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Bilevel ventilation

Sarah Fernández Lafever, Blanca Toledo, Miguel Leiva, Maite Padrón, Marina Balseiro, Angel Carrillo, Jesús López-Herce
BACKGROUND: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children. METHODS: Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years...
November 29, 2016: BMC Pulmonary Medicine
Barry Krakow, Victor A Ulibarri, Natalia D McIver, Michael R Nadorff
Objective: Evidence indicates that behavioral or drug therapy may not target underlying pathophysiologic mechanisms for chronic insomnia, possibly due to previously unrecognized high rates (30%-90%) of sleep apnea in chronic insomnia patients. Although treatment studies with positive airway pressure (PAP) demonstrate decreased severity of chronic sleep maintenance insomnia in patients with co-occurring sleep apnea, sleep-onset insomnia has not shown similar results. We hypothesized advanced PAP technology would be associated with decreased sleep-onset insomnia severity in a sample of predominantly psychiatric patients with comorbid sleep apnea...
September 29, 2016: Primary Care Companion to CNS Disorders
Pnina Weiss, Meir Kryger
Positive airway pressure (PAP) is considered first-line therapy for moderate to severe obstructive sleep apnea and may also be considered for mild obstructive sleep apnea, particularly if it is symptomatic or there are concomitant cardiovascular disorders. Continuous PAP is most commonly used. Other modes, such as bilevel airway pressure, autotitrating positive airway pressure, average volume assured pressure support, and adaptive support ventilation, play important roles in the management of sleep-related breathing disorders...
December 2016: Otolaryngologic Clinics of North America
Gyambo Sithey, Li Ming Wen, Patrick Kelly, Mu Li
STUDY OBJECTIVES: Our aim was to identify clinical predictors associated with changes in settings for pediatric invasive and noninvasive positive airway pressure therapy, which could help inform the allocation of limited polysomnogram (PSG) resources. METHODS: A retrospective review was conducted in children who underwent one or more PSGs for technology titration. Children were included if they were using continuous positive airway pressure (CPAP) therapy, bilevel positive airway pressure (BPAP) therapy, or invasive positive pressure ventilation (IPPV) the night of the PSG...
September 29, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Anna Lavizzari, Mariarosa Colnaghi, Francesca Ciuffini, Chiara Veneroni, Stefano Musumeci, Ivan Cortinovis, Fabio Mosca
Importance: Heated, humidified high-flow nasal cannula (HHHFNC) has gained increasing popularity as respiratory support for newborn infants thanks to ease of use and improved patient comfort. However, its role as primary therapy for respiratory distress syndrome (RDS) of prematurity needs to be further elucidated by large, randomized clinical trials. Objective: To determine whether HHHFNC provides respiratory support noninferior to nasal continuous positive airway pressure (nCPAP) or bilevel nCPAP (BiPAP) as a primary approach to RDS in infants older than 28 weeks' gestational age (GA)...
August 8, 2016: JAMA Pediatrics
Hatice Yağlıoğlu, Güniz Meyancı Köksal, Emre Erbabacan, Birsel Ekici
OBJECTIVE: The aim of our study is to investigate the effect of two different methods of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) and oxygen support under spontaneous ventilation on respiration mechanics, gas exchange, dry mouth and face mask lesion during an early postoperative period in patients undergoing upper abdominal surgery. METHODS: Eighty patients undergoing elective abdominal surgery with laparotomy, between the age of 25 and 75 years and American Society of Anesthesiologists Physical Status score (ASA) II-III with chronic obstructive pulmonary disease (COPD) diagnosis were included to the study...
August 2015: Turkish Journal of Anaesthesiology and Reanimation
Jean-Bernard Michotte, Enrico Staderini, Deborah Le Pennec, Jonathan Dugernier, Rares Rusu, Jean Roeseler, Laurent Vecellio, Giuseppe Liistro, Grégory Reychler
UNLABELLED: Backround: Coupling nebulization with noninvasive ventilation (NIV) has been shown to be effective in patients with respiratory diseases. However, a breath-synchronized nebulization option that could potentially improve drug delivery by limiting drug loss during exhalation is currently not available on bilevel ventilators. The aim of this in vitro study was to compare aerosol delivery of amikacin with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes...
