Medline ® Abstracts for References 1-4
of 'Assessment of respiratory distress in the mechanically ventilated patient'
Worsening oxygenation in the mechanically ventilated patient. Causes, mechanisms, and early detection.
Glauser FL, Polatty RC, Sessler CN
Am Rev Respir Dis. 1988;138(2):458.
Hypoxemia or worsening oxygenation is a common problem in the ICU. Ventilator-related problems, patient-related problems, including progression of the underlying disease process or superimposed disorders, and interventions, procedures, and medications can all adversely affect the patient's oxygenation status. Each of these causes should be sought for in a rapid and expeditious manner and appropriate corrective actions taken.
Department of Medicine, Medical College of Virginia/McGuire Veterans Administration Hospital, Richmond, Virginia 23298-0001.
Tobin MJ, Fahey PJ. Management of the patient who is "fighting the ventilator". In: Principles and Practice of Mechanical Ventilation, McGraw Hill, New York 1994. p.1149.
no abstract available
Respiratory distress in the ventilated patient.
Marcy TW, Marini JJ
Clin Chest Med. 1994;15(1):55.
The onset of agitation and distress in a mechanically ventilated patient should initiate a careful assessment that considers whether there has been progression of the underlying disease, a new medical complication, or adverse effects from medical interventions and procedures, including intubation and mechanical ventilation. This article focuses on problems that relate to mechanical ventilation and the interactions of the "patient-ventilator system". The authors suggest an initial approach to the patient who develops respiratory distress, and then review the appropriate indications for sedative and paralytic medications.
Department of Internal Medicine, University of Vermont College of Medicine, Burlington.
Complications of mechanical ventilation. A bedside approach.
Keith RL, Pierson DJ
Clin Chest Med. 1996;17(3):439.
Instead of cataloging complications reported to occur during mechanical ventilation, the authors have discussed the potential causes for several common scenarios in the management of ventilated patients. These include the new development of hypotension, acute respiratory distress (fighting the ventilator), repeated sounding of the ventilator's high-pressure alarm, hypoxemia, blood from the endotracheal tube, and the problem of diagnosing VAP. In the course of considering likely explanations for this group of circumstances for which the clinician is consulted or called to the bedside, virtually all reported ventilator-associated complications must be discussed. This new approach to an important aspect of ICU care may aid in clinical problem-solving and reduce the likelihood that a diagnosis will be missed or inappropriate measures taken in the absence of a systematic, pathophysiology-based approach.
Department of Internal Medicine, University of Washington School of Medicine, Seattle, USA.