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critical care, respiratory, NAVA

Massimiliano Polastri, Lara Pisani, Andrea Dell'Amore, Stefano Nava
Rehabilitation is an integral component of care for patients affected by either acute or chronic pulmonary diseases. The key elements of rehabilitation treatment for critical respiratory patients are as follows: weaning from mechanical ventilation, respiratory therapy, physical reconditioning, and occupational therapy. It should be noted that patients affected by pulmonary diseases are prone to hospital re-admission due to frequent exacerbations, especially in cases with more severe stages of chronic obstructive pulmonary disease...
September 22, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Gennaro De Pascale, Otavio T Ranzani, Saad Nseir, Jean Chastre, Tobias Welte, Massimo Antonelli, Paolo Navalesi, Eugenio Garofalo, Andrea Bruni, Luis Miguel Coelho, Szymon Skoczynski, Federico Longhini, Fabio Silvio Taccone, David Grimaldi, Helmut J F Salzer, Christoph Lange, Filipe Froes, Antoni Artigas, Emili Díaz, Jordi Vallés, Alejandro Rodríguez, Mauro Panigada, Vittoria Comellini, Luca Fasano, Paolo M Soave, Giorgia Spinazzola, Charles-Edouard Luyt, Francisco Alvarez-Lerma, Judith Marin, Joan Ramon Masclans, Davide Chiumello, Angelo Pezzi, Marcus Schultz, Hafiz Mohamed, Menno Van Der Eerden, Roger A S Hoek, D A M P J Gommers, Marta Di Pasquale, Rok Civljak, Marko Kutleša, Matteo Bassetti, George Dimopoulos, Stefano Nava, Fernando Rios, Fernando G Zampieri, Pedro Povoa, Lieuwe D Bos, Stefano Aliberti, Antoni Torres, Ignacio Martín-Loeches
The clinical course of intensive care unit (ICU) patients may be complicated by a large spectrum of lower respiratory tract infections (LRTI), defined by specific epidemiological, clinical and microbiological aspects. A European network for ICU-related respiratory infections (ENIRRIs), supported by the European Respiratory Society, has been recently established, with the aim at studying all respiratory tract infective episodes except community-acquired ones. A multicentre, observational study is in progress, enrolling more than 1000 patients fulfilling the clinical, biochemical and radiological findings consistent with a LRTI...
October 2017: ERJ Open Research
Pervin Korkmaz Ekren, Burcu Basarik Aydogan, Alev Gurgun, Mehmet Sezai Tasbakan, Feza Bacakoglu, Stefano Nava
BACKGROUND: Noninvasive ventilation (NIV) is a cornerstone for the treatment of acute respiratory failure of various etiologies. Using NIV is discussed in mild-to-moderate acute respiratory distress syndrome (ARDS) patients (PaO2/FiO2 > 150). These patients often have comorbidities that increase the risk for bronchoscopy related complications. The primary outcome of this prospective observational study was to evaluate the feasibility, safety and contribution in diagnosis and/or modification of the ongoing treatment of fiberoptic bronchoscopy (FOB) in patients with ARDS treated with NIV...
May 31, 2016: BMC Pulmonary Medicine
Matthieu Schmidt, Felix Kindler, Jérôme Cecchini, Tymothée Poitou, Elise Morawiec, Romain Persichini, Thomas Similowski, Alexandre Demoule
INTRODUCTION: The objective was to compare the impact of three assistance levels of different modes of mechanical ventilation; neurally adjusted ventilatory assist (NAVA), proportional assist ventilation (PAV), and pressure support ventilation (PSV) on major features of patient-ventilator interaction. METHODS: PSV, NAVA, and PAV were set to obtain a tidal volume (VT) of 6 to 8 ml/kg (PSV₁₀₀, NAVA₁₀₀, and PAV₁₀₀) in 16 intubated patients. Assistance was further decreased by 50% (PSV₅₀, NAVA₅₀, and PAV₅₀) and then increased by 50% (PSV₁₅₀, NAVA₁₅₀, and PAV₁₅₀) with all modes...
February 25, 2015: Critical Care: the Official Journal of the Critical Care Forum
Antonio Artigas, Julie-Lyn Noël, Laurent Brochard, Jamiu O Busari, Dominic Dellweg, Miguel Ferrer, Jens Geiseler, Anders Larsson, Stefano Nava, Paolo Navalesi, Stylianos Orfanos, Paolo Palange, Paolo Pelosi, Gernot Rohde, Bernd Schoenhofer, Theodoros Vassilakopoulos, Anita K Simonds
No abstract text is available yet for this article.
September 2014: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Juan González Del Castillo, Francisco Javier Martín-Sánchez, Pedro Llinares, Rosario Menéndez, Abel Mujal, Enrique Navas, José Barberán
The incidence of community-acquired pneumonia increases with age and is associated with an elevated morbidity and mortality due to the physiological changes associated with aging and a greater presence of chronic disease. Taking into account the importance of this disease from an epidemiological and prognostic point of view, and the enormous heterogeneity described in the clinical management of the elderly, we believe a specific consensus document regarding this patient profile is necessary. The purpose of the present work was to perform a review of the evidence related to the risk factors for the etiology, the clinical presentation, the management and the treatment of community-acquired pneumonia in elderly patients with the aim of producing a series of specific recommendations based on critical analysis of the literature...