August 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Jens Bräunlich, Marcus Köhler, Hubert Wirtz
BACKGROUND: Nasal highflow (NHF) provides a warmed and humidified air stream up to 60 L/min. Recent data demonstrated a positive effect in patients with acute hypoxemic respiratory failure, especially when caused by pneumonia. Preliminary data show a decrease in hypercapnia in patients with COPD. Therefore, NHF should be evaluated as a new ventilatory support device. This study was conducted to assess the impact of different flow rates on ventilatory parameters in patients with COPD. MATERIALS AND METHODS: This interventional clinical study was performed with patients suffering from severe COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Aylin Özsancak Uğurlu, Huriye Berk Takır, Begüm Ergan, Erdal İn, Ezgi Özyilmaz, Özlem Ertan Edipoğlu, Eylem Acartürk, Ege Güleç Balbay, Aslı Görek Dilektaşlı, Tülay Kıvanç, Pervin Korkmaz Ekren, Sevinç Sarınç Ulaşlı, Ilgaz Doğrul, Elif Yılmazel Uçar, Şehnaz Olgun, Özkan Devran, Recai Ergun, Zuhal Karakurt
INTRODUCTION: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation (NIV) use for chronic respiratory failure (CRF), the most currently applied technique for home mechanical ventilation. PATIENTS AND METHODS: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. RESULT: Twenty-seven percent of the pulmonologists responded (n=596). Domiciliary NIV was reported to be prescribed by 340 physicians [57...
December 0: Tüberküloz Ve Toraks
L Nava-Guerra, W H Tran, P Chalacheva, S Loloyan, B Joshi, T G Keens, K S Nayak, S L Davidson Ward, M C K Khoo
Obstructive sleep apnea (OSA) involves the interplay of several different factors such as an unfavorable upper airway anatomy, deficiencies in pharyngeal muscle responsiveness, a low arousal threshold, and ventilatory control instability. Although the stability of ventilatory control has been extensively studied in adults, little is known about its characteristics in the pediatric population. In this study, we developed a novel experimental setup that allowed us to perturb the respiratory system during natural non-rapid eye movement (NREM) sleep conditions by manipulating the inspiratory pressure, provided by a bilevel pressure ventilator, to induce sighs after upper airway stabilization...
July 1, 2016: Journal of Applied Physiology
Paola Palazzo, Amy Brooks, David James, Randy Moore, Andrei V Alexandrov, Anne W Alexandrov
INTRODUCTION: In the hyperacute phase of ischemic stroke, a 0° position is recommended to increase cerebral perfusion in nonhypoxic patients able to tolerate lying flat. However, use of 0° positioning is not uniformly applied in clinical practice, most likely due to concerns of aspiration pneumonia. We aimed to determine the risk of pneumonia associated with 0° head of bed positioning in acute stroke patients treated with thrombolytic therapy. METHODS: A retrospective descriptive study was conducted using prospectively collected, consecutive acute ischemic stroke patients treated with IVtPA whose head of bed was positioned at 0° for the first 24 h...
February 2016: Brain and Behavior
Romy Hoque
STUDY OBJECTIVES: The aim of this review is to review the literature on sleep-disordered breathing in Duchenne muscular dystrophy (DMD). METHODS: PubMed was searched with an array of search terms, including "OSA," "obstructive sleep apnea," "sleep-disordered breathing," "muscular dystrophy," "neuromuscular," "Duchenne muscular dystrophy," "polysomnography," and "portable monitoring." All relevant articles were discussed. RESULTS: Eighteen research articles and 1 consensus statement were reviewed, and assessed with relevant data presented...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Hyunju Yang, Amy M Sawyer
To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words (n = 234). Randomized controlled trials assessed objective sleep quality, cardiac, and self-reported outcomes in adults (≥18 years) with HF (n = 10)...
May 2016: Heart & Lung: the Journal of Critical Care
V Fontana, S Santinelli, M Internullo, P Marinelli, L Sardo, G Alessandrini, L Borgognoni, A M Ferrazza, M Bonini, P Palange
OBJECTIVE: Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV. PATIENTS AND METHODS: Eleven AECOPD patients, with hypercapnic respiratory failure and MA following NIV, were treated with ACET 500 mg for two consecutive days and compared to a matched control group...
