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https://www.readbyqxmd.com/read/29276674/upfront-triple-combination-therapy-induced-pulmonary-edema-in-a-case-of-pulmonary-arterial-hypertension-associated-with-sjogren-s-syndrome
#1
Kimikazu Takeuchi, Kazuhiko Nakayama, Mitsumasa Okano, Naoki Tamada, Hideya Suehiro, Yuto Shinkura, Kenichi Yanaka, Hiroyuki Onishi, Hidekazu Tanaka, Toshiro Shinke, Noriaki Emoto, Ken-Ichi Hirata
Clinical efficacy of combination therapy using vasodilators for pulmonary arterial hypertension (PAH) is well established. However, information on its safety are limited. We experienced a case of primary Sjogren's syndrome associated with PAH where the patient developed pulmonary edema immediately after the introduction of upfront triple combination therapy. Although the combination therapy successfully stabilized her pre-shock state, multiple ground glass opacities (GGO) emerged. We aborted the dose escalation of epoprostenol and initiated continuous furosemide infusion and noninvasive positive pressure ventilation (NPPV), but this did not prevent an exacerbation of pulmonary edema...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29208322/face-mask-leak-with-nasal-cannula-during-noninvasive-positive-pressure-ventilation-a-randomized-crossover-trial
#2
Derek J Brown, Stephen M Carroll, Michael D April
BACKGROUND: Nasal cannula can achieve apneic oxygenation during emergency intubation. However, pre-procedure nasal cannula placement may be difficult in patients undergoing non-invasive positive pressure ventilation (NPPV) prior to intubation. Our objective was to compare mask leak during NPPV with versus without simultaneous application of nasal cannula. We hypothesized mask leak would be no worse with concomitant use of nasal cannula (non-inferiority design). METHODS: We performed a randomized crossover non-inferiority study of healthy volunteers...
December 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29196698/high-pressure-versus-low-pressure-home-non-invasive-positive-pressure-ventilation-with-built-in-software-in-patients-with-stable-hypercapnic-copd-a-pilot-study
#3
Rongchang Chen, Lili Guan, Weiliang Wu, Xiaoying Li, Xin Chen, Bingpeng Guo, Yating Huo, Jiawen Xu, Yuqiong Yang, Luqian Zhou
High-pressure non-invasive positive pressure ventilation (NPPV) is a new strategy targeted at maximally reducing arterial carbon dioxide. However, high inspiratory positive airway pressure (IPAP) might cause respiratory adverse events likely to diminish the benefit of NPPV. In the setting of ventilatory support, monitoring NPPV efficacy and resolving problems promptly are critical. This study assessed the treatment effect of high and low-pressure NPPV in chronic hypercapnic COPD using home ventilator with built-in software...
December 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29066879/efficacy-of-long-term-noninvasive-positive-pressure-ventilation-in-stable-hypercapnic-copd-patients-with-respiratory-failure-a-meta-analysis-of-randomized-controlled-trials
#4
Hao Liao, Wendi Pei, Hongfu Li, Yuwen Luo, Kai Wang, Rui Li, Limei Xu, Xin Chen
INTRODUCTION: The efficacy of long-term noninvasive positive pressure ventilation (NPPV) in stable hypercapnic COPD patients with respiratory failure remains unclear. The aim of this meta-analysis was to critically assess the efficacy of long-term NPPV on mortality, acute exacerbation, exercise capacity, symptoms and significant physiological parameters (lung function, respiratory muscle function and gas exchange). PATIENTS AND METHODS: We performed an electronic literature search using the PubMed, Cochrane Library, Embase, OVID and Chinese Biomedical Literature Database in May 2017...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29029023/comprehensive-evaluation-of-the-effectiveness-and-safety-of-balloon-pulmonary-angioplasty-for-inoperable-chronic-thrombo-embolic-pulmonary-hypertension-long-term-effects-and-procedure-related-complications
#5
Tatsuo Aoki, Koichiro Sugimura, Shunsuke Tatebe, Masanobu Miura, Saori Yamamoto, Nobuhiro Yaoita, Hideaki Suzuki, Haruka Sato, Katsuya Kozu, Ryo Konno, Satoshi Miyata, Kotaro Nochioka, Kimio Satoh, Hiroaki Shimokawa
Aims: Although balloon pulmonary angioplasty (BPA) improves haemodynamics and short-term prognosis in patients with inoperable chronic thrombo-embolic pulmonary hypertension (CTEPH), the long-term effects of BPA, and procedure-related complications remain to be fully elucidated. Methods and results: From July 2009 to October 2016, we performed a total of 424 BPA sessions in 84 consecutive patients with inoperable CTEPH. We used 3D reconstructed computed tomography to determine target lesions of pulmonary arteries and optical computed tomography to select balloon size, if needed...
