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Non-invasive ventilation

M Weigeldt, M Paul, S Schulz-Drost, M D Schmittner
The management of anesthesia plays a central role in the treatment of thoracic trauma, both in the initial phase when safeguarding the difficult airway and in the intensive care unit. A rapid transfer to a trauma center should be considered in order to recognize and treat organ dysfunction in time. Development of atelectasis, pneumonia and acute lung failure are common pulmonary complications. Non-invasive ventilation combined with physiotherapy and respiratory training can help to minimize these pulmonary complications...
June 15, 2018: Der Unfallchirurg
L González Cubillo, A Vallejo de la Cueva, A Martín López
No abstract text is available yet for this article.
June 12, 2018: Medicina Intensiva
Kristof Faes, Joachim Cohen, Lieven Annemans
CONTEXT: Chronic obstructive pulmonary disease (COPD) patients often have several comorbidities, such as cardiovascular diseases (CVD) or lung cancer (LC), which might influence resource use in the final months of life. However, no previous studies documented resource use in end-of-life COPD patients at a population level, thereby differentiating whether COPD patients die of their COPD, CVD or LC. AIM: To describe end-of-life resource use in people diagnosed with COPD and compare this resource use between those dying of COPD, CVD and LC...
June 11, 2018: Journal of Pain and Symptom Management
Laura Ellwein Fix, Joseph Khoury, Russell R Moores, Lauren Linkous, Matthew Brandes, Henry J Rozycki
Non-invasive ventilation is increasingly used for respiratory support in preterm infants, and is associated with a lower risk of chronic lung disease. However, this mode is often not successful in the extremely preterm infant in part due to their markedly increased chest wall compliance that does not provide enough structure against which the forces of inhalation can generate sufficient pressure. To address the continued challenge of studying treatments in this fragile population, we developed a nonlinear lumped-parameter respiratory system mechanics model of the extremely preterm infant that incorporates nonlinear lung and chest wall compliances and lung volume parameters tuned to this population...
2018: PloS One
A Mendes-da-Silva, M Gonçalves-Pinho, A Freitas, I Azevedo
BACKGROUND: Recent studies show contradictory data on the incidence of hospitalizations for acute bronchiolitis (AB) and an escalating increase in public health burden. AIMS AND OBJECTIVES: We aimed to analyze the population-based admission rate for AB in children under 2 years of age, in Portuguese public hospitals, from 2000 to 2015, to assess trends and regional variations in admission rate; outcomes; associated direct health-care costs; and changes in management after the implementation of national guidelines...
June 10, 2018: Pulmonology
Xing-Wang Zhu, Yuan Shi, Li-Ping Shi, Ling Liu, Jiang Xue, Rangasamy Ramanathan
BACKGROUND: Invasive mechanical ventilation (IMV) is associated with the development of adverse pulmonary and non-pulmonary outcomes in very premature infants. Various modes of non-invasive respiratory support are increasingly being used to decrease the incidence of bronchopulmonary dysplasia. The aim of this trial is to compare the effect of non-invasive high-frequency oscillatory ventilation (NHFOV) and nasal continuous positive airway pressure (NCPAP) in preterm infants with respiratory distress syndrome (RDS) as a primary non-invasive ventilation support mode...
June 14, 2018: Trials
Pablo García-Molina, Evelin Balaguer-López, Francisco Pedro García-Fernández, María de Los Ángeles Ferrera-Fernández, José María Blasco, José Verdú
Epidemiological studies on pressure ulcers (PUs) in hospitalised infants are scarce. Spain lacks comprehensive research studies providing data on the prevalence or incidence in this population. This work was developed to determine the incidence of PUs in hospitalised infants admitted to intensive and intermediate care units, along with relevant risk factors and preventive measures. A prospective study appraising the incidence of PUs in infants was performed. The risk factors and preventive measures were evaluated using a multivariate logistic regression model...
