A5062306514- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Cardiac Arrest and Resuscitation
- Neonatal Respiratory Health Research
- Airway Management and Intubation Techniques
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Sepsis Diagnosis and Treatment
- Family and Patient Care in Intensive Care Units
- Mechanical Circulatory Support Devices
- Nosocomial Infections in ICU
- Neuroscience of respiration and sleep
- Hemodynamic Monitoring and Therapy
- Congenital Diaphragmatic Hernia Studies
- Pleural and Pulmonary Diseases
- Tracheal and airway disorders
- Thermal Regulation in Medicine
- Renal function and acid-base balance
- Ultrasound in Clinical Applications
- Inhalation and Respiratory Drug Delivery
- Cardiac, Anesthesia and Surgical Outcomes
- Non-Invasive Vital Sign Monitoring
- Heart Rate Variability and Autonomic Control
- Heart Failure Treatment and Management
- Anesthesia and Sedative Agents
- Trauma and Emergency Care Studies
University of Toronto
2016-2025
St. Michael's Hospital
2016-2025
Muscular Dystrophy Canada
2017-2025
Unity Health Toronto
2020-2024
McMaster University
1998-2024
Canada Research Chairs
2015-2024
St Michael’s Hospital
2018-2024
Hospital for Sick Children
2018-2024
SickKids Foundation
2018-2024
Vall d'Hebron Institut de Recerca
2024
<h3>Importance</h3> Limited information exists about the epidemiology, recognition, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). <h3>Objectives</h3> To evaluate intensive care unit (ICU) incidence outcome ARDS to assess clinician ventilation use adjuncts—for example prone positioning—in routine clinical practice for fulfilling Berlin Definition. <h3>Design, Setting, Participants</h3> The Large Observational Study Understand Global Impact Severe Acute...
Mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, tidal volumes (VT), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS), but relative importance of each these components is uncertain. Because respiratory-system compliance (CRS) strongly related to volume aerated remaining functional lung during disease (termed size), we hypothesized driving pressure (ΔP=VT/CRS),...
Whether noninvasive ventilation should be administered in patients with acute hypoxemic respiratory failure is debated. Therapy high-flow oxygen through a nasal cannula may offer an alternative hypoxemia.
In patients with acute exacerbations of chronic obstructive pulmonary disease, noninvasive ventilation may be used in an attempt to avoid endotracheal intubation and complications associated mechanical ventilation.
The efficacy of venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) remains controversial.
The outcome of patients receiving mechanical ventilation for particular indications has been studied, but the in a large number unselected, heterogeneous not reported.To determine survival and relative importance factors influencing survival.Prospective cohort consecutive adult admitted to 361 intensive care units who received more than 12 hours between March 1, 1998, 31, 1998. Data were collected on each patient at initiation daily throughout course up 28 days.All-cause mortality during...
Section:ChooseTop of pageAbstract <<ContentsOverviewIntroductionMethodsRecommendations for Speci...ConclusionsReferencesCITING ARTICLES
OSITIVE END-EXPIRATORY PRESsure (PEEP) is an essential component of the management acute lung injury (ALI) and respiratory distress syndrome (ARDS). 1 PEEP improves hypoxemia decreases intrapulmonary shunting, these effects have been basis for titrating in clinical practice. 24][5][6] Although mechanisms this protective effect are not fully elucidated, they may be mediated by PEEP-induced alveolar recruitment, which avoids cyclic air-See also pp 637, 691, 693.
Several modalities of ventilatory support have been proposed to gradually withdraw patients from mechanical ventilation, but their respective effects on the outcome weaning ventilation are not known. We conducted a randomized trial in three intensive care units mechanically ventilated who met standard criteria. Those could sustain 2 h spontaneous breathing were randomly assigned be weaned with T-piece trials, synchronized intermittent mandatory (SIMV), or pressure (PSV). Specific criteria...
Mechanical ventilation is used to sustain life in patients with acute respiratory failure. A major concern mechanically ventilated the risk of ventilator-induced lung injury, which partially prevented by lung-protective ventilation. Spontaneously breathing, nonintubated failure may have a high drive and breathe large tidal volumes potentially injurious transpulmonary pressure swings. In existing regional forces generated muscles lead effects on level. addition, increase transmural pulmonary...
Because animal studies have demonstrated that mechanical ventilation at high volume and pressure can be deleterious to the lungs, limitation of airway pressure, allowing hypercapnia if necessary, is already used for acute respiratory distress syndrome (ARDS). Whether a systematic more drastic reduction necessary debatable. A multicenter randomized study was undertaken compare strategy aimed limiting end-inspiratory plateau 25 cm H2O, using tidal (Vt) below 10 ml/kg body weight, versus...
Baseline characteristics and management have changed over time in patients requiring mechanical ventilation; however, the impact of these changes on patient outcomes is unclear.To estimate whether mortality mechanically ventilated has time.Prospective cohort studies conducted 1998, 2004, 2010, including receiving ventilation for more than 12 hours a 1-month period, from 927 units 40 countries. To examine effects intensive care units, we performed generalized estimating equation models.We...
Diaphragm dysfunction worsens outcomes in mechanically ventilated patients, but the clinical impact of potentially preventable changes diaphragm structure and function caused by mechanical ventilation is unknown.To determine whether atrophy developing during leads to prolonged ventilation.Diaphragm thickness was measured daily ultrasound adults requiring invasive ventilation; inspiratory effort assessed thickening fraction. The primary outcome time liberation from ventilation. Secondary...
Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use ARDS remains relatively sparse.To determine whether, during NIV, the categorization of severity based on PaO2/FiO2 Berlin criteria useful.The LUNG SAFE (Large Observational Study to Understand Global Impact Severe Acute Respiratory Failure) study described management ARDS. This substudy examines current practice ARDS, utility ratio classifying...
Rationale: Diaphragm atrophy and dysfunction have been reported in humans during mechanical ventilation, but the prevalence, causes, functional impact of changes diaphragm thickness routine ventilation for critically ill patients are unknown.Objectives: To describe evolution over time its on function, influence inspiratory effort this phenomenon.Methods: In three academic intensive care units, 107 were enrolled shortly after initiating along with 10 nonventilated unit (control subjects)....
A lung-protective ventilatory strategy with low tidal volume (VT) has been proposed for use in acute respiratory distress syndrome (ARDS). Alveolar derecruitment may occur during the of a and be prevented by recruiting maneuvers. This study examined hypothesis that effectiveness maneuver to improve oxygenation patients ARDS would influenced elastic properties lung chest wall.Twenty-two were studied ARDSNet strategy: VT was set at 6 ml/kg predicted body weight positive end-expiratory pressure...
Section:ChooseTop of pageAbstract <<Purpose this Position ...DefinitionsNationwide/Regional Organ...Mobile ECMO TeamIntrahospital Transport o...General Structure an E...StaffingPhysical Facilities and E...Non-ICU Support ServicesStaff Training Contin...Program Evaluation Qu...Patient Follow-upResearchConclusionsReferencesCITING ARTICLES
Extubation failure is associated with a poor prognosis, but the respective roles for reintubation per se and underlying disease severity remain unclear. Our objectives were to evaluate impact of failed extubation, whether planned or unplanned, on patient outcomes identify subset at risk extubation failure.Prospective 1-yr observational study daily data collection.: Thirteen-bed medical intensive care unit in teaching hospital.Consecutive patients requiring invasive mechanical ventilation...