November 2014: Revista Española de Geriatría y Gerontología
Evangelia Akoumianaki, Salvatore M Maggiore, Franco Valenza, Giacomo Bellani, Amal Jubran, Stephen H Loring, Paolo Pelosi, Daniel Talmor, Salvatore Grasso, Davide Chiumello, Claude Guérin, Nicolo Patroniti, V Marco Ranieri, Luciano Gattinoni, Stefano Nava, Pietro-Paolo Terragni, Antonio Pesenti, Martin Tobin, Jordi Mancebo, Laurent Brochard
This report summarizes current physiological and technical knowledge on esophageal pressure (Pes) measurements in patients receiving mechanical ventilation. The respiratory changes in Pes are representative of changes in pleural pressure. The difference between airway pressure (Paw) and Pes is a valid estimate of transpulmonary pressure. Pes helps determine what fraction of Paw is applied to overcome lung and chest wall elastance. Pes is usually measured via a catheter with an air-filled thin-walled latex balloon inserted nasally or orally...
March 1, 2014: American Journal of Respiratory and Critical Care Medicine
Luca Fasano, Chiara Mega, Lara Pisani, Paolo Navalesi, Andrea Bellone, Raffaele Scala, Vanessa Repetto, Corrado Zenesini, Stefano Nava
SESSION TYPE: Respiratory Support PostersPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: The helmet is widely employed to deliver NIV in hypoxic respiratory failure; its use in AHRF is not yet well established.METHODS: 31 COPD patients admitted to a Respiratory Intensive Care Unit (RICU) for AHRF and supported with NIV were randomly assigned to receive as interface the FULL FACE MASK (group A, n.16; pH 7.26±0.08 PaCO2 75.1±11.8 PaO2/FiO2 95.9±55.6) or the HELMET (group B, n. 15; pH 7...
October 1, 2012: Chest
Ilaria Valentini, Angela Maria Grazia Pacilli, Paolo Carbonara, Luca Fasano, Rita Vitale, Corrado Zenesini, Rita Maria Melotti, Stefano Faenza, Stefano Nava
BACKGROUND: The outcomes of patients admitted to a respiratory ICU (RICU) have been evaluated in the past, but no study has considered the influence of location prior to RICU admission. METHODS: We analyzed prospectively collected data from 326 consecutive patients admitted to a 7-bed RICU. The primary end points were survival and severity of morbidity-related complications, evaluated according to the patient's location prior to RICU admission. Three admission pathways were considered: step-down for patients transferred from the ICUs of our hospital; step-up for patients coming from our respiratory wards or other medical wards; and directly for patients coming from the emergency department...
December 2013: Respiratory Care
Antonio Artigas, Paolo Pelosi, Dominic Dellweg, Laurent Brochard, Miguel Ferrer, Jens Geiseler, Anders Larsson, Stefano Nava, Paolo Navalesi, Julie-Lyn Noël, Stylianos Orfanos, Paolo Palange, Bernd Schoenhofer, Theodoros Vassilakopoulos, Anita Simonds
No abstract text is available yet for this article.
June 2012: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
A Navas, R Ferrer, M Martínez, M L Martínez, C de Haro, A Artigas
OBJECTIVES: To analyze the evolution of patients subjected to renal replacement therapy (RRT), and to determine risk factors associated with mortality and the recovery of renal function. DESIGN: A prospective, observational study of critically ill patients. SETTING: Clinical-surgical Intensive Care Unit (ICU) of Sabadell Hospital (Spain). PATIENTS: Inclusion of all patients treated in our Unit due to acute renal failure (ARF) requiring RRT...
November 2012: Medicina Intensiva
A Rodríguez, L Alvarez-Rocha, J M Sirvent, R Zaragoza, M Nieto, A Arenzana, P Luque, L Socías, M Martín, D Navarro, J Camarena, L Lorente, S Trefler, L Vidaur, J Solé-Violán, F Barcenilla, A Pobo, J Vallés, C Ferri, I Martín-Loeches, E Díaz, D López, M J López-Pueyo, F Gordo, F del Nogal, A Marqués, S Tormo, M P Fuset, F Pérez, J Bonastre, B Suberviola, E Navas, C León
The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. Molecular methods based on nucleic acid amplification techniques (RT-PCR) are the gold standard for the diagnosis of influenza A/H1N1...
March 2012: Medicina Intensiva
Stefano Nava, Ania Schreiber, Guido Domenighetti
Few studies have been performed on noninvasive ventilation (NIV) to treat hypoxic acute respiratory failure in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The outcomes of these patients, for whom endotracheal intubation is not mandatory, depend on the degree of hypoxia, the presence of comorbidities and complications, and their illness severity. The use of NIV as an alternative to invasive ventilation in severely hypoxemic patients with ARDS (ie, P(aO(2))/F(IO(2)) < 200) is not generally advisable and should be limited to hemodynamically stable patients who can be closely monitored in an intensive care unit by highly skilled staff...