June 13, 2018: International Wound Journal
Ruth Grychtol, Elaine Y Chan
Patients with cerebral palsy (CP), especially those at the severe end of the spectrum (Gross Motor Function Classification System levels IV-V equivalent), frequently suffer from sleep disturbance and sleep-disordered breathing (SDB). Non-invasive ventilation (NIV) is increasingly used in this patient group, albeit with little published evidence of its effectiveness in CP. This article aims to review the current evidence in the use of NIV in children with CP, highlighting areas of uncertainties, as well as the balance of potential risks, challenges and benefits...
June 9, 2018: Archives of Disease in Childhood
Isabel Cristina Muñoz, Alher Mauricio Hernández, Yessika María Ortega, Miguel Ángel Mañanas
The hypothesis of this study is that muscular activity measured through surface electromyography (sEMG) is useful to estimate the work of breathing (WOB) and respiratory mechanics. Thirty-two healthy volunteers were non-invasively ventilated, and an airflow resistor was attached to the airway circuit. sEMG signals from diaphragm, intercostal and sternocleidomastoid muscles were processed and compared with WOB changes. The airway resistance was increased from a median of 9.58 to 22.51 cmH2 O/L/s adding a resistance of 20 cmH2 O/L/s, achieving the lower compliance too...
June 7, 2018: Respiratory Physiology & Neurobiology
Ruchi Amin, Marjorie J Arca
BACKGROUND: The use of neurally adjusted ventilator assist (NAVA) in congenital diaphragmatic hernia (CDH) patients has been historically deemed unwise, since the trigger for breaths is the electromyographic activity of the diaphragmatic muscle. We report on our NAVA experience in CDH patients. METHODS: We performed an IRB-approved retrospective review of newborns from 1/1/2012-1/1/2017 at a Level I Children's Surgery Center undergoing CDH repair. Data obtained included demographics, defect type and repair, respiratory support, and outcomes...
May 19, 2018: Journal of Pediatric Surgery
Gianfranco Sanson, Massimiliano Sartori, Lorella Dreas, Roberta Ciraolo, Adam Fabiani
BACKGROUND: Extubation failure (ExtF) is associated with prolonged hospital length of stay and mortality in adult cardiac surgery patients postoperatively. In this population, ExtF-related variables such as the arterial partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2 /FiO2 ), rapid shallow breathing index, cough strength, endotracheal secretions and neurological function have been sparsely researched. AIM: To identify variables that are predictive of ExtF and related outcomes...
June 1, 2018: European Journal of Cardiovascular Nursing
Oluwasola Lawal, Hugo Knobel, Hans Weda, Lieuwe D Bos, Tamara M E Nijsen, Royston Goodacre, Stephen J Fowler
Bacteria are found ubiquitously within and on nearly every site within humans, including the airways. Microbes interact with airway epithelial cells in lung infections such as ventilator-associated pneumonia (VAP). Development of infection results in the production of oxidants such as hydrogen peroxide that may further damage the epithelium. VAP is difficult to diagnose and associated with significant mortality. Current methods are invasive and time consuming impacting on appropriate therapy, antimicrobial resistance and financial costs...
June 7, 2018: Analyst
Ramón Fernández Álvarez, Gemma Rubinos Cuadrado, Ines Ruiz Alvarez, Tamara Hermida Valverde, Marta Iscar Urrutia, María José Vázquez Lopez, Pere Casan Clara
INTRODUCTION: Respiratory center (RC) dysfunction has been implicated in the pathogenesis of obesity-hypoventilation syndrome (OHS), and often requires treatment with home non-invasive ventilation (NIV). Our objective was to measure the effect of NIV on RC function in patients with OHS, and the factors that determine such an effect. METHODS: We performed a prospective, repeated measures study to evaluate hypercapnia response (HR) by determining the p01/pEtCO2 ratio slope at baseline and after 6months of treatment with NIV in a group of OHS patients...
June 2, 2018: Archivos de Bronconeumología
Nevena Markovic, Marcus Povitz, Joanne Smith, David Leasa, Christen Shoesmith, Teneille E Gofton
BACKGROUND: Non-invasive ventilation (NIV) improves quality of life and survival in patients with amyotrophic lateral sclerosis (ALS) and respiratory symptoms. Little is known about the patterns of NIV use over time and the impact of NIV on end-of-life decision-making in ALS. OBJECTIVE: This study assessed the pattern of NIV use over the course of the disease and the timing of end-of-life discussions in people living with ALS. METHOD: A retrospective single-center cohort study was performed at London Health Sciences Centre...
