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Weaning Failure in Mechanical Ventilation: a Literature Review Sakti, Pradhika Perdana; Anjarwani, Setyasih
Heart Science Journal Vol. 4 No. 4 (2023): The Science and Art of Caring for Critically III Patients in Intensive Cardiac
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.04.2

Abstract

Mechanical ventilation is a method of ventilation support through positive pressure breath application. It is used in cases of ventilation and/ or oxygenation failure. Due to its related complications mechanical ventilation should be withdrawn from the patient as soon as possible, called a weaning process. The result of the weaning of mechanical ventilation determines the patient’s prognosis. Patient will go through several assessments before a weaning decision is made. Subsequently, patient will be placed on an unconstrained breathing test (SBT) to check whether the patient's respiratory muscle is equipped for accepting its work of relaxing. Weaning disappointment is characterized as disappointment on SBT or reintubation at 48 hours following extubation. Several factors related to weaning failure are increasing airflow resistance, decreasing compliance, respiratory muscle fatigue, and the patient’s underlying conditions. Techniques to conquer these variables are expected to lessen the pace of disappointment of the weaning system.
The Role of International Normalized Ratio (INR) in Heart Failure Patient With Sepsis: Hidden in Plain Sight Sakti, Pradhika Perdana
Eduvest - Journal of Universal Studies Vol. 4 No. 10 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i10.38811

Abstract

Heart failure is a clinical syndrome characterized by symptoms and signs caused by a structural and/or functional impairment of the heart. Sepsis in heart failure may cause significant mortality and morbidity rates. Clinically, the presence of heart dysfunction in heart failure worsens outcomes in unstable hemodynamic conditions, for instance, in cases of sepsis, particularly in patients with HFrEF. This research aims to survey the blend of heart failure and sepsis and current updates regarding using the International Normalized Ratio (INR) to detect sepsis. Information was collected from various sources, and updated literature was compiled into a review article. The presence of heart failure with sepsis is associated with horrible clinical results. If fluid alone is insufficient to restore perfusion, the fundamental structure of sepsis includes strong fluid recovery followed by vasopressor association (and possibly inotropic support). In any case, in patients with heart failure, high-portion fluid boluses and vasoactive experts might deteriorate the condition. Heart failure and sepsis can overlap and lead to hemodynamic disturbances and challenging treatment. Meanwhile, aggressive fluid resuscitation is necessary for sepsis; conventional heart failure management requires reducing fluid intake. The International Normalized Ratio (INR) is one of the coagulation parameters that may help determine sepsis in patients with heart failure, thus improving appropriate diagnosis and treatment.