the current and evolving practice in managing mechanically ventilated patients with ARDS related to COVID-19.

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16

Surani, Salim, Munish Sharma, Kevin Middagh, Hector Bernal, Joseph Varon, Iqbal Ratnani, Humayun Anjum, and Alamgir Khan. "Weaning from Mechanical Ventilator in a Long-term Acute Care Hospital: A Retrospective Analysis." Open Respiratory Medicine Journal 14, no. 1 (December 18, 2020): 62–66. http://dx.doi.org/10.2174/1874306402014010062.

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Background: Prolonged Mechanical Ventilation (PMV) is associated with a higher cost of care and increased morbidity and mortality. Patients requiring PMV are referred mostly to Long-Term Acute Care (LTAC) facilities. Objective: To determine if protocol-driven weaning from mechanical ventilator by Respiratory Therapist (RT) would result in quicker weaning from mechanical ventilation, cost-effectiveness, and decreased mortality. Methods: A retrospective case-control study was conducted that utilized protocol-driven ventilator weaning by respiratory therapist (RT) as a part of the Respiratory Disease Certification Program (RDCP). Results: 51 patients on mechanical ventilation before initiation of protocol-based ventilator weaning formed the control group. 111 patients on mechanical ventilation after implementation of the protocol formed the study group. Time to wean from the mechanical ventilation before the implementation of protocol-driven weaning by RT was 16.76 +/- 18.91 days, while that after the implementation of protocol was 7.67 +/- 6.58 days (p < 0.0001). Mortality proportion in patients after implementation of protocol-based ventilator weaning was 0.21 as compared to 0.37 in the control group (p=0.0153). The daily cost of patient care for the LTAC while on mechanical ventilation was $2200/day per patient while it was $ 1400/day per patient while not on mechanical ventilation leading to significant cost savings. Conclusion: Protocol-driven liberation from mechanical ventilation in LTAC by RT can significantly decrease the duration of a mechanical ventilator, leading to decreased mortality and cost savings.

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17

Butt, Raheel Farooq, Neelam Khan, Sana Khan, Amna Akbar, Sarosh Khan Jadoon, and Areeba Tanveer. "A Research Study on Prompt Results and Physical Assessment of Mechanically Ventilated Children." Pakistan Journal of Medical and Health Sciences 17, no. 5 (May 30, 2023): 631–34. http://dx.doi.org/10.53350/pjmhs2023175631.

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Objective: There is alarming information on the usage of MV in PICUs from Asian nations. The goals of this research were to identify the patients' clinical profiles, traits, frequent causes of breathing problems, complications connected to ventilation problems, and ultimate outcomes. For admittance to the pediatric critical care unit, the criterion for mechanical ventilation (MV) is rigorous (ICU). It may be difficult to manage children in impoverished nations with minimal resources that need invasive ventilation. Methods: The information gathered included epidemiological trends, ventilation indications, problems, duration of use of the ventilator, and results. From January 2022 to December 2022, a retrospective analysis of kids who needed ventilator support in the Liaqaut National Hospital, Karachi was conducted. Results: The most frequent indications for ventilation in this research were impending respiratory arrest (34.6%) and a low Glasgow coma rating (17.8%). Of the 1172 patients who were brought to the PICU, 101 (8.6%) needed mechanical ventilation. 75% of the patients on mechanical ventilation were male, and 42% were newborns. We discuss the epidemiological patterns, prevalence, causes, and results of pediatric intensive care unit ventilator support cases. Planning better treatment plans in the future may assist improve outcomes, which can be achieved by analysis of this data. The average MV lasted 2.1 days. These kids had a 38.6% death rate. Conclusions: In summary, there is little MV activity in our PICU. The most frequent justification for mechanical ventilation was respiratory failure. Keywords: Respiratory Failure, Mechanically Ventilated, Pediatrics Intensive Care Unit.

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Pearson, Steven D., Jay L. Koyner, and Bhakti K. Patel. "Management of Respiratory Failure." Clinical Journal of the American Society of Nephrology 17, no. 4 (March 10, 2022): 572–80. http://dx.doi.org/10.2215/cjn.13091021.