2016: European Review for Medical and Pharmacological Sciences
Ayhan Yaman, Tanıl Kendirli, Çağlar Ödek, Can Ateş, Nevin Taşyapar, Melek Güneş, Erdal İnce
PURPOSE: To determine the efficiency of noninvasive mechanical ventilation (NIV) both in protection from intubation and in preventing reintubation of postextubation in patients in the pediatric intensive care unit (PICU). METHODS: A prospective observational study was conducted in a multidisciplinary 10-bed tertiary PICU of a university hospital. All patients were admitted to our unit from June 2012 to May 2014 and deemed to be candidates to receive continuous positive airway pressure or bilevel positive airway pressure...
April 2016: Journal of Critical Care
Paula de Souza Silva, Sérgio Saldanha Menna Barreto
OBJECTIVE: To evaluate the quality of available evidence to establish guidelines for the use of noninvasive ventilation for the management of status asthmaticus in children unresponsive to standard treatment. METHODS: Search, selection and analysis of all original articles on asthma and noninvasive ventilation in children, published until September 1, 2014 in all languages in the electronic databases PubMed, Web of Science, Cochrane Library, Scopus and SciELO, located using the search terms: "asthma", "status asthmaticus", "noninvasive ventilation", "Bronchospasm", "continuous positive airway pressure", "child", "infant", "pediatrics", "hypercapnia", "respiratory failure" and the keywords "BIPAP", "CPAP", "Bilevel", "acute asthma" and "near fatal asthma"...
October 2015: Revista Brasileira de Terapia Intensiva
Susie So-Hyun Lee, Mitchell F Berman
In this case report, we describe the use of the Draeger Apollo anesthesia machine to deliver bilevel positive airway pressure (BiPAP) to a patient with severe chronic obstructive pulmonary disease and a history of lung resection undergoing frontal craniotomy for the removal of a brain tumor under moderate to deep sedation. BiPAP in the perioperative period has been described for purposes of preoxygenation and postextubation recruitment. Although its utility as a mode of ventilation during moderate to deep sedation has been demonstrated, it has not come into widespread use...
December 1, 2015: A & A Case Reports
Mark Pluym, Asad Waseem Kabir, Ashraf Gohar
Noninvasive positive pressure ventilation (NPPV) is an important tool in the management of acute and chronic respiratory failure. Traditionally, continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP) have been the most commonly utilized modes for these purposes. Newer hybrid modes of NPPV, such as average volume-assured pressure support (VAPS), combine the properties of both volume- and pressure-controlled NPPV and represent another tool in the treatment of acute and chronic respiratory failure...
2015: Hospital Practice (Minneapolis)
Debora A S Faria, Edina M K da Silva, Álvaro N Atallah, Flávia M R Vital
BACKGROUND: Each year, more than four million abdominal surgeries are performed in the US and over 250,000 in England. Acute respiratory failure, a common complication that can affect 30% to 50% of people after upper abdominal surgery, can lead to significant morbidity and mortality. Noninvasive ventilation has been associated with lower rates of tracheal intubation in adults with acute respiratory failure, thus reducing the incidence of complications and mortality. This review compared the effectiveness and safety of noninvasive positive pressure ventilation (NPPV) versus standard oxygen therapy in the treatment of acute respiratory failure after upper abdominal surgery...
2015: Cochrane Database of Systematic Reviews
Alejandro A Rabinstein
PURPOSE OF REVIEW: Neurologists working in the hospital are often called to evaluate patients with severe muscle weakness. Some of these patients can develop ventilatory compromise and require admission to the intensive care unit (ICU). This article reviews the general evaluation of neuromuscular respiratory failure, discusses its differential diagnosis, and provides practical advice on the management of its most common causes. RECENT FINDINGS: Determining the cause of acute neuromuscular respiratory failure is crucial because functional prognosis is poor in patients for whom the cause cannot be defined...
October 2015: Continuum: Lifelong Learning in Neurology
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