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non invasive mechanical ventilation in acute respiratory failure

John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fabiana Madotto, Ednan K Bajwa, Laurent Brochard, Kevin Clarkson, Andres Esteban, Luciano Gattinoni, Frank van Haren, Leo M Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Anders Larsson, Daniel F McAuley, Lia McNamee, Nicolas Nin, Haibo Qiu, Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. METHODS: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents...
October 18, 2016: Intensive Care Medicine
Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini, Alessandro Marchioni
BACKGROUND AND OBJECTIVE: The prevalence and clinical consequences of diaphragmatic dysfunction (DD) during acute exacerbations of COPD (AECOPD) remain unknown. The aim of this study was (i) to evaluate the prevalence of DD as assessed by ultrasonography (US) and (ii) to report the impact of DD on non-invasive mechanical ventilation (NIV) failure, length of hospital stay and mortality in severe AECOPD admitted to respiratory intensive care unit (RICU). METHODS: Forty-one consecutive AECOPD patients with respiratory acidosis admitted over a 12-month period to the RICU of the University Hospital of Modena were studied...
October 14, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
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
Esra Adıyeke, Asu Ozgultekin, Guldem Turan, Altay Iskender, Gamze Canpolat, Abdullah Pektaş, Osman Ekinci
BACKGROUND AND OBJECTIVES: This study compared the rates of acute respiratory failure, reintubation, length of intensive care stay and mortality in patients in whom the non-invasive mechanical ventilation (NIMV) was applied instead of the routine venturi face mask (VM) application after a successful weaning. METHODS: Following the approval of the hospital ethics committee, 62 patients who were under mechanical ventilation for at least 48hours were scheduled for this study...
September 14, 2016: Revista Brasileira de Anestesiologia
Marta Raurell-Torredà, E Argilaga-Molero, M Colomer-Plana, A Ródenas-Fransico, M T Ruiz-Garcia, J Uya Muntaña
BACKGROUND: Use of noninvasive ventilation (NIV) has extended beyond intensive care units (ICUs), becoming usual practice in emergency departments (EDs) and general wards. OBJECTIVE: To analyse the relationship between nursing care and NIV outcome in different hospital units. DESIGN AND SETTINGS: Three university hospitals and one community hospital participated in a prospective observational cohort study. PARTICIPANTS: Ten units participated: 4 ICUs (1 surgical, 3 medical-surgical), 3 recovery (1 postsurgical, 2 EDs, 3 general wards)...
September 6, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Trupti H Trivedi
Over years, the number of patients requiring prolonged mechanical ventilation (PMV) in ICU has increased. Trends in the numbers of patients requiring PMV are of interest to health service planners because they consume a disproportionate amount of healthcare resources, and have high illness costs.1 PMV is defined as need of invasive mechanical ventilation for consecutive 21 days for at least 6 hours per day. With improvement in ICU care more patients survive acute respiratory failure and with that number of patients requiring PMV is likely to increase further...
October 2015: Journal of the Association of Physicians of India
Anita K Simonds
Prevalence studies have shown heterogeneous use of home mechanical ventilation (HMV) in different conditions, but a marked increase in uptake especially in users of non-invasive ventilation (NIV). While there have been randomised controlled trials of NIV in acute exacerbations of COPD, for weaning from invasive ventilation and post-extubation respiratory failure, the evidence base for long term NIV and comparisons with invasive ventilation are less well-developed. The combination of NIV and cough assist devices has reduced the indications for tracheotomy ventilation in some situations eg...
August 25, 2016: Annals of the American Thoracic Society
Ghilas Boussaïd, Frédéric Lofaso, Dante Brasil Santos, Isabelle Vaugier, Sandra Pottier, Hélène Prigent, David Orlikowski, Stéphane Bahrami
This study evaluated compliance with non-invasive ventilation in patients with myotonic dystrophy type 1 and identified predictors of cessation at 5 years in a cohort of patients followed in a specialist center for Neuromuscular Diseases in France. Mechanical ventilation in these patients poses a very strong challenge to caregivers. Factors predicting relative compliance were identified using multivariate linear regressions. Cox proportional-hazards regression was used to estimate hazard ratios associated with risk of cessation...
