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acute hypercapnic respiratory failure

Kasper Linde Ankjærgaard, Daniel Bech Rasmussen, Signe Høyer Schwaner, Helle Frost Andreassen, Ejvind Frausing Hansen, Jon Torgny Wilcke
In severe COPD, patients having survived acute hypercapnic respiratory failure (AHRF) treated with noninvasive ventilation (NIV) have a high mortality and risk of readmissions. The aim was to analyze the prognosis for patients with COPD having survived AHRF and to assess whether previous admissions with NIV predict new ones.We conducted a retrospective follow-up analysis of 201 patients two years after NIV treatment of AHRF. Comparison of time-to-event in patients previously treated with NIV versus patients with no previous NIV treatment...
October 10, 2016: COPD
Kathrin Fricke, Stanislav Tatkov, Ulrike Domanski, Karl-Josef Franke, Georg Nilius, Hartmut Schneider
Chronic obstructive pulmonary disease (COPD) with hypercapnia is associated with increased mortality. Non-invasive ventilation (NIV) can lower hypercapnia and ventilator loads but is hampered by a low adherence rate leaving a majority of patients insufficiently treated. Recently, nasal high flow (NHF) has been introduced in the acute setting in adults, too. It is an open nasal cannula system for delivering warm and humidified air or oxygen at high flow rates (2-50 L/min) assisting ventilation. It was shown that this treatment can improve hypercapnia...
2016: Respiratory Medicine Case Reports
Tracy A Smith, Meera Agar, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
OBJECTIVE: Non-invasive ventilation (NIV) is widely used in the management of acute and acute-on-chronic respiratory failure. Understanding the experiences of patients treated with NIV is critical to person-centred care. We describe the subjective experiences of individuals treated with NIV for acute hypercapnic respiratory failure. DESIGN: Qualitative face-to-face interviews analysed using thematic analysis. SETTING: Australian tertiary teaching hospital...
August 26, 2016: BMJ Supportive & Palliative Care
Telma C A Sequeira, Ahmed S BaHammam, Antonio M Esquinas
Obesity is a global epidemic that adversely affects respiratory physiology. Sleep-disordered breathing and obesity hypoventilation syndrome (OHS) are among the most common pulmonary complications related to obesity class III. Patients with OHS may present with acute hypercapnic respiratory failure (AHRF) that necessitates immediate noninvasive ventilation (NIV) or invasive ventilation and intensive care unit (ICU) monitoring. The OHS is underrecognized as a cause of AHRF. The management of mechanical ventilation in obese ICU patients is one of the most challenging problems facing respirologists, intensivists, and anesthesiologists...
August 15, 2016: Journal of Intensive Care Medicine
Stephan Braune, Annekatrin Sieweke, Franz Brettner, Thomas Staudinger, Michael Joannidis, Serge Verbrugge, Daniel Frings, Axel Nierhaus, Karl Wegscheider, Stefan Kluge
INTRODUCTION: The aim of the study was to evaluate the feasibility and safety of avoiding invasive mechanical ventilation (IMV) by using extracorporeal CO2 removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure refractory to noninvasive ventilation (NIV). METHODS: Case-control study. Patients with acute hypercapnic respiratory failure refractory to NIV being treated with a pump-driven veno-venous ECCO2R system (iLA-Activve(®); Novalung, Heilbronn, Germany) were prospectively observed in five European intensive care units (ICU)...
September 2016: Intensive Care Medicine
Stefano Romagnoli, Giovanni Zagli, Zaccaria Ricci, Gianluca Villa, Francesco Barbani, Fulvio Pinelli, Raffaele De Gaudio, Cosimo Chelazzi
The iLA-activve(®) Novalung is a new extracorporeal device specifically designed for lung support in patients with hypercapnic and/or hypoxemic respiratory failure. To date, only low-flow applications for decompensated hypercapnic chronic obstructive pulmonary disease have been reported in the literature. Here, we briefly report three cases of iLA-activve use in patients with hypercapnic-hypoxemic acute lung failure assisted with mid-flow (up to 2.4 L/min) and different single/double venous cannulation. The main findings of our small case series were: firstly, extracorporeal blood flows over 2...