October 2011: Respiratory Care
Hadrien Rozé, Abdelghani Lafrikh, Virginie Perrier, Arnaud Germain, Antoine Dewitte, Francis Gomez, Gérard Janvier, Alexandre Ouattara
PURPOSE: To determine the feasibility of daily titration of the neurally adjusted ventilatory assist (NAVA) level in relation to the maximal diaphragmatic electrical activity (EAdi(maxSBT)) measured during a spontaneous breathing trial (SBT) during pressure support ventilation (PSV). METHODS: The study included 15 consecutive patients in whom mechanical ventilation weaning was initiated with the NAVA mode. EAdi(maxSBT) was determined daily during an SBT using PSV with 7 cmH2O of inspiratory pressure and no positive end-expiratory pressure (PEEP)...
July 2011: Intensive Care Medicine
Francesco Fanfulla, Piero Ceriana, Nadia D'Artavilla Lupo, Rossella Trentin, Francesco Frigerio, Stefano Nava
BACKGROUND: Severe sleep disruption is a well-documented problem in mechanically ventilated, critically ill patients during their time in the intensive care unit (ICU), but little attention has been paid to the period when these patients become clinically stable and are transferred to a step-down unit (SDU). We monitored the 24-h sleep pattern in 2 groups of patients, one on mechanical ventilation and the other breathing spontaneously, admitted to our SDU to assess the presence of sleep abnormalities and their association with mechanical ventilation...
March 2011: Sleep
Michael L Green, Brian K Walsh, Gerhard K Wolf, John H Arnold
BACKGROUND: The placement of nasal or oral gastric tubes is one of the most frequently performed procedures in critically ill children; tube malposition, particularly in the trachea, is an important complication. Neurally adjusted ventilatory assist (NAVA) ventilation (available only on the Servo-i ventilator, Maquet Critical Care, Solna, Sweden) requires a proprietary-design catheter (Maquet Critical Care, Solna, Sweden) with embedded electrodes that detect the electrical activity of the diaphragm (EA(di))...
April 2011: Respiratory Care
Enrico M Clini, Ernesto Crisafulli, Francesca Degli Antoni, Claudio Beneventi, Ludovico Trianni, Stefania Costi, Leonardo M Fabbri, Stefano Nava
BACKGROUND: Rehabilitation is a non-pharmacologic therapy that can restore health and reverse the patient's disability, but the efficacy of rehabilitation in critically ill patients is not well documented. METHODS: In a prospective cohort study, we assessed whether the degree of change in functional status after comprehensive rehabilitation influenced clinical outcomes in 77 tracheotomized patients (mean ± SD age 75 ± 7 y) admitted for difficult weaning to our regional weaning center...
March 2011: Respiratory Care
J Bonhoeffer, D Trachsel, J Hammer, E Nava, U Heininger
BACKGROUND: Human-to-human transmission of Fusobacterium necrophorum has not been described before. CASE PRESENTATION: We present the case of a 15-year-old girl with Lemierre Syndrome and possible nosocomial transmission of F. necrophorum to her treating physician in hospital. CONCLUSION: Early diagnosis and treatment of anaerobic pharyngitis is critical to prevent Lemierre Syndrome. Respiratory precautions should be recommended to medical staff caring for patients with suspected Lemierre Syndrome to prevent nosocomial transmission...
December 2010: Klinische Pädiatrie
Yannael Coisel, Gerald Chanques, Boris Jung, Jean-Michel Constantin, Xavier Capdevila, Stefan Matecki, Salvatore Grasso, Samir Jaber
BACKGROUND: Neurally adjusted ventilatory assist (NAVA) is a new mode of mechanical ventilation that delivers ventilatory assist in proportion to the electrical activity of the diaphragm. This study aimed to compare the ventilatory and gas exchange effects between NAVA and pressure support ventilation (PSV) during the weaning phase of critically ill patients who required mechanical ventilation subsequent to surgery. METHODS: Fifteen patients, the majority of whom underwent abdominal surgery, were enrolled...
October 2010: Anesthesiology
Christina Passath, Jukka Takala, Daniel Tuchscherer, Stephan M Jakob, Christer Sinderby, Lukas Brander
BACKGROUND: Neurally adjusted ventilatory assist (NAVA) delivers airway pressure (Paw) in proportion to neural inspiratory drive as reflected by electrical activity of the diaphragm (EAdi). Changing positive end-expiratory pressure (PEEP) impacts respiratory muscle load and function and, hence, EAdi. We aimed to evaluate how PEEP affects the breathing pattern and neuroventilatory efficiency during NAVA. METHODS: In 20 adult patients, adequate assist (NAVAal) was first identified based on Paw and tidal volume (Vt) responses to systematic increases in NAVA level while using preset PEEP (PEEPbl)...
September 2010: Chest
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