Do not Routinely Extubate on Clinical Picture Alone Ronald W. Pauldine MD The benefits of separating patients from mechanical ventilation include decreasing the risk of ventilator-associated pneumonia and ventilator-induced lung…
Treat Ventilator-Associated Pneumonia for 8 days B. Robert Gibson MD Ventilator-associated pneumonia (VAP) refers to a pneumonia that arises after 48 hours of mechanical ventilation. Unfortunately, it is common, costly,…
Keep the Head of Bed Elevated at Least 30 degrees for Intubated Patients if no Contraindications Exist Deborah B. Hobson BSN Sean M. Berenholtz MD, MHS Mechanical ventilation is a…
Empirically Cover the Common Nosocomial Microbes in Ventilator-Associated Pneumonia until the Cultures are Returned Anthony D. Slonim MD, DrPH Nosocomial pneumonia is an important hospital-acquired infection that occurs 48 hours…
Remove Continuous Positive Airway Pressure and Bilevel Positive Airway Pressure Masks Periodically Bradford D. Winters MD, PhD Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) are two…
Do Not Attempt to Reverse Neuromuscular Blockade if there are no Twitches E. David Bravos MD Paralysis through the use of neuromuscular blockers can provide optimal conditions for many surgical…
Use Glycopyrrolate Before Using Neostigmine when Reversing Neuromuscular Blockade Leo Hsiao DO During surgery it is often necessary to achieve dense-muscle relaxation to facilitate surgical technique or to ensure patient…
Do Not Reverse Neuromuscular Blockade Unless the Patient is Warm James F. Weller MD Neuromuscular blocking agents (Table 123.1) are used routinely during general anesthesia to facilitate endotracheal intubation and…
Select an Initial Pressure Setting that is Just Slightly Higher than the Patient’s Peak Pressure When Attempting a Pressure Support Wean Anthony D. Slonim MD, DrPH Pressure-support ventilationis a flow-cycled…
Be Cautious in Using Positive End-Expiratory Pressure After Single-Lung Transplants Eric S. Weiss MD Ashish S. Sanh MD Case A 63-year-old man with an extensive history of cigarette smoking and…