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Mechanical ventilation is a lifesaving therapy for critically ill patients with respiratory failure, but like all treatments, it has the potential to cause harm if not administered appropriately. This review aims to give an overview of the basic principles of invasive and noninvasive mechanical ventilation. Topics covered include modes of mechanical ventilation, respiratory mechanics and ventilator waveform interpretation, strategies for initial ventilator settings, indications and contraindications for noninvasive ventilation, and the effect of the ventilator on kidney function.

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19

Ouellette, Daniel R. "New Developments in Mechanical Ventilation." US Respiratory & Pulmonary Diseases 12, no. 02 (2017): 21. http://dx.doi.org/10.17925/usrpd.2017.12.02.21.

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Positive pressure ventilation was developed in the 1950s as a way to treat respiratory failure due to ventilatory insufficiency. While lifesaving, mechanical ventilation, especially when prolonged, can be associated with a host of complications. Current advances focus on strategies to liberate patients from the ventilator. New guidelines have been published to aid practitioners in this area.

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Maccari, Juçara Gasparetto, Cassiano Teixeira, Marcelo Basso Gazzana, Augusto Savi, Felippe Leopoldo Dexheimer-Neto, and Marli Maria Knorst. "Inhalation therapy in mechanical ventilation." Jornal Brasileiro de Pneumologia 41, no. 5 (October 2015): 467–72. http://dx.doi.org/10.1590/s1806-37132015000000035.

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Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients.

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21

Franklin, Emily. "Mechanical ventilation." Nursing Standard 20, no. 33 (April 26, 2006): 67–68. http://dx.doi.org/10.7748/ns.20.33.67.s54.

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Walter, Kristin. "Mechanical Ventilation." JAMA 326, no. 14 (October 12, 2021): 1452. http://dx.doi.org/10.1001/jama.2021.13084.

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Henderson, Nigel. "Mechanical ventilation." Nursing Standard 13, no. 44 (July 21, 1999): 49–53. http://dx.doi.org/10.7748/ns1999.07.13.44.49.c2648.

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24

Dries, David J. "MECHANICAL VENTILATION." Shock 21, no. 6 (June 2004): 579. http://dx.doi.org/10.1097/00024382-200406000-00016.

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Curley, Gerard F., Leo G. Kevin, and John G. Laffey. "Mechanical Ventilation." Anesthesiology 111, no. 4 (October 1, 2009): 701–3. http://dx.doi.org/10.1097/01.anes.0000358753.29528.fb.

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26

Henning, Robert J. "Mechanical Ventilation." Critical Care Medicine 13, no. 12 (December 1985): 1082. http://dx.doi.org/10.1097/00003246-198512000-00028.

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Bray, Jack G., and Roy D. Cane. "Mechanical ventilation." Current Opinion in Anaesthesiology 5, no. 6 (December 1992): 855–58. http://dx.doi.org/10.1097/00001503-199212000-00018.

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Thornton, Kevin. "Mechanical Ventilation." ICU Director 4, no. 6 (August 21, 2013): 301–5. http://dx.doi.org/10.1177/1944451613501196.

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29

Tobin, Martin J. "Mechanical Ventilation." New England Journal of Medicine 330, no. 15 (April 14, 1994): 1056–61. http://dx.doi.org/10.1056/nejm199404143301507.

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30

Fenstermacher, Denise, and Dennis Hong. "Mechanical Ventilation." Critical Care Nursing Quarterly 27, no. 3 (July 2004): 258–94. http://dx.doi.org/10.1097/00002727-200407000-00006.

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Lareau, Suzanne. "Mechanical Ventilation." Dimensions of Critical Care Nursing 4, no. 5 (September 1985): 295. http://dx.doi.org/10.1097/00003465-198509000-00008.

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Cohen, Ian L., James Lambrinos, Donald B. Chalfin, and Frank V. McL. "MECHANICAL VENTILATION." Critical Care Medicine 22, no. 1 (January 1994): A199. http://dx.doi.org/10.1097/00003246-199401000-00382.

