The Use Of Protective Lung Strategies And Effects On Mortality Rate For Patients With Acute Respiratory Distress Syndrome

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

1. A physician is called to the intensive care unit to provide care for a patient who received second- and third-degree burns over 50 percent of his body due to a chemical fire. The patient is in respiratory distress and is suffering from severe dehydration. The physician provides support for two hours. Later that day the physician returns and provides an additional hour of critical care support to the patient.

Dimich-Ward, Helen, PhD; Michelle Lee Wymer, BSc; and Moira Chan-Yeung, MB. “Respiratory Health Survey of Respiratory Therapists” CHEST; Oct2004, Vol. 126 Issue 4, p1048-1053,

Respiratory therapy refers to both a subject area within clinical medicine and to a distinct health care profession. During the 20th century, there were many health care fundamental transformations. Here are 10 possible predictions of what may occur in the future of respiratory care: (1) Less focus on raising PaO2 as a primary goal in managing patients with acute hypoxemic respiratory failure. (2) More attention to

J., Cormier, S., & Meyer, T. (2012). Reduction in the Incidence of Ventilator Associated Pneumonia: A Multidisciplinary Approach. Respiratory Care, 57(5). 688-696. DOI: 10.4187/respcare.01392

Respiratory therapists have one of the most exciting and gratifying careers within the medical field. Unfortunately as with any other job or career, it doesn’t come without having challenging times. Respiratory therapists work along-side physicians and are highly trained to treat patients with any sort of lung concern or breathing complications. This job requires hands on care, and deals with life and death daily. One specific scope of this field involves caring for patients (of all ages) attached to mechanical ventilation. It is the respiratory therapists’ responsibility to remove assistive ventilation to patients with written order from the doctor; which ultimately results in death of the patient (Keene, Samples, Masini, Byington).

According to the American Lung Association, “Acute respiratory distress syndrome (ARDS) is a rapidly progressive disease occurring in critically ill patients.” ARDS is an extreme manifestation of a lung injury that can be associated with an acute medical problem. This occurs as a result of direct or indirect trauma to the lungs. With nearly 200,000 cases in the United States each year, ARDS is not extremely common (“Acute Respiratory Distress Syndrome”). Most people who acquire this disease are critically ill patients within the hospital. The most common predisposing medical problems of ARDS consist of: shock, trauma, pulmonary infections, sepsis, aspiration, and cardiopulmonary bypass (Ignatavicious, 2013). ARDS is a severe syndrome and even with prompt and aggressive medical treatment, almost fifty percent of those diagnosed do not survive. Those who survive have a longer hospital stay along with recurring hospital admissions throughout their lifetime (“Acute Respiratory Distress Syndrome”). Acute respiratory distress syndrome is a rapidly progressive disease which requires thorough assessment, rapid diagnosis, and emergency treatment measures in order to successfully respond to the disease process.

Ventilator-associated pneumonia (VAP) remains a big drawback within the hospital setting, with terribly high morbidity, mortality, and cost. Some people tend to perform an evidence-based review of the literature that specializes in clinically relevant pharmacological and non-pharmacological interventions to prevent VAP. Thanks to the importance of this condition the implementation of preventive measures is predominant within the care of mechanically ventilated patients. There is proof that these measures decrease the incidence of VAP and improve outcomes within the intensive care unit. A multidisciplinary approach, continuing

The nature of the study recommended in the paper was to assess the effects of protocolized weaning from mechanical ventilation on the total duration of mechanical ventilation for critically ill adults and ascertain differences between protocolized and non-protocolized weaning in terms of adverse events, mortality, quality of life, weaning duration, intensive care unit (ICU) and hospital length of stay (LOS) and explore the variation in outcomes by the type of ICU, type of protocol and approach to delivering the protocol.

During mechanical ventilation, patients are at risk of injuries to their lungs caused by improper settings on ventilators. Mechanical ventilator induced lung injury (VILI) can affect the lung in several ways. Some of the ways the lung become affected is by excessive pressure, excessive volume, and not enough volume. When the lungs are affected by excessive pressure its termed pulmonary barotrauma. On the other hand, if the lungs receive too much volume it’s called volutrauma. However, when the lungs don’t receive enough volume its termed atelectrauma. This paper describes how pulmonary barotrauma, pulmonary volutrauma, and pulmonary atelectrauma affects the lungs during mechanical ventilation and ways to prevent them from happening.

The literature found in this study was found by searching for relevant papers on MedScape. The keywords “chlorhexidine,” “ventilator-associated pneumonia,” “long-term ventilation” and “prevention.”

TBI is the leading cause due to high incidence, complexity and the presence of challenging clinical management situations such as intracranial hypertension, thoracic trauma and intra-abdominal hypertension. The most common manifestation of a TBI is acute RDS with a high mortality rate. Respiratory failure paired with high PEEP setting and low tidal volumes make patients with increased intracranial hypertension harder to manage. It is hard to maintain these patient’s PaCO2 within a normal range causing protective ventilation strategies to be more difficult. The protective ventilations strategies recommend the mechanical ventilation include maintaining plateau pressures lower than 30cm H2O independently of ARDS severity. However, in patients with a TBI are at greater risk for pulmonary injury, which depends on the trauma severity, even in patients with a TBI and no RDS. In both patient types, TBI with and without RDS, the protective mechanical ventilation strategies are aimed at protecting the lungs and the lung function. Because of the variety of disease causes, there is speculation as to whether ARDS should be described as a single entity, or whether for each special situation it could all be described as a specific class of ARDS, with different management of the ventilation. The aim of this study

The study listed clear inclusion and exclusion criteria stating that patients were not to be selected if they had acute respiratory problems, or whether the patients had sustained any injury which did not allow chest physiotherapy to be provided. Inclusion criteria was that the patient had to be mechanically ventilated and

Acute respiratory distress syndrome is a disease process that requires specific, intensive care to increase the odds of patient survival. Due to the rapid and significant decline in a patient’s ability to maintain their respiratory status, ventilation techniques in treating acute respiratory distress syndrome are specific and unique. Multiple techniques have been studied extensively and a few stand above the rest in changing the mortality rate. High frequency percussive ventilation and high frequency oscillatory ventilation may be good options for ventilating some of the most critical patients.

Keeley frames the problem to be addressed as how clinicians can reduce the occurrence and severity of ventilator-acquired pneumonia (VAP), which affects up to 25% of all ventilated patients in hospitals. Seventy percent of patients who die of acute respiratory distress syndrome have VAP and VAP is the leading cause of deaths among all hospital-acquired infections. The research did incorporate statistical research. The statistical methodology included randomly separating the targeted population into two groups and applying different interventions to each one. Keeley found that patients who were inclined at a 45 degree angle were less likely to contract VAP than those at a 25 degree angle. Thus, the article did support the proposed change to reduce incidence. The sample size, however, was too small to make any statistically significant finding.