Thursday, November 18, 2010

Ventilator-induced respiratory muscle weakness

---an emerging issue in mechanical ventilation with inadequate research evidence to make definitive recommendations for change in practice. From a review in Annals of Internal Medicine:

Scientific understanding of ventilator-induced respiratory muscle injury has not reached the stage where meaningful controlled trials can be done, and thus, it is not possible to give concrete recommendations for patient management. In the meantime, clinicians are advised to select ventilator settings that avoid both excessive patient effort and excessive respiratory muscle rest. The contour of the airway pressure waveform on a ventilator screen provides the most practical indication of patient effort, and clinicians are advised to pay close attention to the waveform as they titrate ventilator settings.

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