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Meschia, J. F. "Mechanical ventilation." Neurology 49, no. 1 (July 1, 1997): 311. http://dx.doi.org/10.1212/wnl.49.1.311.

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Krieger, D., S. E. Kasner, and J. C. Grotta. "Mechanical ventilation." Neurology 49, no. 1 (July 1, 1997): 311. http://dx.doi.org/10.1212/wnl.49.1.311-a.

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El-Ad, B., N. M. Bornstein, and A. D. Korczyn. "Mechanical ventilation." Neurology 49, no. 1 (July 1, 1997): 311–12. http://dx.doi.org/10.1212/wnl.49.1.311-b.

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36

Popovich, John. "Mechanical ventilation." Postgraduate Medicine 79, no. 1 (January 1986): 217–27. http://dx.doi.org/10.1080/00325481.1986.11699248.

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Jung, Ralph C. "MECHANICAL VENTILATION." Chest 88, no. 6 (December 1985): 19. http://dx.doi.org/10.1016/s0012-3692(16)40706-3.

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Byrum, Diane, and Cherri Crabtree. "Mechanical ventilation." Nursing Made Incredibly Easy! 7, no. 5 (September 2009): 44–52. http://dx.doi.org/10.1097/01.nme.0000359671.91946.3f.

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&NA;. "Mechanical ventilation." Nursing Made Incredibly Easy! 7, no. 5 (September 2009): 52–54. http://dx.doi.org/10.1097/01.nme.0000359672.69076.d9.

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Hiscock, Corrine, and Moira O'Connell. "Mechanical Ventilation." Physiotherapy 87, no. 8 (August 2001): 442. http://dx.doi.org/10.1016/s0031-9406(05)65463-6.

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Cardin, Patricia, Luz Taylor, and Katy Vorster. "Mechanical ventilation." Journal of PeriAnesthesia Nursing 14, no. 1 (February 1999): 55–57. http://dx.doi.org/10.1016/s1089-9472(99)90012-6.

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James, Mollie M., and Greg J. Beilman. "Mechanical Ventilation." Surgical Clinics of North America 92, no. 6 (December 2012): 1463–74. http://dx.doi.org/10.1016/j.suc.2012.08.003.

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Santanilla, Jairo I., Brian Daniel, and Mei-Ean Yeow. "Mechanical Ventilation." Emergency Medicine Clinics of North America 26, no. 3 (August 2008): 849–62. http://dx.doi.org/10.1016/j.emc.2008.04.007.

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Barbarash, Rick A., Linda A. Smith, Jeffrey E. Godwin, and Steven A. Sahn. "Mechanical Ventilation." DICP 24, no. 10 (October 1990): 959–70. http://dx.doi.org/10.1177/106002809002401011.

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Milap, Aditi S. "Mechanical Ventilation." Asian Journal of Nursing Education and Research 9, no. 4 (2019): 588. http://dx.doi.org/10.5958/2349-2996.2019.00129.0.

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Slutsky, Arthur S. "Mechanical Ventilation." Chest 104, no. 6 (December 1993): 1833–59. http://dx.doi.org/10.1378/chest.104.6.1833.

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Marini, John J. "Mechanical Ventilation." Critical Care Clinics 34, no. 3 (July 2018): xiii—xiv. http://dx.doi.org/10.1016/j.ccc.2018.04.001.

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Torpy, Janet M. "Mechanical Ventilation." JAMA 303, no. 9 (March 3, 2010): 902. http://dx.doi.org/10.1001/jama.303.9.902.

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Shapiro, Barry A. "Mechanical Ventilation." JAMA: The Journal of the American Medical Association 254, no. 10 (September 13, 1985): 1378. http://dx.doi.org/10.1001/jama.1985.03360100132032.

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Brochard, Laurent J. "Mechanical Ventilation." Critical Care Clinics 39, no. 3 (July 2023): 437–49. http://dx.doi.org/10.1016/j.ccc.2022.12.002.

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