November 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28936951/-preliminary-evaluation-of-sequential-therapy-by-high-flow-nasal-cannula-oxygen-therapy-following-endotracheal-tube-extubation-in-mechanically-ventilated-patients
#6
Zhengfang Zhu, Yuhao Liu, Qixing Wang, Sheng Wang
OBJECTIVE: To evaluate the feasibility and effect of sequential treatment by the heated humidified high flow nasal cannula oxygen therapy (HFNC) in mechanically ventilated patients following endotracheal tube extubation. METHODS: A prospective randomized controlled trial was conducted. Forty-nine patients with the sequential treatment after tracheal intubation extraction admitted to Department of Critical Care Medicine of Shanghai Tenth People's Hospital from January 1st to December 31st 2016 were enrolled...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28810276/-home-mechanical-ventilation-concepts-and-therapy-recommendations
#7
Sarah Bettina Schwarz, Friederike Sophie Magnet, Bernd Schönhofer, Wolfram Windisch
The prognosis of patients receiving home mechanical ventilation is very heterogeneous and depends on the underlying disease, the degree of respiratory dependency and the comorbidities. Due to the severe chronic diseases, the initiation of a long-term NIV must be done during an inpatient treatment. Two recently published randomized controlled trials using more aggressive forms of NPPV targeted at normalizing hypercapnic PaCO2 values, showed improved long term survival also in patients with an underlying diagnosis of COPD...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28770093/the-clinical-practice-guideline-for-the-management-of-ards-in-japan
#8
Satoru Hashimoto, Masamitsu Sanui, Moritoki Egi, Shinichiro Ohshimo, Junji Shiotsuka, Ryutaro Seo, Ryoma Tanaka, Yu Tanaka, Yasuhiro Norisue, Yoshiro Hayashi, Eishu Nango
BACKGROUND: The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. METHOD: The guideline was developed applying the GRADE system for performing robust systematic reviews with plausible recommendations. The guideline consists of 13 clinical questions mainly regarding ventilator settings and drug therapies (the last question includes 11 medications that are not approved for clinical use in Japan)...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28623885/monitoring-the-electric-activity-of-the-diaphragm-during-noninvasive-positive-pressure-ventilation-a-case-report
#9
Fabia Diniz-Silva, Anna Miethke-Morais, Adriano M Alencar, Henrique T Moriya, Pedro Caruso, Eduardo L V Costa, Juliana C Ferreira
BACKGROUND: In patients with post-extubation respiratory distress, delayed reintubation may worsen clinical outcomes. Objective measures of extubation failure at the bedside are lacking, therefore clinical parameters are currently used to guide the need of reintubation. Electrical activity of the diaphragm (EAdi) provides clinicians with valuable, objective information about respiratory drive and could be used to monitor respiratory effort. CASE PRESENTATION: We describe the case of a patient with Chronic Obstructive Pulmonary Disease (COPD), from whom we recorded EAdi during four different ventilatory conditions: 1) invasive mechanical ventilation, 2) spontaneous breathing trial (SBT), 3) unassisted spontaneous breathing, and 4) Noninvasive Positive Pressure Ventilation (NPPV)...
