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https://www.readbyqxmd.com/read/28711371/extubation-to-high-flow-nasal-cannula-in-critically-ill-surgical-patients
#1
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Danielle Polevoi, Richard Liang, Galinos Barmparas, Eric J Ley
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly used to reduce reintubations in patients with respiratory failure. Benefits include providing positive end expiratory pressure, reducing anatomical dead space, and decreasing work of breathing. We sought to compare outcomes of critically ill surgical patients extubated to HFNC versus conventional therapy. METHODS: A retrospective review was conducted in the surgical intensive care unit of an academic center during August 2015 to February 2016...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28701227/high-flow-nasal-cannula-oxygen-therapy-is-superior-to-conventional-oxygen-therapy-but-not-to-noninvasive-mechanical-ventilation-on-intubation-rate-a-systematic-review-and-meta-analysis
#2
Huiying Zhao, Huixia Wang, Feng Sun, Shan Lyu, Youzhong An
BACKGROUND: High-flow nasal cannula oxygen (HFNC) is a relatively new therapy used in adults with respiratory failure. Whether it is superior to conventional oxygen therapy (COT) or to noninvasive mechanical ventilation (NIV) remains unclear. The aim of the present study was to investigate whether HFNC was superior to either COT or NIV in adult acute respiratory failure patients. METHODS: A review of the literature was conducted from the electronic databases from inception up to 20 October 2016...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28699611/impact-of-high-flow-nasal-cannula-therapy-in-quality-%C3%A4-mprovement-and-clinical-outcomes-in-a-non-invasive-ventilation-device-free-pediatric-%C3%A4-ntensive-care-unit
#3
Fulva Kamit Can, Ayse Berna Anil, Murat Anil, Neslihan Zengin, Alkan Bal, Yuksel Bicilioglu, Gamze Gokalp, Fatih Durak, Gulberat Ince
OBJECTIVE: To analyze the change in quality indicators due to the use of high-flow nasal cannula therapy as a non-invasive ventilation method in children with respiratory distress/failure in a noninvasive ventilation device-free pediatric intensive care unit. METHODS: The study was a retrospective chart review of children with respiratory distress/failure admitted 1 year before (period before high-flow nasal cannula therapy) and 1 year after (period after high-flow nasal cannula therapy) the introduction of high-flow nasal cannula therapy...
July 11, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28682836/a-technique-of-awake-bronchoscopic-endotracheal-intubation-for-respiratory-failure-in-patients-with-right-heart-failure-and-pulmonary-hypertension
#4
Jimmy Johannes, David A Berlin, Parimal Patel, Edward J Schenck, Frances Mae West, Rajan Saggar, Igor Z Barjaktarevic
OBJECTIVE: Patients with pulmonary hypertension and right heart failure have a high risk of clinical deterioration and death during or soon after endotracheal intubation. The effects of sedation, hypoxia, hypoventilation, and changes in intrathoracic pressure can lead to severe hemodynamic instability. In search for safer approach to endotracheal intubation in this cohort of patients, we evaluate the safety and feasibility of an alternative intubation technique. DATA SOURCES: Retrospective data analysis...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28681626/pharmacokinetics-and-safety-of-fentanyl-sublingual-spray-and-fentanyl-citrate-intravenous-a-single-ascending-dose-study-in-opioid-na%C3%A3-ve-healthy-volunteers
#5
Richard Rauck, D Alexander Oh, Neha Parikh, Christian Koch, Neil Singla, Jin Yu, Srinivas Nalamachu, Santosh Vetticaden
OBJECTIVE: Fentanyl sublingual spray offers rapid pain relief in opioid-tolerant cancer patients, and may be useful in acute or postoperative pain. Both opioid-naïve or nontolerant patients are likely to receive opioids in these settings. Understanding the relationship between systemic exposure of fentanyl sublingual spray and effects on respiratory function in opioid-naïve or nontolerant populations is important to ensure patient safety. This study evaluated single-dose fentanyl sublingual spray in opioid-naïve participants...
July 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28669609/the-relationship-between-high-flow-nasal-cannula-flow-rate-and-effort-of-breathing-in-children
#6
Thomas Weiler, Asavari Kamerkar, Justin Hotz, Patrick A Ross, Christopher J L Newth, Robinder G Khemani
OBJECTIVE: To use an objective metric of effort of breathing to determine optimal high flow nasal cannula (HFNC) flow rates in children <3 years of age. STUDY DESIGN: Single-center prospective trial in a 24-bed pediatric intensive care unit of children <3 years of age on HFNC. We measured the percent change in pressure∙rate product (PRP) (an objective measure of effort of breathing) as a function of weight-indexed flow rates of 0.5, 1.0, 1.5, and 2.0 L/kg/minute...