July 20, 2016: Perfusion
S P Rai, B N Panda, K K Upadhyay
Noninvasive positive pressure ventilation (NIPPV) delivered by nasal route or facemask is increasingly being used in the management of patients with acute respiratory failure. 45 patients (29 males,16 females) with a mean age of 68.32 years (range 29 to 82 years) having acute onset hypoxemic and/or hypercapnic respiratory failure who were managed with NIPPV in a tertiary care centre of Armed Forces were analyzed retrospectively. Patients with hemodynamic instability, coma and uncooperative patients were excluded from study...
July 2004: Medical Journal, Armed Forces India
Juan F Masa, Isabel Utrabo, Javier Gomez de Terreros, Myriam Aburto, Cristóbal Esteban, Enric Prats, Belén Núñez, Ángel Ortega-González, Luis Jara-Palomares, M Jesus Martin-Vicente, Eva Farrero, Alicia Binimelis, Ernest Sala, José C Serrano-Rebollo, Emilia Barrot, Raquel Sánchez-Oro-Gomez, Ramón Fernández-Álvarez, Francisco Rodríguez-Jerez, Javier Sayas, Pedro Benavides, Raquel Català, Francisco J Rivas, Carlos J Egea, Antonio Antón, Patricia Peñacoba, Ana Santiago-Recuerda, M A Gómez-Mendieta, Lidia Méndez, José J Cebrian, Juan A Piña, Enrique Zamora, Gonzalo Segrelles
BACKGROUND: Severe acidosis can cause noninvasive ventilation (NIV) failure in chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure (AHRF). NIV is therefore contraindicated outside of intensive care units (ICUs) in these patients. Less is known about NIV failure in patients with acute cardiogenic pulmonary edema (ACPE) and obesity hypoventilation syndrome (OHS). Therefore, the objective of the present study was to compare NIV failure rates between patients with severe and non-severe acidosis admitted to a respiratory intermediate care unit (RICU) with AHRF resulting from ACPE, COPD or OHS...
2016: BMC Pulmonary Medicine
D Bhattacharyya, Bnbm Prasad, P S Tampi, R Ramprasad
BACKGROUND: Non-invasive positive pressure ventilation (NIPPV) has emerged as a significant advancement in the management of acute hypercapnic respiratory failure. METHOD: Patients with hypercapnic respiratory failure requiring ventilation therapy (respiratory rate [RR] of > 30 breaths per minutes, PaCO2 > 55 mmHg and arterial pH < 7.35) were included in the study. Baseline clinical parameters and arterial blood gas (ABG) were recorded before initiating NIPPV...
October 2011: Medical Journal, Armed Forces India
Zulian Liu, Rui V Duarte, Sue Bayliss, George Bramley, Carole Cummins
BACKGROUND: The extracorporeal membrane carbon dioxide removal (ECCO2R) system is primarily designed for the purpose of removing CO2 from the body for patients with potentially reversible severe acute hypercapnic respiratory failure or being considered for lung transplantation. Systematic reviews have focused on the effectiveness of ECCO2R. To the author's best knowledge, this is the first systematic review to focus on the adverse effects of this procedure. METHODS: We will conduct a systematic review of procedure-related adverse effects of ECCO2R systems...
2016: Systematic Reviews
Jean-Pierre Frat, Stéphanie Ragot, Christophe Girault, Sébastien Perbet, Gwénael Prat, Thierry Boulain, Alexandre Demoule, Jean-Damien Ricard, Rémi Coudroy, René Robert, Alain Mercat, Laurent Brochard, Arnaud W Thille
BACKGROUND: The use of non-invasive ventilation is controversial in immunocompromised patients with acute respiratory failure, whereas the use of high-flow nasal cannula oxygen therapy is growing as an alternative to standard oxygen. We aimed to compare outcomes of immunocompromised patients with acute respiratory failure treated with standard oxygen with those treated with high-flow nasal cannula oxygen alone or high-flow nasal cannula oxygen associated with non-invasive ventilation...
