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Mechanical ventilation can be injurious, even when correctly administered. Ventilator-induced lung injury is an important cause of mortality in ARDS patients. Lung-protective ventilation strategies were developed to minimize lung injury (Amato MB et al. N Engl J Med. 1998 Feb 5;338(6):347-54 and ARDSnet. N Engl J Med. 2000 May 4;342), but for many reasons lung-protective ventilation is not sufficiently used (Kalhan R et al. Crit Care Med. 2006 Feb;34(2):300-6).
Ventilator-associated pneumonia (VAP) occurs in up to 15% of all mechanically ventilated patients, increasing mortality by up to 14% (Ibrahim EH et al. Chest. 2001;120:555-561). VAP clearly depends on how long a patient remains on the ventilator, so reducing ventilator-days is of paramount importance. Unfortunately, manual “weaning” often takes much too long.
Medical errors are closely linked to excessive workload: - Errors made almost doubled when ICU nurses worked 12.5 or more consecutive hours (Scott LD et al. J Nurs Adm. 2006 Feb;36(2):86-95).
- Residents averaging more than 80 work hours per week were more likely to make a significant medical error (Baldwin DC et al. Acad Med. 2003;78:1154-1164).
This is relevant, because tasks related to the patient's breathing are not only first in number of activities, but according to a study from Israel are also second in number of errors (Donchin et al. Crit Care Med; 1995;23;294–300.).
Intelligent ventilators can improve this situation, because they
- reduce ventilator interactions required by ICU staff
- enforce lung protective ventilation - a “safety net” that minimizes the impact of operator error and risks inherent
in mechanical ventilation - reduce the time a patient spends on the ventilator
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