June 29, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28665698/an-official-american-thoracic-society-workshop-report-noninvasive-identification-of-inspiratory-flow-limitation-in-sleep-studies
#7
Sushmita Pamidi, Susan Redline, David Rapoport, Indu Ayappa, Luciana Palombini, Ramon Farre, Jason Kirkness, Jean-Louis Pépin, Olli Polo, Andrew Wellman, R John Kimoff
This report summarizes the proceedings of the American Thoracic Society Workshop on the Noninvasive Identification of Inspiratory Flow Limitation in Sleep Studies held on May 16, 2015, in Denver, Colorado. The goal of the workshop was to discuss methods for standardizing the scoring of flow limitation from nasal cannula pressure tracings. The workshop began with presentations on the physiology underlying flow limitation, existing methods of scoring flow limitation, the effects of signal acquisition and filtering on flow shapes, and a review of the literature examining the adverse outcomes related to flow limitation...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28661028/increased-use-of-heated-humidified-high-flow-nasal-cannula-is-associated-with-longer-oxygen-requirements
#8
Rachael C Heath Jeffery, Margaret Broom, Bruce Shadbolt, David A Todd
AIM: There has been an increased use of heated humidified high flow nasal canula (HFNC) in premature babies (PBs) admitted to our neonatal unit. The aim of this study is to identify clinical characteristics in PBs < 29 weeks gestational age (GA) that distinguish between those who did not or did receive HFNC. METHODS: This study compared prospectively collected data from 2010 to 2012. Comparisons were undertaken between PBs<29 weeks GA who received continuous positive airway pressure (CPAP: 44/72 (61...
June 29, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28654138/a-prospective-cohort-study-of-awake-fibreoptic-intubation-practice-at-a-tertiary-centre
#9
K El-Boghdadly, D N Onwochei, J Cuddihy, I Ahmad
Contemporary data are lacking for procedural practice, training provision and outcomes for awake fibreoptic intubation in the UK. We performed a prospective cohort study of awake fibreoptic intubations at a tertiary centre to assess current practice. Data from 600 elective or emergency awake fibreoptic intubations were collected to include information on patient and operator demographics, technical performance and complications. This comprised 1.71% of patients presenting for surgery requiring a general anaesthetic, with the majority occurring in patients presenting for head and neck surgery...
June 2017: Anaesthesia
https://www.readbyqxmd.com/read/28644243/role-of-breathing-conditions-during-exercise-testing-on-training-prescription-in-chronic-obstructive-pulmonary-disease
#10
Daniel Neunhäuserer, Eva Steidle-Kloc, Marco Bergamin, Gertraud Weiss, Andrea Ermolao, Bernd Lamprecht, Michael Studnicka, Josef Niebauer
This study investigated whether different breathing conditions during exercise testing will influence measures of exercise capacity commonly used for training prescription in chronic obstructive pulmonary disease. Twenty-seven patients with chronic obstructive pulmonary disease (forced expiratory volume in 1 sec = 45.6 [9.4]%) performed three maximal exercise tests within 8 days, but at least 48 hrs apart. Subjects were thereby breathing either room air through a tightly fitting face mask like during any cardiopulmonary exercise test (MASK), room air without mask (No-MASK), or 10 l/min of oxygen via nasal cannula (No-MASK + O2)...
June 21, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28643443/national-high-flow-nasal-cannula-and-bronchiolitis-survey-highlights-need-for-further-research-and-evidence-based-guidelines
#11
Paula Sokuri, Paula Heikkilä, Matti Korppi
AIM: High-flow nasal cannula (HFNC) therapy provides non-invasive respiratory support for infant bronchiolitis and its use has increased following good clinical experiences. This national study describes HFNC use in Finland during a severe respiratory syncytial virus (RSV) epidemic. METHODS: A questionnaire on using HFNC for infant bronchiolitis during the 2015-2016 RSV epidemic was sent to the head physicians of 18 Finnish children's hospitals providing inpatient care for infants: 17 hospitals answered, covering 77...
June 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28632528/false-low-etco2-measurements-from-carbon-dioxide-sampling-nasal-cannula-and-how-to-correct-the-situation
#12
Jonathan V Roth
No abstract text is available yet for this article.
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28623005/pre-oxygenation-implications-in-emergency-airway-management
#13
REVIEW
Ali Pourmand, Chelsea Robinson, Kelsey Dorwart, Francis O'Connell
Transient oxygen desaturation during emergency department intubation is an event with potentially devastating consequences. Pre-oxygenation is an important means of increasing a patient's oxygen reserve and duration of safe apnea prior to intubation. In the emergent setting, important modifications to pre-oxygenation techniques need to be considered to best manage critically ill patients. In this review, we discuss recent updates in pre-oxygenation techniques and evaluate the evidence supporting both commonly used and newly emerging techniques for pre-oxygenation, assessing nature and level of illness, the best delivery method of oxygen, using delayed sequence intubation in patients who cannot tolerate non-invasive pre-oxygenation and using apneic oxygenation via nasal cannula and non-rebreather mask during intubation...
