SCCM Resource Library-Year in Review Internal Medicine: Topic 2

Video Transcription

Video Summary

Dr. Deepshika Ishana presents findings from three French trials addressing mechanical ventilation. The NICO trial examined conservative airway strategies for comatose patients, suggesting that withholding routine intubation could reduce ICU stay and aspiration pneumonia without increasing mortality risk. This challenges the prevailing practice of intubating patients with suspected poisoning. The second trial compared pressure support ventilation (PSV) and TPs for spontaneous breathing trials (SBTs) in high-risk extubation patients, finding no significant difference in ventilator-free days or reintubation rates, suggesting both methods are viable. Lastly, the third trial assessed continued enteral nutrition versus fasting before extubation, showing no significant differences in reintubation or mortality. Continued nutrition potentially offers better caloric intake and reduced hypoglycemia risk, supporting its use until extubation. These trials challenge existing protocols and propose more efficient resource use and patient-centered care in mechanical ventilation practices.

Asset Caption

Year in Review | Year in Review: Internal Medicine

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

mechanical ventilation

intubation strategies

spontaneous breathing trials

enteral nutrition

ICU protocols

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