October 2016: Neuromuscular Disorders: NMD
Andrea Vianello, Giovanna Arcaro, Luciana Paladini, Silvia Iovino
Patients with Idiopathic Pulmonary Fibrosis (IPF) requiring Invasive Mechanical Ventilation (IMV) following unsuccessful treatment with Non-Invasive Ventilation (NIV) have a high mortality rate. IMV is, moreover, an independent predictor of poor outcome during the post-transplantation period in patients on waiting lists for Lung Transplantation (LT). Here we describe the successful management of an IPF patient with acute respiratory failure (ARF) using a pump-assisted veno-venous system for extracorporeal CO2 removal (ECCO2R) (ProLUNG® system) as an alternative to endotracheal intubation (ETI) following NIV failure...
2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Faeq Husain-Syed, Arthur S Slutsky, Claudio Ronco
Discoveries have emerged highlighting the complex nature of the interorgan cross-talk between the kidney and the lung. Vascular rigidity, neurohormonal activation, tissue hypoxia, and abnormal immune cell signaling have been identified as common pathways leading to the development and progression of chronic kidney disease. However, our understanding of the causal relationships between lung injury and kidney injury is not precise. This review discusses a number of features and mechanisms of renal dysfunction in pulmonary disorders in relation to respiratory acidosis, impaired gas exchange, systemic congestion, respiratory support/replacement therapies, and other issues relevant to the clinical care of these patients...
August 15, 2016: American Journal of Respiratory and Critical Care Medicine
Yusuke Fujiwara, Hiroki Yamaguchi, Katsuya Kobayashi, Atsushi Marumo, Ikuko Omori, Satoshi Yamanaka, Shunsuke Yui, Keiko Fukunaga, Takeshi Ryotokuji, Tsuneaki Hirakawa, Masahiro Okabe, Satoshi Wakita, Hayato Tamai, Muneo Okamoto, Kazutaka Nakayama, Shinhiro Takeda, Koiti Inokuchi
Objective In hematological malignancy patients, the complication of acute respiratory failure often reaches a degree of severity that necessitates mechanical ventilation. The objective of the present study was to investigate the therapeutic outcomes of mechanical ventilation in hematological malignancy patients with respiratory failure and to analyze the factors that are associated with successful treatment in order to identify the issues that should be addressed in the future. Methods The present study was a retrospective analysis of 71 hematological malignancy patients with non-cardiogenic acute respiratory failure who were treated with mechanical ventilation at Nippon Medical School Hospital between 2003 and 2014...
2016: Internal Medicine
A Roca-Biosca, L Rubio-Rico, M C Velasco-Guillen, L Anguera-Saperas
: A 69 year old man was admitted to the Intensive Care Unit (ICU) from the Emergency Department due to severe respiratory failure. Due to unsuccessful non-invasive mechanical ventilation, endotracheal intubation was performed. A category I ulcer in coccyx was detected 48h after admission. Eight hours later, a double erythema (the second one darker than the first one) with displacement between 30-45° over the bony prominence suggested there was a deep tissue injury. The lesion progressed rapidly during the next 24h...
May 21, 2016: Enfermería Intensiva
Ines Maria Grazia Piroddi, Cornelius Barlascini, Antonio Esquinas, Fulvio Braido, Paolo Banfi, Antonello Nicolini
The treatment of acute respiratory failure with non-invasive ventilation (NIV) as a first-line therapy is increasingly common in intensive care units. The reduced invasiveness of NIV leads to better outcomes than endotracheal intubation in carefully selected groups of patients. Furthermore, the use of NIV as a palliative treatment for respiratory failure and dyspnea has become increasingly common. NIV also has an impact on the use of "do not intubate" orders. In the present narrative review, we explore the use and outcome of NIV in elderly patients...