June 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28606907/first-line-support-for-assistance-in-breathing-in-children-first-abc-protocol-for-a-multicentre-randomised-feasibility-trial-of-non-invasive-respiratory-support-in-critically-ill-children
#14
Padmanabhan Ramnarayan, Paula Lister, Troy Dominguez, Parviz Habibi, Naomi Edmonds, Ruth Canter, Paul Mouncey, Mark J Peters
INTRODUCTION: Over 18 000 children are admitted annually to UK paediatric intensive care units (PICUs), of whom nearly 75% receive respiratory support (invasive and/or non-invasive). Continuous positive airway pressure (CPAP) has traditionally been used to provide first-line non-invasive respiratory support (NRS) in PICUs; however, high-flow nasal cannula therapy (HFNC), a novel mode of NRS, has recently gained popularity despite the lack of high-quality trial evidence to support its effectiveness...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28603625/physiological-impact-of-high-flow-nasal-cannula-therapy-on-postextubation-acute-respiratory-failure-after-pediatric-cardiac-surgery-a-prospective-observational-study
#15
Naohiro Shioji, Tatsuo Iwasaki, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tomohiko Suemori, Kentaro Sugimoto, Yasutoshi Kuroe, Hiroshi Morimatsu
BACKGROUND: Reintubation after pediatric cardiac surgery is associated with a high rate of mortality. Therefore, adequate respiratory support for postextubation acute respiratory failure (ARF) is important. However, little is known about the physiological impact of high-flow nasal cannula (HFNC) therapy on ARF after pediatric cardiac surgery. Our working hypothesis was that HFNC therapy for postextubation ARF after pediatric cardiac surgery improves hemodynamic and respiratory parameters...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28601264/high-flow-nasal-cannula-versus-conventional-oxygen-therapy-in-emergency-department-patients-with-cardiogenic-pulmonary-edema-a%C3%A2-randomized-controlled-trial
#16
Onlak Makdee, Apichaya Monsomboon, Usapan Surabenjawong, Nattakarn Praphruetkit, Wansiri Chaisirin, Tipa Chakorn, Chairat Permpikul, Phakphoom Thiravit, Tanyaporn Nakornchai
STUDY OBJECTIVE: High-flow nasal cannula is a new method for delivering high-flow supplemental oxygen for victims of respiratory failure. This randomized controlled trial compares high-flow nasal cannula with conventional oxygen therapy in emergency department (ED) patients with cardiogenic pulmonary edema. METHODS: We conducted an open-label randomized controlled trial in the ED of Siriraj Hospital, Bangkok, Thailand. Patients aged 18 years or older with cardiogenic pulmonary edema were randomly assigned to receive either conventional oxygen therapy or high-flow nasal cannula...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28598946/dexmedetomidine-for-sedation-during-noninvasive-ventilation-in-pediatric-patients
#17
Rasika Venkatraman, James L Hungerford, Mark W Hall, Melissa Moore-Clingenpeel, Joseph D Tobias
OBJECTIVES: To describe the use of dexmedetomidine for sedation in a large cohort of nonintubated children with acute respiratory insufficiency receiving noninvasive ventilatory support. DESIGN: Single-center, retrospective, observational cohort study. SETTING: A large quaternary-care PICU. PATIENTS: The study cohort included 202 children receiving noninvasive ventilatory and a dexmedetomidine infusion within 48 hours of PICU admission over a 6-month period...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28588119/high-flow-nasal-cannula-utilization-in-pediatric-critical-care
#18
Kristen D Coletti, Dayanand N Bagdure, Linda K Walker, Kenneth E Remy, Jason W Custer
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. METHODS: This study is a retrospective cohort study of patients admitted to a tertiary children's hospital pediatric ICU and placed on HFNC from October 1, 2011 to October 31, 2013...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28588117/aerosol-delivery-through-adult-high-flow-nasal-cannula-with-heliox-and-oxygen
#19
Patricia A Dailey, Robert Harwood, Kyle Walsh, James B Fink, Tina Thayer, Greg Gagnon, Arzu Ari
BACKGROUND: Heliox (helium-oxygen mixture) has been shown to reduce turbulence and improve aerosol delivery in a range of clinical settings. We questioned whether heliox as compared with oxygen via high-flow nasal cannula (HFNC) would affect aerosol delivery. We hypothesized that heliox would have a significant effect on aerosol delivery as compared with oxygen with both quiet and distressed breathing patterns. METHODS: A vibrating mesh nebulizer was placed at the inlet of a humidifier via HFNC with small adult cannula distal to the heated-wire circuit with prongs placed into simulated nares with a T-shaped trap and absolute filter connected to a breath simulator set to adult quiet and distressed breathing parameters...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28575343/maintaining-oxygenation-with-high-flow-nasal-cannula-during-emergent-awake-surgical-tracheostomy
#20
R Ffrench-O'Carroll, K Fitzpatrick, W R Jonker, M Choo, O Tujjar
No abstract text is available yet for this article.
June 1, 2017: British Journal of Anaesthesia
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