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Noninvasive Ventilation

Gail S Drescher, Cathy W Hughes
BACKGROUND: Bench and clinical data indicate that techniques for applying noninvasive respiratory support may vary in terms of effectiveness, application, and tolerability. We implemented a new nasal interface and flow-generation system for the delivery of noninvasive respiratory support (NRS) to replace previously used systems. Our goal was to determine whether there were significant differences in clinically relevant outcomes between our new method and conventional systems. METHODS: We conducted a prospective observational study of preterm infants requiring noninvasive respiratory support during our initial implementation of a new nasal interface (RAM), and compared these data with a historic control group...
October 2018: Respiratory Care
Carlos L Alviar, P Elliott Miller, Dorothea McAreavey, Jason N Katz, Burton Lee, Brad Moriyama, Jeffrey Soble, Sean van Diepen, Michael A Solomon, David A Morrow
Contemporary cardiac intensive care units (CICUs) provide care for an aging and increasingly complex patient population. The medical complexity of this population is partly driven by an increased proportion of patients with respiratory failure needing noninvasive or invasive positive pressure ventilation (PPV). PPV often plays an important role in the management of patients with cardiogenic pulmonary edema, cardiogenic shock, or cardiac arrest, and those undergoing mechanical circulatory support. Noninvasive PPV, when appropriately applied to selected patients, may reduce the need for invasive mechanical PPV and improve survival...
September 25, 2018: Journal of the American College of Cardiology
Raisa Rentola, Johanna Hästbacka, Erkki Heinonen, Per H Rosenberg, Tom Häggblom, Markus B Skrifvars
Arterial blood gas (ABG) analysis is the traditional method for measuring the partial pressure of carbon dioxide. In mechanically ventilated patients a continuous noninvasive monitoring of carbon dioxide would obviously be attractive. In the current study, we present a novel formula for noninvasive estimation of arterial carbon dioxide. Eighty-one datasets were collected from 19 anesthetized and mechanically ventilated pigs. Eleven animals were mechanically ventilated without interventions. In the remaining eight pigs the partial pressure of carbon dioxide was manipulated...
September 19, 2018: Journal of Clinical Medicine
Giuseppe Fiorentino, Anna Annunziata, Anna Michela Gaeta, Maurizia Lanza, Antonio Esquinas
Respiratory failure is a recognized late complication of amyotrophic lateral sclerosis. It is related to the neurological progression of the diseases with the impairment of the respiratory musculature. Survival and quality of life of amyotrophic lateral sclerosis patients is improved by using noninvasive mechanical ventilation. The rate of long-term mechanical ventilation is different within and between countries. Cultural factors, socioeconomic conditions, and physician attitude often influence the decision to start noninvasive ventilation...
2018: Degenerative Neurological and Neuromuscular Disease
Milind P Sovani, Antonio M Esquinas
No abstract text is available yet for this article.
October 2018: Critical Care Medicine
Etienne J Couture, Jan-Alexis Tremblay, Mahsa Elmi-Sarabi, Yoan Lamarche, André Y Denault
We describe the cases of 2 patients free from mechanical ventilation after a cardiac surgery with systemic venous congestion from right ventricular (RV) failure. Management of these patients included RV preload reduction with diuretics and RV afterload reduction with inhaled pulmonary vasodilators. Noninvasive combination of inhaled epoprostenol and inhaled milrinone through the AirLife filtered nebulizer system (CareFusion) was used. Reduction of splanchnic venous congestion was assessed by Doppler portal flow pulsatility...
