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non-invasive ventilation AND weaning

R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Smeeta Sardesai, Manoj Biniwale, Fiona Wertheimer, Arlene Garingo, Rangasamy Ramanathan
Respiratory distress syndrome (RDS) due to surfactant deficiency is the most common cause of respiratory failure in preterm infants. Tremendous progress has been made since the original description that surfactant deficiency is the major cause of RDS. Surfactant therapy has been extensively studied in preterm infants and has been shown to significantly decrease air leaks and neonatal and infant mortality. Synthetic and animal-derived surfactants from bovine as well as porcine origin have been evaluated in randomized controlled trials...
October 5, 2016: Pediatric Research
Savino Spadaro, Salvatore Grasso, Tommaso Mauri, Francesca Dalla Corte, Valentina Alvisi, Riccardo Ragazzi, Valentina Cricca, Giulia Biondi, Rossella Di Mussi, Elisabetta Marangoni, Carlo Alberto Volta
BACKGROUND: The rapid shallow breathing index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), is one of the most widely used indices to predict weaning outcome. Whereas the diaphragm plays a fundamental role in generating VT, in the case of diaphragmatic dysfunction the inspiratory accessory muscles may contribute. If this occurs during a weaning trial, delayed weaning failure is likely since the accessory muscles are more fatigable than the diaphragm. Hence, we hypothesised that the traditional RSBI could be implemented by substituting VT with the ultrasonographic evaluation of diaphragmatic displacement (DD)...
September 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
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
(no author information available yet)
BACKGROUND: In 40 % of all ventilated patients weaning is problematic. Prolonged weaning is associated with an increased mortality. METHODS: For the first time, data on epidemiology and outcomes of 6899 patients with prolonged weaning from the WeanNet register are published in this study. RESULTS: Patients with prolonged weaning suffer from profound comorbidities (median 5 relevant comorbidities). The majority of patients (62.2 %) were successfully weaned from the ventilator and dischared from the weaning unit without invasive ventialtion after a median of 33 days...
September 2016: Deutsche Medizinische Wochenschrift
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
Ghada F El-Baradey, Nagat S El-Shmaa, Fatma Elsharawy
OBJECTIVE: To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). DESIGN: Prospective, observer-blinded study. SETTING: Carried out in intensive care unit in Tanta university hospital. PATIENTS: 432 patients of both sexes received mechanical ventilation for more than 24 hours and met defined criteria for a weaning trial...
July 16, 2016: Journal of Critical Care
Steven McVea, Andrew James Thompson, Noina Abid, Julie Richardson
A 13-year-old boy with a background of Prader-Willi syndrome (PWS) was admitted to the regional paediatric intensive care unit, with community-acquired pneumonia. Despite a week of intravenous antibiotics, resolution of inflammatory markers and resolving consolidation on radiograph, he remained feverish. Fever of unknown origin investigations were negative and he was diagnosed with central thermal dysregulation secondary to hypothalamic dysfunction in PWS. Following a hyperpyrexia period, secondary rhabdomyolysis and renal failure developed...
2016: BMJ Case Reports
O Torres, L Delgado, E Monares, A Sanchez-Calzada, R Gastelum, J L Navarro, P Romano, J Franco
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Yuanlin Song, Rongchang Chen, Qingyuan Zhan, Shujing Chen, Zujin Luo, Jiaxian Ou, Chen Wang
COPD is characterized by a progressive decline in lung function and mental and physical comorbidities. It is a significant burden worldwide due to its growing prevalence, comorbidities, and mortality. Complication by bronchial-pulmonary infection causes 50%-90% of acute exacerbations of COPD (AECOPD), which may lead to the aggregation of COPD symptoms and the development of acute respiratory failure. Non-invasive or invasive ventilation (IV) is usually implemented to treat acute respiratory failure. However, ventilatory support (mainly IV) should be discarded as soon as possible to prevent the onset of time-dependent complications...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Joke M Wielenga, Agnes van den Hoogen, Henriette A van Zanten, Onno Helder, Bas Bol, Bronagh Blackwood
BACKGROUND: Mechanical ventilation is a life-saving intervention for critically ill newborn infants with respiratory failure admitted to a neonatal intensive care unit (NICU). Ventilating newborn infants can be challenging due to small tidal volumes, high breathing frequencies, and the use of uncuffed endotracheal tubes. Mechanical ventilation has several short-term, as well as long-term complications. To prevent complications, weaning from the ventilator is started as soon as possible...
2016: Cochrane Database of Systematic Reviews
Denise Mifsud Bonnici, Thomas Sanctuary, Alex Warren, Patrick B Murphy, Joerg Steier, Philip Marino, Hina Pattani, Ben C Creagh-Brown, Nicholas Hart
OBJECTIVES: According to National Health Service England (NHSE) specialist respiratory commissioning specification for complex home ventilation, patients with weaning failure should be referred to a specialist centre. However, there are limited data reporting the clinical outcomes from such centres. SETTING: Prospective observational cohort study of patients admitted to a UK specialist weaning, rehabilitation and home mechanical ventilation centre between February 2005 and July 2013...
