0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Updates |

1996-97 SERIES

Series Editor John Roberts, MD

Update in Critical Care Medicine

Martin J. Tobin, MD; and John M. Luce, MD
[+] Article and Author Information

From Loyola University of Chicago, Maywood, Illinois; and San Francisco General Hospital, San Francisco, California. Requests for Reprints: Martin J. Tobin, MD, Division of Pulmonary Medicine, Loyola University of Chicago, 2160 First Avenue, Maywood, IL 60153. Current Author Addresses: Dr. Tobin: Division of Pulmonary Medicine, Loyola University of Chicago, 2160 First Avenue, Maywood, IL 60153.


Ann Intern Med. 1996;125(11):909-916. doi:10.7326/0003-4819-125-11-199612010-00007
Text Size: A A A

The practice of critical care medicine extends from medical ethics to the technical aspects of mechanical ventilation. Recent studies have produced several important findings. First, physicians often make unilateral decisions to limit treatment. Second, studies of the severely ill have uncovered a wide spectrum of systemic inflammatory syndromes, some of which are often not associated with infection. Third, some simple new techniques to wean patients from mechanical ventilation appear to be superior to traditional ones. Finally, the use of noninvasive ventilation strategies reduces the need for intubation of patients with chronic obstructive pulmonary disease.

First Page Preview

View Large
First page PDF preview

Figures

Grahic Jump Location
Figure 1. values were derived from unpaired -tests between both groups for each day. Bars represent 1 SE. Reproduced with permission from Amato MB, et al. Am J Respir Crit Care Med. 1995; 152:1835-46.
Evolution of the minute volume required during the first week of mechanical ventilation.Pt
Grahic Jump Location
Grahic Jump Location
Figure 2. values were derived from unpaired -tests between both groups for each day. Bars represent 1 SE. Reproduced with permission from Amato MB, et al. Am J Respir Crit Care Med. 1995; 152:1835-46.
Arterial carbon dioxide levels obtained during the first week of mechanical ventilation.Pt
Grahic Jump Location
Grahic Jump Location
Figure 3. After adjustment for baseline characteristics in a Cox proportional-hazards model, the rate of successful weaning with a once-daily trial of spontaneous breathing was 2.83 times higher than that with intermittent mandatory ventilation ( < 0.006) and 2.05 times higher than that with pressure-support ventilation ( < 0.04). Reproduced with permission from Esteban A, et al. N Engl J Med. 1995;332:345-50.
Kaplan-Meier curves of the probability of successful weaning with intermittent mandatory ventilation, pressure-support ventilation, intermittent trials of spontaneous breathing, and a once-daily trial of spontaneous breathing.PP
Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)