Management of ventilator dependency following heart surgery. 1991

E D Sivak
Department of Pulmonary Disease, Cleveland Clinic Foundation, OH 44195.

The foregoing discussion has reviewed the concept that postoperative ventilator dependency following heart surgery is due to a combination of risk factors, partly due to the nature of the patient population and partly to the process of patient care. Weaning from mechanical ventilation has been a controversial topic for decades, but the issue of rehabilitation before successful weaning has only recently achieved recognition. The fact that this process is often prolonged suggests that a certain logic must be used during the rehabilitation process. Appropriate minimization of risks with continued mechanical ventilation and concise protocols for gradually withdrawing support of mechanical ventilation may insure the quality of the patient care process. It should be understood by both the physician and patient that the ventilator for the patient population discussed previously acts merely as a "crutch" that will facilitate the process of rehabilitation.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D009752 Nutritional Status State of the body in relation to the consumption and utilization of nutrients. Nutrition Status,Status, Nutrition,Status, Nutritional
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012133 Respiratory Paralysis Complete or severe weakness of the muscles of respiration. This condition may be associated with MOTOR NEURON DISEASES; PERIPHERAL NERVE DISEASES; NEUROMUSCULAR JUNCTION DISEASES; SPINAL CORD DISEASES; injury to the PHRENIC NERVE; and other disorders. Diaphragmatic Paralysis,Paralysis, Respiratory Muscle,Muscle Paralyses, Respiratory,Muscle Paralysis, Respiratory,Paralysis, Diaphragmatic,Paralysis, Respiratory,Respiratory Muscle Paralysis
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D014139 Tracheostomy Surgical formation of an opening into the trachea through the neck, or the opening so created. Tracheostomies
D015300 Ventilator Weaning Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation. Mechanical Ventilator Weaning,Respirator Weaning,Ventilator Weaning, Mechanical,Weaning, Mechanical Ventilator,Weaning, Respirator,Weaning, Ventilator

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