2016: BMJ Open
Dominic Wilkinson, Chad Andersen, Colm P F O'Donnell, Antonio G De Paoli, Brett J Manley
BACKGROUND: High flow nasal cannulae (HFNC) are small, thin, tapered binasal tubes that deliver oxygen or blended oxygen/air at gas flows of more than 1 L/min. HFNC are increasingly being used as a form of non-invasive respiratory support for preterm infants. OBJECTIVES: To compare the safety and efficacy of HFNC with other forms of non-invasive respiratory support in preterm infants. SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 1), MEDLINE via PubMed (1966 to 1 January 2016), EMBASE (1980 to 1 January 2016), and CINAHL (1982 to 1 January 2016)...
2016: Cochrane Database of Systematic Reviews
Han Zhang, Min Yang, Hong Luo, Ping Chen, Min Fu
No abstract text is available yet for this article.
January 2016: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
M Westhoff, B Schönhofer, P Neumann, J Bickenbach, T Barchfeld, H Becker, R Dubb, H Fuchs, H J Heppner, U Janssens, T Jehser, O Karg, E Kilger, H-D Köhler, T Köhnlein, M Max, F J Meyer, W Müllges, C Putensen, D Schreiter, J H Storre, W Windisch
The non-invasive ventilation (NIV) is widespread in the clinical medicine and has attained meanwhile a high value in the clinical daily routine. The application of NIV reduces the length of ICU stay and hospitalization as well as mortality of patients with hypercapnic acute respiratory failure. Patients with acute respiratory failure in context of a cardiopulmonary edema should be treated in addition to necessary cardiological interventions with continuous positive airway pressure (CPAP) or NIV. In case of other forms of acute hypoxaemic respiratory failure it is recommended the application of NIV to be limited to mild forms of ARDS as the application of NIV in severe forms of ARDS is associated with higher rates of treatment failure and mortality...
December 2015: Pneumologie
C Romero-Dapueto, H Budini, F Cerpa, D Caceres, V Hidalgo, T Gutiérrez, J Keymer, R Pérez, J Molina, C Giugliano-Jaramillo
Noninvasive mechanical ventilation (NIMV) was created for patients who needed noninvasive ventilator support, this procedure decreases the complications associated with the use of endotracheal intubation (ETT). The application of NIMV has acquired major relevance in the last few years in the management of acute respiratory failure (ARF), in patients with hypoxemic and hypercapnic failure. The main advantage of NIMV as compared to invasive mechanical ventilation (IMV) is that it can be used earlier outside intensive care units (ICUs)...
2015: Open Respiratory Medicine Journal
Aroonwan Preutthipan
The number of children dependent on home mechanical ventilation has been reported to be increasing in many countries around the world. Home mechanical ventilation has been well accepted as a standard treatment of children with chronic respiratory failure. Some children may need mechanical ventilation as a lifelong therapy. To send mechanically ventilated children back home may be more difficult than adults. However, relatively better outcomes have been demonstrated in children. Children could be safely ventilated at home if they are selected and managed properly...
September 2015: Indian Journal of Pediatrics
Louise Rose
Identification and adoption of strategies to promote timely and successful weaning from mechanical ventilation remain a research and quality improvement priority. The most important steps in the weaning process to prevent unnecessary prolongation of mechanical ventilation are timely recognition of both readiness to wean and readiness to extubate. Strategies shown to be effective in promoting timely weaning include weaning protocols and use of spontaneous breathing trials. This review explores various other strategies that also may promote timely and successful weaning including bundling of spontaneous breathing trials with sedation and delirium monitoring/management as well as early mobility, the use of automated weaning systems and modes that improve patient-ventilator interaction, mechanical insufflation-exsufflation as a weaning adjunct, early extubation to non-invasive ventilation and high flow humidified oxygen...
August 2015: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Seung Han Shin, Chang Won Choi, Ee-Kyung Kim, Beyong Il Kim, Jung-Hwan Choi
OBJECTIVE: To compare non-invasive ventilation neurally adjusted ventilatory assist (NIV-NAVA) and non-invasive pressure support (NIV-PS) in preterm infants on patient-ventilator synchrony. DESIGN: A randomised phase II crossover trial. SETTING: Neonatal intensive care units of two tertiary university hospitals in Korea. PATIENTS: Preterm infants born <32 weeks. INTERVENTION: NIV-NAVA and NIV-PS were applied in random order after ventilator weaning...
November 2015: Archives of Disease in Childhood. Fetal and Neonatal Edition
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