August 2016: Lancet Respiratory Medicine
Caroline E Moss, Eleanor J Galtrey, Luigi Camporota, Chris Meadows, Stuart Gillon, Nicholas Ioannou, Nicholas A Barrett
We aimed to describe the use of venovenous extracorporeal carbon dioxide removal (ECCO2R) in patients with hypercapnic respiratory failure. We performed a retrospective case note review of patients admitted to our tertiary regional intensive care unit and commenced on ECCO2R from August 2013 to February 2015. Fourteen patients received ECCO2R. Demographic data, physiologic data (including pH and partial pressure of carbon dioxide in arterial blood [PaCO2]) when starting ECCO2R (t = 0), at 4 hourly intervals for the first 24 hours, then at 24 hour intervals until cessation of ECCO2R, and overall outcome were recorded...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Vito Defilippis, Davide D'Antini, Gilda Cinnella, Michele Dambrosio, Fernando Schiraldi, Vito Procacci
BACKGROUND: Patients with severe hypercapnia represent a particularly serious condition in an emergency department (ED), requiring immediate attention. Noninvasive ventilation (NIV) is an integral part of the treatment for acute respiratory failure. The present study aimed to validate the measurement of end-tidal CO2 (EtCO2) as a noninvasive technique to evaluate the effectiveness of NIV in acute hypercapnic respiratory failure. METHODS: Twenty consecutive patients admitted to the ED with severe dyspnea were enrolled in the study...
2013: Open Access Emergency Medicine: OAEM
Lorenzo Del Sorbo, Angela Jerath, Martin Dres, Matteo Parotto
The survival rate of immunocompromised patients has improved over the past decades in light of remarkable progress in diagnostic and therapeutic options. Simultaneously, there has been an increase in the number of immunocompromised patients with life threatening complications requiring intensive care unit (ICU) treatment. ICU admission is necessary in up to 15% of patients with acute leukemia and 20% of bone marrow transplantation recipients, and the main reason for ICU referral in this patient population is acute hypoxemic respiratory failure, which is associated with a high mortality rate, particularly in patients requiring endotracheal intubation...
March 2016: Journal of Thoracic Disease
Bassam Redwan, Stephan Ziegeler, Stefan Freermann, Thomas Meemann, Michael Semik, Nicolas Dickgerber, Stefan Fischer
The application of extracorporeal lung support (ECLS) in patients with acute respiratory distress syndrome is a well-established concept. In patients receiving ECLS therapy, hemodynamic monitoring is often required. However, less is known about the effect of ECLS on hemodynamic measurements. In the present work, the influence of single-site low-flow veno-venous ECLS (LFVV-ECLS) on hemodynamic monitoring by transpulmonary thermodilution (TPTD) was prospectively investigated. Five consecutive patients undergoing single-site LFVV-ECLS for severe hypercapnic respiratory failure were included in this study...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Kasper Linde Ankjærgaard, Sophia Liff Maibom, Jon Torgny Wilcke
BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients who have had an episode of acute hypercapnic respiratory failure (AHRF) have a large 1-year risk of death or readmission. Acute non-invasive ventilation (NIV) has been shown to be an effective treatment of AHRF; and long-term NIV (LTNIV) has been shown to be an effective treatment of chronic respiratory failure in stable hypercapnic COPD. We investigated the effects of LTNIV in a group of patients with severe, unstable COPD: frequent admissions and multiple previous episodes of AHRF treated with NIV...
2016: European Clinical Respiratory Journal
Craig Davidson, Steve Banham, Mark Elliott, Daniel Kennedy, Colin Gelder, Alastair Glossop, Colin Church, Ben Creagh-Brown, James Dodd, Tim Felton, Bernard Foëx, Leigh Mansfield, Lynn McDonnell, Robert Parker, Caroline Patterson, Milind Sovani, Lynn Thomas
No abstract text is available yet for this article.
2016: BMJ Open Respiratory Research
Raffaele Scala
Flexible bronchoscopy (FBO) and non-invasive positive pressure ventilation (NIPPV) are largely applied in respiratory and general intensive care units. FBO plays a crucial role for the diagnosis of lung infiltrates of unknown origin and for the treatment of airways obstruction due to bronchial mucous plugging and hemoptysis in critical patients. NIPPV is the first-choice ventilatory strategy for acute respiratory failure (ARF) of different causes as it could be used as prevention or as alternative to the conventional mechanical ventilation (CMV) via endotracheal intubation (ETI)...
September 2016: Panminerva Medica
A Craig Davidson, Stephen Banham, Mark Elliott, Daniel Kennedy, Colin Gelder, Alastair Glossop, Alistair Colin Church, Ben Creagh-Brown, James William Dodd, Tim Felton, Bernard Foëx, Leigh Mansfield, Lynn McDonnell, Robert Parker, Caroline Marie Patterson, Milind Sovani, Lynn Thomas
No abstract text is available yet for this article.
April 2016: Thorax
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