Metabolic and nutrition support in the chronic critical illness syndrome.

Abstract:

:Technological innovations in the ICU have led to artificially prolonged life, with an associated cost. Chronic critical illness (CCI) occurs in patients with prolonged mechanical ventilation and allostatic overload, and is associated with a discrete and consistent metabolic syndrome. Metabolic interventions are extrapolated from clinical critical care research, scientific theory, and years of CCI patient care experience. Intensive metabolic support (IMS) is a multi-targeted approach consisting of tight glycemic control with intensive insulin therapy, early and adequate nutrition therapy, nutritional pharmacology, management of metabolic bone disease, and meticulous attention to other endocrine/metabolic derangements. Ideally, IMS should be under the supervision of a metabolic support consultative team. Further research specifically focused on the CCI population is needed to validate this current approach.

journal_name

Respir Care

journal_title

Respiratory care

authors

Schulman RC,Mechanick JI

doi

10.4187/respcare.01620

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

958-77; discussion 977-8

issue

6

eissn

0020-1324

issn

1943-3654

journal_volume

57

pub_type

杂志文章,评审
  • Central respiratory drive in patients with neuromuscular diseases.

    abstract:BACKGROUND:The contribution of the central respiratory drive in the hypercapnic respiratory failure of neuromuscular diseases (NMD) is controversial. OBJECTIVE:To compare the CO2 response and the duration of weaning of mechanical ventilation between a group of NMD patients and a group of quadriplegic patients due to I...

    journal_title:Respiratory care

    pub_type: 杂志文章,多中心研究

    doi:10.4187/respcare.01873

    authors: Rialp G,Raurich JM,Llompart-Pou JA,Ayestarán I,Ibáñez J

    更新日期:2013-03-01 00:00:00

  • Extracorporeal membrane oxygenation for neonatal respiratory failure.

    abstract::Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass adapted for long-term use. Blood is drained from the patient, pumped through an artificial lung or membrane where gas exchange is augmented, and then re-infused back to the patient. ECMO provides support for the neonate with severe respirat...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Betit P,Craig N

    更新日期:2009-09-01 00:00:00

  • Increased Accuracy After Adjustment of Spirometry Threshold for Diagnosing COPD Based on Pre-Bronchodilator FEV1/FVC.

    abstract:BACKGROUND:COPD is a leading cause of morbidity and mortality worldwide. Spirometry is the most common lung function test for diagnosing COPD with a post-bronchodilator FEV1/FVC < 0.70 confirming the presence of the disease. However, diagnosticians appear reluctant to use bronchodilators, which have been linked to the ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06148

    authors: Kronborg T,Hangaard S,Cichosz SL,Hejlesen O

    更新日期:2019-01-01 00:00:00

  • Chest radiography validity in screening pulmonary tuberculosis in immigrants from a high-burden country.

    abstract:BACKGROUND:Chest x-ray (CXR) is widely used for diagnosing and screening pulmonary tuberculosis (PTB), yet its validity is debatable and its costs are relatively high. This study aimed to determine the validity of CXR screening in detecting radiological findings compatible with active PTB or with old healed tuberculos...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01475

    authors: Mor Z,Leventhal A,Weiler-Ravell D,Peled N,Lerman Y

    更新日期:2012-07-01 00:00:00

  • The role of the respiratory care practitioner in the evaluation of medical devices.

    abstract::Health care costs continue to skyrocket, and a large portion of these costs can be attributed to technology. Some technology, such as oximetry, is relatively inexpensive compared to CAT scanning and magnetic resonance imaging. Therefore, it may elude close scrutiny and direct health care planning and, with little fanf...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Harris KW

    更新日期:1988-04-01 00:00:00

  • Adjunct therapies during mechanical ventilation: airway clearance techniques, therapeutic aerosols, and gases.