June 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28540092/anti-musk-positive-myasthenic-crisis-in-a-7-year-old-female
#10
Harrison J Matthews, Apisadaporn Thambundit, Brandon R Allen
A seven-year-old African American female with anti-MuSK-positive Juvenile Myasthenia Gravis collapsed while at school from progressively worsening weakness and dyspnea. On initial emergency department presentation, she required 15 liters per minute of supplemental oxygen to maintain oxygen saturation above 92%. Initial pulmonary function tests and venous blood gas led to the decision to place her on noninvasive positive pressure ventilation (NPPV) with BiPAP in the emergency department. Due to worsening hypercarbia, she later required mechanical intubation in the PICU and underwent IVIG therapy followed by plasmapheresis in order to achieve a stable discharge from the hospital...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28531211/noninvasive-positive-pressure-ventilation-enhances-the-effects-of-aerobic-training-on-cardiopulmonary-function
#11
Takashi Moriki, Takeshi Nakamura, Yoshi-Ichiro Kamijo, Yukihide Nishimura, Motohiko Banno, Tokio Kinoshita, Hiroyasu Uenishi, Fumihiro Tajima
PURPOSE: The purpose of this study was to determine the effect of aerobic training under noninvasive positive pressure ventilation (NPPV) on maximal oxygen uptake ([Formula: see text]). METHODS: Ten healthy young male volunteers participated in the study. Before the training, stroke volume (SV) and cardiac output (CO) were measured in all subjects under 0, 4, 8, and 12 cmH2O NPPV at rest. Then, the subjects exercised on a cycle ergometer at 60% of pre-training [Formula: see text] for 30 min daily for 5 consecutive days with/without NPPV...
2017: PloS One
https://www.readbyqxmd.com/read/28494170/why-high-intensity-nppv-is-favourable-to-low-intensity-nppv-clinical-and-physiological-reasons
#12
S B Schwarz, F S Magnet, W Windisch
High-intensity non-invasive positive pressure ventilation (NPPV) was originally described for chronic hypercapnic chronic obstructive pulmonary disease (COPD) patients in 2009, and refers to a specific ventilatory approach whereby NPPV settings are aimed at achieving the lowest arterial partial pressure of carbon dioxide (PaCO2) values possible. Thus, high-intensity NPPV requires ventilator settings to be increased in a stepwise approach to either an individually tolerated maximum, or to the levels necessary to achieve normocapnia...
August 2017: COPD
https://www.readbyqxmd.com/read/28490871/home-noninvasive-positive-pressure-ventilation-with-built-in-software-in-stable-hypercapnic-copd-a-short-term-prospective-multicenter-randomized-controlled-trial
#13
Luqian Zhou, Xiaoying Li, Lili Guan, Jianhua Chen, Bingpeng Guo, Weiliang Wu, Yating Huo, Ziqing Zhou, Zhenyu Liang, Yuqi Zhou, Jie Tan, Xin Chen, Yuanlin Song, Rongchang Chen
BACKGROUND: The benefits of noninvasive positive pressure ventilation (NPPV) in patients with hypercapnic COPD are controversial. It is presumed that methodology and appropriate use of NIV ventilator might be crucial for the outcomes. With the new built-in software, the performance of NIV can be monitored at home, which can guarantee the compliance and appropriate use. This study investigated effects of home use of NIV in hypercapnia in COPD patients using the NIV ventilator with built-in software for monitoring...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#14
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28482421/-effect-of-home-noninvasive-positive-pressure-ventilation-on-patients-with-severe-stable-chronic-obstructive-pulmonary-disease-a-meta-analysis
#15
Y Liu, B Dai, J Su, Y Peng, W Tan, H W Zhao
Objective: To evaluate the effect of home noninvasive positive pressure ventilation (NPPV) on patients with severe stable chronic obstructive pulmonary disease(COPD) by meta-analysis. Methods: The data of this meta-analysis was retrieved from the PubMed, EMBASE, Cochrane library, Wanfang, Weipu and CNKI databases from January 1980 to January 2016. Randomized controlled trials (RCTs) on comparison of the effect of home NPPV in patients with severe stable COPD were enrolled. The enrolled data were divided into different subgroups in terms of the levels of inspiratory positive airway pressure(IPAP), different duration of ventilation per day, and different levels of baseline hypercapnia on change in PaCO(2)...
