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Intervention patients were randomized to receive EMV via face mask or endotracheal intubation owing to the presence or absence of impaired swallowing (experimental arm), or to receive conventional care that may include invasive mechanical ventilation whenever acute respiratory failure occurred (control arm).
The compendium recommends using noninvasive mechanical ventilation whenever possible, minimizing sedation, interrupting sedatives and assessing readiness to extubate daily, mobilizing patients early, using endotracheal tubes with subglottic secretion drainage, changing ventilator circuits only if visibly soiled or malfunctioning, and elevating the head of the bed.
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The trial was interrupted and mechanical ventilation resumed whenever one of the following occurred: 1) respiratory rate >35/min, 2) signs of evident respiratory distress (diaphoresis, accessory muscles recruitment, thoraco-abdominal paradox), 3) peripheral oxygen saturation (SpO2) <90%%, 4) SBP <90 mmHg or >180 mmHg, 5) heart rate >140/min.
Treatment of sepsis included antibiotics and drainage, whenever possible, and intubation, mechanical ventilation, and continuous veno-venous hemofiltration (CVVH) were instituted when needed.
Some limitations have to be taken into account whenever using STE in critically ill patients undergoing mechanical ventilation.
Partial modes of ventilatory support should be used whenever possible, since these modes attenuate the deleterious effects of mechanical ventilation on respiratory muscles.
Whenever the spontaneous breathing trial failed, administration of nitroglycerin was stopped at the time of resumption of mechanical ventilation.
Liberating brain-injured patients from mechanical ventilation.
Air curing is accomplished mainly by mechanical ventilation inside buildings.
Predicting noninvasive mechanical ventilation outcome: early may be too early!
Duration of mechanical ventilation was 14 +/- 9 days.
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