    abstract::Mechanically ventilated patients in respiratory failure often require adjunct therapies to address special needs such as inhaled drug delivery to alleviate airway obstruction, treat pulmonary infection, or stabilize gas exchange, or therapies that enhance pulmonary hygiene. These therapies generally are supportive in ...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.02217

    authors: Kallet RH

    更新日期:2013-06-01 00:00:00

  • Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort.

    abstract:BACKGROUND:Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses water vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patien...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06294

    authors: Nakanishi N,Oto J,Itagaki T,Nakataki E,Onodera M,Nishimura M

    更新日期:2019-02-01 00:00:00

  • Decreasing Unplanned Extubation in the Neonatal ICU With a Focus on Endotracheal Tube Tip Position.

    abstract:BACKGROUND:Unplanned extubation (UE) is an important quality metric in the neonatal ICU that is associated with hypoxia, bradycardia, and risk for airway trauma with emergent re-intubation. Initial efforts to reduce UE in our level 4 neonatal ICU included standardized securement of the endotracheal tube (ETT) and requi...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07446

    authors: Morris HF,Schuller L,Archer J,Niesen A,Ellsworth S,Egan J,Rao R,Vesoulis ZA,Mathur AM

    更新日期:2020-11-01 00:00:00

  • Imaging of acute respiratory distress syndrome.

    abstract::Chest radiography and computed tomography (CT) have a crucial role to play in the diagnosis and management of acute respiratory distress syndrome (ARDS). The identification of pulmonary opacification is a requirement for the definition of ARDS on the chest radiograph, while CT has a role to play, not only in the diag...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01731

    authors: Sheard S,Rao P,Devaraj A

    更新日期:2012-04-01 00:00:00

  • Cost-benefit considerations in managing oxygenation failure.

    abstract::The evaluation of new therapy poses a formidable challenge in intensive care medicine. When therapy evaluation cannot be double-blinded, as in the evaluation of extracorporeal support, the problem becomes more difficult. The result of the extracorporeal clinical trial, like that of the ECMO trial in the 1970s, is a po...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Morris AH

    更新日期:1993-07-01 00:00:00

  • How to write an effective discussion.

    abstract::Explaining the meaning of the results to the reader is the purpose of the discussion section of a research paper. There are elements of the discussion that should be included and other things that should be avoided. Always write the discussion for the reader; remember that the focus should be to help the reader unders...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Hess DR

    更新日期:2004-10-01 00:00:00

  • High-Risk Smoking Behaviors and Barriers to Smoking Cessation Among Homeless Individuals.

    abstract:BACKGROUND:Although tobacco practices and the effects of tobacco use among the general American population are well described, minimal data exist regarding tobacco use and barriers to smoking cessation among homeless individuals. METHODS:Anonymous, voluntary surveys based on a previously implemented instrument were co...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.04439

    authors: Chen JS,Nguyen AH,Malesker MA,Morrow LE

    更新日期:2016-05-01 00:00:00

  • Relationship between functional residual capacity, respiratory compliance, and oxygenation in patients ventilated after cardiac surgery.

    abstract:BACKGROUND:Measurement of functional residual capacity (FRC) is now possible at bedside, during mechanical ventilation. OBJECTIVES:To determine the relationship of measured absolute and relative predicted FRC values to oxygenation and respiratory-system compliance, and to identify variables that influence FRC in venti...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Heinze H,Sedemund-Adib B,Heringlake M,Meier T,Eichler W

    更新日期:2010-05-01 00:00:00

  • Use of a computerized respiratory care record system to study utilization of IPPB therapy.

    abstract::Increases in the utilization of respiratory therapy and the need to avoid its misuse have placed increasing management responsibilities on medical and technical supervisors of respiratory care services. To improve our managerial capabilities we designed a computerized respiratory care record system. Respiratory therap...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Chase CR,Merz BA,Shinozaki T,Greenwood SA,Deane RS

    更新日期:1983-03-01 00:00:00

  • An Interrater Reliability Study of Pulmonary Function Assessment With a Portable Spirometer.