May 23, 2016: Geriatrics & Gerontology International
Ghilas Boussaïd, Frédéric Lofaso, Dante Brasil Santos, Isabelle Vaugier, Sandra Pottier, Hélène Prigent, Stéphane Bahrami, David Orlikowski
BACKGROUND: Many patients with DMD undergo tracheostomy. Tracheostomy is associated with certain complications, however its effect on prognosis is not known. METHODS: The relationship between type of mechanical ventilation and survival at 12 years was evaluated in a prospective cohort of patients with Duchenne muscular dystrophy followed in a French reference center for Neuromuscular Diseases. Cox proportional-hazards regressions were used to estimate the hazard ratios associated with risk of switching from non-invasive to invasive ventilation, and with risk of death...
June 2016: Respiratory Medicine
Ewan C Goligher, Niall D Ferguson, Laurent J Brochard
Mechanical ventilation supports gas exchange and alleviates the work of breathing when the respiratory muscles are overwhelmed by an acute pulmonary or systemic insult. Although mechanical ventilation is not generally considered a treatment for acute respiratory failure per se, ventilator management warrants close attention because inappropriate ventilation can result in injury to the lungs or respiratory muscles and worsen morbidity and mortality. Key clinical challenges include averting intubation in patients with respiratory failure with non-invasive techniques for respiratory support; delivering lung-protective ventilation to prevent ventilator-induced lung injury; maintaining adequate gas exchange in severely hypoxaemic patients; avoiding the development of ventilator-induced diaphragm dysfunction; and diagnosing and treating the many pathophysiological mechanisms that impair liberation from mechanical ventilation...
April 30, 2016: Lancet
Kaito Harada, Shuhei Kurosawa, Yutaro Hino, Keita Yamamoto, Masahiro Sakaguchi, Shuntaro Ikegawa, Keiichro Hattori, Aiko Igarashi, Kyoko Watakabe, Yasushi Senoo, Yuho Najima, Takeshi Hagino, Noriko Doki, Takeshi Kobayashi, Kazuhiko Kakihana, Toshihiro Iino, Hisashi Sakamaki, Kazuteru Ohashi
A high-flow nasal cannula (HFNC) is a newly developed device that enables high-flow oxygen therapy for patients with serious cardiopulmonary problems, but there are few data regarding its use in patients with hematological disease. The efficacy and tolerability of HFNCs for patients who developed ARF during the treatment of various hematological diseases was evaluated. Fifty-six patients underwent HFNC therapy during the last 2 years, and the causes of ARF were mainly pneumonia (n = 37) or acute congestive heart failure (n = 7)...
2016: SpringerPlus
Brittany Pardue Jones, Geoffrey M Fleming, Jaime Kaye Otillio, Ishan Asokan, Donald H Arnold
OBJECTIVE: The goal of this report is to review available modalities for assessing and managing acute asthma exacerbations in pediatric patients, including some that are not included in current expert panel guidelines. While it is not our purpose to provide a comprehensive review of the National Asthma Education and Prevention Program (NAEPP) guidelines, we review NAEPP-recommended treatments to provide the full range of treatments available for managing exacerbations with an emphasis on the continuum of care between the ER and ICU...
August 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Yoko Sato, Noriyuki Saeki, Takuma Asakura, Kazutetsu Aoshiba, Toru Kotani
PURPOSE: Biphasic cuirass ventilation (BCV) is a form of non-invasive extrathoracic positive and negative pressure mechanical ventilation. The present study was conducted to quantify our positive experience using BCV to dramatically improve gas exchange and cardiac function in patients with acute exacerbation of chronic respiratory failure and secondary pulmonary hypertension (PH). METHODS: BCV was applied for 2 weeks in 17 patients with PH caused by lung disease...
August 2016: Journal of Anesthesia
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
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
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