May 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28443953/flexible-bronchoscopy-and-mechanical-ventilation-in-managing-mounier-kuhn-syndrome-a-case-report
#16
Aslihan Gürün Kaya, Aydin Çiledağ, Çetin Atasoy, Demet Karnak
CONTEXT: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support. CASE REPORT: The patient was a 60-year-old male with recurrent hospital admission. He was admitted in this case due to dyspnea, cough and sputum production. An arterial blood sample revealed decompensated respiratory acidosis with moderate hypoxemia. A chest computed tomography (CT) scan showed dilatation of the trachea and bronchi, tracheal diverticula and bronchiectasis...
April 20, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28437202/low-dose-morphine-for-dyspnea-in-terminally-ill-patients-with-idiopathic-interstitial-pneumonias
#17
Yoshinobu Matsuda, Isseki Maeda, Kazunobu Tachibana, Keiko Nakao, Yumiko Sasaki, Chikatoshi Sugimoto, Toru Arai, Akihiro Tokoro, Masanori Akira, Yoshikazu Inoue
BACKGROUND: Dyspnea is highly prevalent in patients with idiopathic interstitial pneumonias (IIPs). OBJECTIVE: The objective of this study is to examine the effectiveness and safety of continuous subcutaneous morphine for dyspnea in terminally ill IIP patients. SETTING/SUBJECTS: We retrospectively reviewed cases of terminally ill IIP patients who received continuous subcutaneous morphine for dyspnea. MEASUREMENTS: We reviewed dyspnea severity measured using numerical rating scale (NRS) and respiratory rate (RR) before and two and four hours after morphine initiation...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28395405/-effect-of-oxygen-tubing-connection-site-on-percutaneous-oxygen-partial-pressure-and-percutaneous-carbon-dioxide-partial-pressure-in-patients-with-chronic-obstructive-pulmonary-disease-during-noninvasive-positive-pressure-ventilation
#18
S Mi, L M Zhang
Objective: We evaluated the effects of administering oxygen through nasal catheters inside the mask or through the mask on percutaneous oxygen partial pressure (PcO(2))and percutaneous carbon dioxide partial pressure (PcCO(2)) during noninvasive positive pressure ventilation (NPPV) to find a better way of administering oxygen, which could increase PcO(2) by increasing the inspired oxygen concentration. Methods: Ten healthy volunteers and 9 patients with chronic obstructive pulmonary disease complicated by type Ⅱ respiratory failure were included in this study...
April 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28379133/-non-invasive-ventilation-in-patients-with-diaphragmatic-paralysis-case-report
#19
Magali Blanco, Glenda Ernst, A Salvado, V H Cambursano, E Borsini
Background Diaphragmatic paralysis (DP) is a rare disease, usually secondary to systemic processes, although idiopathic forms have been described. Aim To describe the use of non-invasive ventilation as a treatment to patients with DP. Material and methods Descriptive study about consecutive cases of DP in a general hospital. Results It has been described 4 patients, all of them with a diminished the maximum mouth pressures and vital capacity in supine position. Three patients presented hypercapnia, and one of them, required intubation with invasive mechanical ventilation...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28331103/two-cases-of-young-children-with-acute-severe-asthma-treated-by-noninvasive-positive-pressure-ventilation-via-a-helmet
#20
Yuko Amimoto, Naoko Tamura, Natsuki Kitaura, Osamu Hirata, Osamu Arashin, Masakuni Wago
We used noninvasive positive pressure ventilation (NPPV) with a helmet-type mask in two young children with acute severe bronchial asthma. The intervention was well-tolerated, because the helmet-type mask caused no pain or discomfort, as compared to the face mask. Tracheal intubation can be avoided by the start of the NPPV. Thus, the respiratory symptoms improved by the use of NPPV in children with acute severe asthma with respiratory muscle fatigue and failure of medical treatment.
2017: Arerugī, [Allergy]
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