    abstract:BACKGROUND:In this study, we aimed to validate the agreement between pulmonary function measurements obtained with a portable spirometer and measurements obtained with conventional spirometry in Chinese pediatric and adult populations. METHODS:Pulmonary function testing was performed to evaluate subjects enrolled at S...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07116

    authors: Zhang H,Li L,Jiao D,Yang Y,Pan C,Ye L,Wei S,Jin M

    更新日期:2020-05-01 00:00:00

  • Missed bronchodilator medication treatments in respiratory therapy: frequency and underlying causes.

    abstract:BACKGROUND:In the context of increasing attention to medical errors, missed therapies have become a subject of focus both for optimizing clinical care and for assuring appropriate institutional performance during external review by accrediting bodies. Because the issue of missed treatments in respiratory therapy has re...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Stoller JK,Orens DK,Kester L

    更新日期:2003-02-01 00:00:00

  • Respiratory dysfunction and pulmonary disease in cirrhosis and other hepatic disorders.

    abstract::End-stage liver disease and its complications are a leading cause of death among adults in the United States, and thousands of patients await liver transplantation. The liver plays a central role in health and homeostasis and thus the diseased liver leads to many deleterious effects on multiple organ systems, includin...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Huffmyer JL,Nemergut EC

    更新日期:2007-08-01 00:00:00

  • The impact of computer-age technology on respiratory therapy.

    abstract::Computer-age technology is changing the face of respiratory therapy as it is that of nearly every other technical field. In some hospital respiratory therapy departments computers are presently being used for a wide range of functions such as blood gas result reporting, billing, budgeting, purchasing, hemodynamic calc...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: McPeck M

    更新日期:1982-07-01 00:00:00

  • Home-Based Pulmonary Rehabilitation for Subjects With COPD: A Randomized Study.

    abstract:BACKGROUND:The aim of this study was to develop an efficient, low-cost, home-based pulmonary rehabilitation program and to evaluate the impact of the program on exercise as measured by the 6-min walk test (6MWT) and treadmill endurance test. METHODS:Twenty-nine subjects with COPD (FEV1 = 62.4 ± 10.7% of predicted, 62....

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:10.4187/respcare.02994

    authors: Pradella CO,Belmonte GM,Maia MN,Delgado CS,Luise AP,Nascimento OA,Gazzotti MR,Jardim JR

    更新日期:2015-04-01 00:00:00

  • Efficacy of high-flow oxygen by nasal cannula with active humidification in a patient with acute respiratory failure of neuromuscular origin.

    abstract::The treatment of choice for patients with respiratory failure of neuromuscular origin, especially in patients with hypercapnic respiratory acidosis, is noninvasive ventilation (NIV). Endotracheal intubation and invasive ventilation are indicated for patients with severe respiratory compromise or failure of NIV. In rec...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02115

    authors: Díaz-Lobato S,Folgado MA,Chapa A,Mayoralas Alises S

    更新日期:2013-12-01 00:00:00

  • Evaluation of an oxygen mask-based capnometry device in subjects extubated after abdominal surgery.

    abstract:BACKGROUND:For early detection of respiratory and hemodynamic changes during anesthesia, continuous end-tidal carbon dioxide concentration (PETCO2) is monitored by capnometry. However, the accuracy of CO2 monitoring during spontaneous breathing in extubated patients remains undetermined. Therefore, we aimed to compare ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03557

    authors: Takaki S,Mihara T,Mizutani K,Yamaguchi O,Goto T

    更新日期:2015-05-01 00:00:00

  • Patient-ventilator interaction in the long-term acute-care hospital.

    abstract::Optimizing patient-ventilator synchrony is essential in managing patients who require prolonged mechanical ventilation in the long-term acute-care hospital. Inadequate synchrony can increase work of breathing, cause patient discomfort, and delay both weaning and general rehabilitation. Achieving optimal synchrony in t...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.01084

    authors: Ghamloush M,O'Connor HH,White AC

    更新日期:2011-02-01 00:00:00

  • Emergency airway management.

