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acute hypercapnic respiratory failure

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https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#1
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#2
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27896329/myasthenia-gravis-with-acute-respiratory-failure-in-the-emergency-department
#3
Hasan Huseyin Kozak, Ali Ulvi Uca, Turgut Teke, Mustafa Altas, Emine Karatas
Acute respiratory failure (ARF) is defined as a sudden malfunction in the ability of respiratory system to maintain adequate gas exchange. Acute hypercapnic respiratory failure develops as a result of ventilation deficiency and it is defined as an increase of PaCO2 above 45 mmHg. Myasthenia Gravis (MG) is a sporadically developing auto-immune deficiency where the neuro-muscular transmission is affected and it is one of the important reasons for neurologically-induced respiratory distress. Here, we report a case of a 75-year-old male patient previously undiagnosed MG, who presented with ARF...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27878795/transcutaneous-versus-blood-carbon-dioxide-monitoring-during-acute-noninvasive-ventilation-in-the-emergency-department-a-retrospective-analysis
#4
Christian Michael Horvath, Martin Hugo Brutsche, Florent Baty, Jochen Julius Rüdiger
QUESTIONS UNDER STUDY: Transcutaneous measurement of carbon dioxide (PtCO2) has been suggested as an alternative to invasively obtained PaCO2 for the monitoring of patients with hypercapnic respiratory failure during noninvasive ventilation (NIV). Current data on monitoring in hypoxaemic respiratory failure are scarce and show conflicting results in hypercapnic patients in the emergency department. METHODS AND SETTING: We performed a retrospective comparison of real-time PtCO2 (SenTec Digital Monitor) and arterial/venous carbon dioxide tension (PaCO2/PvCO2) measurements in patients with severe hypoxaemic and/or hypercapnic respiratory failure during NIV...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27842751/noninvasive-ventilation
#5
REVIEW
Giuseppe Bello, Gennaro De Pascale, Massimo Antonelli
Noninvasive ventilation (NIV) has assumed a prominent role in the treatment of patients with both hypoxemic and hypercapnic acute respiratory failure (ARF). The main theoretic advantages of NIV include avoiding side effects and complications associated with endotracheal intubation, improving patient comfort, and preserving airway defense mechanisms. Factors that affect the success of NIV in patients with ARF are clinicians' expertise, selection of patient, choice of interface, selection of ventilator setting, proper monitoring, and patient motivation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27842746/managing-respiratory-failure-in-obstructive-lung-disease
#6
REVIEW
Stephen P Bergin, Craig R Rackley
Exacerbations of obstructive lung disease are common causes of acute respiratory failure. Short-acting bronchodilators and systemic glucocorticoids are the foundation of pharmacologic management. For patients requiring ventilator support, use of noninvasive ventilation reduces the risk of mortality and progression to invasive mechanical ventilation. Challenges associated with invasive ventilation include ventilator dyssynchrony, air trapping, and dynamic hyperinflation. Careful monitoring and adjustment of ventilatory support parameters helps to optimize the patient-ventilator interaction and minimizes the risk of associated morbidity...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27794085/should-we-use-volume-targeted-noninvasive-ventilation-in-patients-with-acute-hypercapnic-respiratory-failure
#7
EDITORIAL
Jean-Pierre Frat, Arnaud W Thille
No abstract text is available yet for this article.
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27794079/volume-targeted-versus-pressure-limited-noninvasive-ventilation-in-subjects-with-acute-hypercapnic-respiratory-failure-a-multicenter-randomized-controlled-trial
#8
Zhixin Cao, Zujin Luo, Anna Hou, Qingrong Nie, Baoyuan Xie, Xiaojie An, Zifen Wan, Xianwei Ye, Yanju Xu, Xisheng Chen, Honghai Zhang, Zhenyang Xu, Jinxiang Wang, Fucheng An, Pengfei Li, Chunxiao Yu, Yandong Liang, Yongxiang Zhang, Yingmin Ma
BACKGROUND: Volume-targeted noninvasive ventilation (VT-NIV), a hybrid mode that delivers a preset target tidal volume (VT) through the automated adjustment of pressure support, could guarantee a relatively constant target VT over pressure-limited noninvasive ventilation (PL-NIV) with fixed-level pressure support. Whether VT-NIV is more effective in improving ventilatory status in subjects with acute hypercapnic respiratory failure (AHRF) remains unclear. Our aim was to verify whether, in comparison with PL-NIV, VT-NIV would be more effective in correcting hypercapnia, hence reducing the need for intubation and improving survival in subjects with AHRF...
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27723369/copd-mortality-and-readmissions-in-relation-to-number-of-admissions-with-noninvasive-ventilation
#9
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
https://www.readbyqxmd.com/read/27668173/nasal-high-flow-reduces-hypercapnia-by-clearance-of-anatomical-dead-space-in-a-copd-patient
#10
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
https://www.readbyqxmd.com/read/27566721/experience-of-acute-noninvasive-ventilation-insights-from-behind-the-mask-a-qualitative-study
#11
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
https://www.readbyqxmd.com/read/27530511/noninvasive-ventilation-in-the-critically-ill-patient-with-obesity-hypoventilation-syndrome-a-review
#12
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
https://www.readbyqxmd.com/read/27456703/the-feasibility-and-safety-of-extracorporeal-carbon-dioxide-removal-to-avoid-intubation-in-patients-with-copd-unresponsive-to-noninvasive-ventilation-for-acute-hypercapnic-respiratory-failure-eclair%C3%A2-study-multicentre-case-control-study
#13
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
https://www.readbyqxmd.com/read/27440800/cardiac-output-a-central-issue-in-patients-with-respiratory-extracorporeal-support
#14
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
https://www.readbyqxmd.com/read/27407637/noninvasive-positive-pressure-ventilation-in-patients-with-acute-respiratory-failure
#15
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
https://www.readbyqxmd.com/read/27387544/noninvasive-ventilation-for-severely-acidotic-patients-in-respiratory-intermediate-care-units-precision-medicine-in-intermediate-care-units
#16
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
https://www.readbyqxmd.com/read/27365838/early-predictors-of-success-of-non-invasive-positive-pressure-ventilation-in-hypercapnic-respiratory-failure
#17
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
https://www.readbyqxmd.com/read/27267600/adverse-effects-of-extracorporeal-carbon-dioxide-removal-ecco2r-for-acute-respiratory-failure-a-systematic-review-protocol
#18
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
https://www.readbyqxmd.com/read/27245914/effect-of-non-invasive-oxygenation-strategies-in-immunocompromised-patients-with-severe-acute-respiratory-failure-a-post-hoc-analysis-of-a-randomised-trial
#19
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
https://www.readbyqxmd.com/read/27195746/a-retrospective-observational-case-series-of-low-flow-venovenous-extracorporeal-carbon-dioxide-removal-use-in-patients-with-respiratory-failure
#20
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
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