Crtical Care and Shock Journal

Psychological dependence to mechanical ventilation

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Overview

In the last 50 years, medicine in intensive care units has focused in improving quality and safety processes involved in the attention of critically ill patients, and to reduce co-morbidities associated with these units. This goes beyond offering new treatments or drastic and innovating changes in the intervention of these conditions. (1)
Methods and ways in which these processes are carried out, have become crucial points of the assessment in patient care.
We are referring to psychiatric disorders frequently associated with critically ill patients, out of which delirium is the most studied one. However, depression and anxiety will also often be present, resulting in an extended hospital stay and/or complications.
Mechanical ventilation is an immediate synonym of anxiety, just like it’s also a necessary treatment for patients with respiratory distress, frequently used in intensive care units. When the critically ill patient’s basal condition that led them to need said support, has improved, its withdrawal, also necessary, turns into another problem to take into account, and a number of complications may arise in the process. (2)
One of the aspects, long evaluated, has been ventilator weaning, of which much has been talked about, and different approaches for its achievement have been proposed, as well as the measurement of pulmonary function tests, in order to ensure a successful extubation.
The main determinants of the outcome of weaning include the adequacy of pulmonary gas exchange, respiratory muscle function and psychological problems. (3)

Cynthia Ocegueda-Pacheco, Samantha Fernandez Hernandez

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