    abstract::Emergency airway management is associated with a high complication rate. Evaluating the patient prior to airway management is important to identify patients with increased risk of failed airways. Pre-oxygenation of critically ill patients is less effective in comparison to less sick patients. Induction agents are ofte...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Gudzenko V,Bittner EA,Schmidt UH

    更新日期:2010-08-01 00:00:00

  • Accuracy and Precision of an Optoacoustic Prototype in Determining Endotracheal Tube Position in Children.

    abstract:BACKGROUND:Confirmation of endotracheal tube (ETT) tip position and timely identification and correction of malposition is an essential component of care for endotracheally intubated and mechanically ventilated children. We evaluated the ability of a prototype optoacoustic medical device to determine ETT tip position. ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06140

    authors: Volsko TA,Petrov Y,McNinch NL,Prough DS,Anderson CR,Bigham MT

    更新日期:2018-12-01 00:00:00

  • Pulmonary function testing and outcomes in subjects with heart failure listed for heart transplantation.

    abstract:BACKGROUND:Impaired spirometric parameters have been reported in patients with stage C heart failure and portend worse outcomes in these patients. The impact of spirometric parameters on outcomes in patients with stage D heart failure listed for heart transplantation is unknown. METHODS:We collected data on consecutiv...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03709

    authors: Georgiopoulou VV,Deka A,Li S,Niazi AA,Farooq K,Kalogeropoulos AP,Butler J,Alexopoulos D

    更新日期:2015-05-01 00:00:00

  • Respiratory controversies in the critical care setting. Should heliox be used for mechanically ventilated patients?

    abstract::Helium is an inert gas with a very low density (0.18 g/L), which allows it to pass through narrowed passages with less turbulence than nitrogen or oxygen. For many years, helium-oxygen mixture (heliox) has been used for patients with severe airway obstruction. However, the data supporting the clinical application of h...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Hurford WE,Cheifetz IM

    更新日期:2007-05-01 00:00:00

  • Ventilatory adjuncts.

    abstract::A number of adjuncts to mechanical ventilation have been the focus of recent research. Automatic tube compensation (the regulation of airway pressure by estimation of tracheal pressure) appears to be an ideal approach to unloading the resistive effort imposed by the endotracheal tube. Randomized controlled trials have...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Kacmarek RM

    更新日期:2002-03-01 00:00:00

  • Should PEEP Titration Be Based on Chest Mechanics in Patients With ARDS?

    abstract::Functional residual capacity (FRC) is essentially the alveolar volume and a determinant of both oxygenation and respiratory system compliance (CRS). ARDS decreases FRC, and sufficient PEEP restores FRC; thus, assessments of PEEP by its impact on oxygenation and CRS are intimately linked. PEEP also can ameliorate or ag...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.04657

    authors: Kallet RH

    更新日期:2016-06-01 00:00:00

  • Spontaneous Breathing Trials With T-Piece or Pressure Support Ventilation.

    abstract::Spontaneous breathing trials (SBTs) are among the most commonly employed techniques to facilitate weaning from mechanical ventilation. The preferred SBT technique, however, is still unclear. To clarify the preferable SBT (T-piece or pressure support ventilation [PSV]), we conducted this systematic review. We then sear...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.04816

    authors: Pellegrini JA,Moraes RB,Maccari JG,de Oliveira RP,Savi A,Ribeiro RA,Burns KE,Teixeira C

    更新日期:2016-12-01 00:00:00

  • The importance of nonelectrostatic materials in holding chambers for delivery of hydrofluoroalkane albuterol.

    abstract:INTRODUCTION:Electrostatic attraction of aerosolized particles to the inner walls of an aerosol holding chamber (HC) made from a nonconducting material can reduce medication delivery, particularly if there is a delay between actuation and inhalation. OBJECTIVE:Compare total emitted mass and fine-particle mass (mass of...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Rau JL,Coppolo DP,Nagel MW,Avvakoumova VI,Doyle CC,Wiersema KJ,Mitchell JP

    更新日期:2006-05-01 00:00:00