June 6, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Dominik Roth, Johannes Mayer, Wolfgang Schreiber, Harald Herkner, Anton N Laggner
Carbon monoxide (CO) is a leading cause of morbidity and mortality. Treatment focuses on the rapid elimination of CO and management of hypoxia. Oxygen is the cornerstone of therapy, and usually applied via a reservoir face mask. Hyperbaric oxygen therapy eliminates CO faster, but requires extensive equipment and expertise. Non-invasive continuous positive airway pressure (CPAP) ventilation using a tight mask provides a higher inspired fraction of oxygen (FiO2 ) compared to a reservoir face mask, and increases gas exchange...
May 29, 2018: American Journal of Emergency Medicine
Padmanabhan Ramnarayan, Paula Lister, Troy Dominguez, Parviz Habibi, Naomi Edmonds, Ruth R Canter, Jerome Wulff, David A Harrison, Paul M Mouncey, Mark J Peters
BACKGROUND: Although high-flow nasal cannula therapy (HFNC) has become a popular mode of non-invasive respiratory support (NRS) in critically ill children, there are no randomised controlled trials (RCTs) comparing it with continuous positive airway pressure (CPAP). We performed a pilot RCT to explore the feasibility, and inform the design and conduct, of a future large pragmatic RCT comparing HFNC and CPAP in paediatric critical care. METHODS: In this multi-centre pilot RCT, eligible patients were recruited to either Group A (step-up NRS) or Group B (step-down NRS)...
June 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
Marcelo A Holanda, Mirizana Alves-de-Almeida, José W O Lima, Tauily C D Taunay, Francisco A A Gondim, Renesa P R Cavalvanti, Francisco J A Mont, Nancy Delma S V C Sousa, Mayron F Oliveira, Eanes D B Pereira
OBJECTIVES: Investigate the acute effects of non-invasive ventilation (NIV) on cerebral blood flow (CBF) and on cognitive functions in COPD. METHODS: Nine non-hypercapnic stable COPD and twelve healthy controls were enrolled. CBF (transcranial Doppler), cognitive tests and cardiorespiratory response were performed at baseline, during one hour of NIV and after 30 minutes. RESULTS: Both groups had an increase in tidal volume and reduction in respiratory rate during NIV, but only controls showed PaCO2 reductions (41...
May 31, 2018: Respiratory Physiology & Neurobiology
Bernd Schönhofer
In recent decades, respiratory medicine has become established as an integral part of intensive care medicine. In addition to continuous improvement of the technical possibilities, the availability of differentiated ventilation methods, sound pathophysiological and clinical knowledge are indispensable for realizing respiratory medicine at a high level of quality.Based on relevant experience, knowledge and research on the major topics of mechanical ventilation recently in Germany the following 4 guidelines have been published:S3 - guideline: Non-invasive mechanical ventilation in acute respiratory failureS2k - guideline: Non-Invasive and invasive home mechanical ventilation for treatment of chronic respiratory failureS2k - guideline: Prolonged WeaningS3 - guideline: Mechanical ventilation and use of extracorporal procedures in acute respiratory failureIn this article the main recommendations and take home messages of these guidelines are presented...
June 2018: Deutsche Medizinische Wochenschrift
Valentina Assenzo, Cristina Assenzo, Rosalinda Filippo, Morgan Le Guen, Edouard Sage, Antoine Roux, Marc Fischler, Ngai Liu
OBJECTIVES: We introduced an extubation strategy for emphysema patients after bilateral lung transplantation. Patients who met the extubation criteria were extubated in the operating room (OR) followed by non-invasive ventilation, and the other patients were extubated in the intensive care unit (ICU). The primary objective was to determine the extubation rate. The secondary outcomes were to determine the factors allowing for extubation in the OR and the postoperative course. METHODS: This study is a single-centre retrospective database analysis of 96 patients...
May 23, 2018: European Journal of Cardio-thoracic Surgery
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