PREVENTION OF COMPLICATIONS OF ARTIFICIAL LUNG VENTILATION IN THE INTENSIVE CARE UNIT

Аннотация

INTRODUCTION duration of the plateau phase or to switch to Artificial ventilation with positive inspiratory pressure-controlled ventilation. In the case of pressure does not belong to physiologic methods of prolonged periods of ventilation for more than a respiratory support. Pulmonary vein occlusion is day to use intubation tubes with low-pressure cuffs accompanied by a number of complications, the and devices with wide functionality, equipped with probability of occurrence of which is directly a graphical monitor of respiratory function[3]. proportional to its duration, which makes it necessary to follow the protocol of this procedure. Of great importance are measures aimed at Currently, the advantages of ventilator support preventing ventilator-associated pneumonia, with small respiratory volumes (6-10 ml/kg) have primarily the use of filters of the breathing circuit, been proven[1]. In the intensive care unit, 20 minimizing procedures associated with patients were individually selected under control depressurization of the breathing circuit and of respiratory mechanics, pulse-oximetry and deflation of the cuff of the intubation tube. In order blood gas analysis, and 20 patients were ventilated to reduce the likelihood of contamination of the as usual. In case of high airway resistance, it is respiratory tract with microflora from the advisable to select the optimal value of peak gastrointestinal tract, the head end of the bed is inspiratory flow, the shape of the flow curve, the raised by 15-30 °, monitor the pH of gastric https://www.theamericanjournals.com/index.php/tajmspr 67 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE01 secretion, avoiding the unjustified prescription of fixed, meaning that patients can be switched from antacid and suppressing secretion of drugs, a broad-spectrum antimicrobial therapy regimen measures to stimulate the intestine, if possible, to a regimen targeting the involved pathogen once prescribe early enteral nutrition with special the culture results and sensitivity patterns have nutritional mixtures, taking into account the been determined. . This may involve changing energy and metabolic needs of the patient. antimicrobial agent or switching from combination Antibacterial therapy is carried out taking into therapy to monotherapy. [7] account the results of bacteriologic study of Clinical criteria and procalcitonin (PCT) levels can bronchial secretion[5]. Of great importance is the be used to determine discontinuation of performance of diagnostic and sanation antimicrobial therapy, although it is unclear bronchoscopy. In order to improve the passage of whether PCT is indeed a significantly useful sputum carry out inhalation of broncho- and indicator. [9] mucolytics through a nebulizer, synchronized with the respiratory cycle, vibromassage and It is important to note that immunocompromised physiotherapeutic procedures. Aspiration of patients due to a predisposition to opportunistic secretions is carried out with disposable catheters infections will require a different treatment or with the help of "closed loop" systems. All approach; however, some management principles procedures associated with the disconnection of will be the same. [10] the respiratory circuit, performed in sterile Early weaning from ventilator without gloves[4]. complications was noted in 20 patients: 13 patients With prolonged ventilation, especially in cases of on day 3-4 and the rest up to day 10; in the normal severe forms of respiratory failure, a positive effect group, 70% were weaned on day 7-8 and the rest has a positive effect kinetic therapy - ventilation in were weaned after more than 10 days with the position on the side and on the stomach. complications[15]. One of the modes of mechanical Weaning from the ventilator requires careful ventilation, known as intrapulmonary percussion monitoring of respiratory function of the ventilation (IPVL), theoretically has life-saving patient[8]. With assisted breathing, it is advisable properties in patients with refractory acute to move as early as possible to non-invasive mask respiratory distress syndrome (ARDS) requiring ventilation. Inhaled antimicrobial therapy as an respiratory assistance[11]. Unfortunately, there adjunct to systemic therapy is recommended for are limited publications in the current scientific patients with this pathology caused by gram- literature regarding the practical application of negative bacilli sensitive only to aminoglycosides IPVL to improve gas exchange function. Moreover, or polymyxins[14]. Additional inhaled there is no discussion among practicing specialists antimicrobial therapy may also be considered in about the benefits and harms of the IPVL method patients not responding to systemic therapy alone, itself, which makes it difficult to form a clear regardless of concerns about the emergence of clinical paradigm[13]. microbial drug resistance.