September 11, 2018: A&A practice
Sophie Blouet, Jasmine Sutter, Emeline Fresnel, Adrien Kerfourn, Antoine Cuvelier, Maxime Patout
Introduction: Acute exacerbation of COPD (AECOPD) is associated with poor outcome. Noninvasive ventilation (NIV) is recommended to treat end-stage COPD. We hypothesized that changing breathing pattern of COPD patients on NIV could identify patients with severe AECOPD prior to admission. Methods: This is a prospective monocentric study including all patients with COPD treated with long-term home NIV. Patients were divided in two groups: a stable group in which patients were admitted for the usual respiratory review and an exacerbation group in which patients were admitted for inpatient care of severe AECOPD...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Laura M Kleinschmidt, Matthew E Kinney, Gerardo R Camilo, Tim Thier, Martha Fischer, Christopher S Hanley, Luis R Padilla
The aims of this study were to determine if a propofol constant rate infusion (CRI) in Speke's gazelle, Gazella spekei, would serve as an effective alternative maintenance anesthetic, result in shorter recovery times, and improve anesthetic recovery quality when compared with isoflurane. Eight adult gazelle were enrolled in this complete crossover study with a minimum 3-wk washout period. All gazelle were induced with 10 mg/kg intravenous propofol and maintained with either propofol CRI (0.4 mg/kg/min) or isoflurane (1-3%) for 45 min...
September 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Billy C Wang, Theodore Pei, Cheryl B Lin, Rong Guo, David Elashoff, James A Lin, Carol Pineda
AIM: To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation (NIMV) use in acute pediatric respiratory failure. METHODS: We identified all patients treated with NIMV in the pediatric intensive care unit (PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic centers. Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included. Data included demographics, vital signs on admission and prior to initiation of NIMV, pediatric risk of mortality III (PRISM-III) scores, complications, respiratory support characteristics, PICU and hospital length of stays, duration of respiratory support, and complications...
September 7, 2018: World Journal of Critical Care Medicine
Jin-Hao Tao, Guo-Ping Lu
Acute respiratory distress syndrome (ARDS) is a common critical illness in children and has high incidence and mortality rates among critically ill pediatric patients. Noninvasive ventilation has become a common treatment method for ARDS because of its unique features. This article reviews the research status in the application of noninvasive ventilation in children with ARDS.
September 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Jan-Alexis Tremblay, Étienne J Couture, Martin Albert, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Yoan Lamarche, André Y Denault
OBJECTIVE: The authors aimed to assess the hemodynamic effects and demonstrate the feasibility of inhaled nitric oxide (iNO) in hemodynamically unstable patients with acute right ventricular (RV) dysfunction and to explore the safety profile of this approach. DESIGN: Retrospective cohort study. SETTING: Intensive care unit (ICU) of 2 tertiary care centers between January 2013 and 2017. PARTICIPANTS: All patients with RV dysfunction in whom iNO was initiated without invasive mechanical ventilation...
August 8, 2018: Journal of Cardiothoracic and Vascular Anesthesia
L Q Wu, J Yang, C R Tong, Y S Yu, X W Zhang
Objective: By retrospectively analyzing the clinical data of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure, to find the associated factors for failure of invasive-noninvasive sequential ventilation therapy. Methods: We conducted a cohort study of 64 patients with AECOPD complicated with respiratory failure, who were treated by invasive-noninvasive sequential ventilation. We took re-intubation, death or spontaneous discharge within 7 days following extubation as the endpoints...
September 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
J Y Hu, Z G Zheng, N Liu, L L Zhong, R C Chen
Objective: To investigate the effect of connecting airbag in different filling state at the front end of piezometric tube in the noninvasive ventilation circuit on pressure transmission and human-machine synchronization. Method: In test 1, the airbag was connected to a piezometric tube which was placed in a closed container, the filling state of the airbag was regulated, and the pressure inside the container was changed to observe the corresponding pressure change in the piezometric tube. In test 2, the airbag in different filling state was connected at the front end of piezometric tube in noninvasive ventilation circuit...
September 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Selina Hein, Fabian Aus Dem Siepen, Ralf Bauer, Hugo A Katus, Arnt V Kristen
INTRODUCTION: Cardiopulmonary exercise testing (CPET) has repeatedly been reported to reliably predict adverse outcomes in different forms of heart failure. However, it has not been elucidated in detail in cardiac amyloidosis (CA). Therefore, we evaluated the predictive value of CPET parameters in patients with CA regarding disease severity and prediction of mortality. METHODS: Twenty-seven consecutive patients with CA were assessed noninvasively, including electrocardiography, echocardiography, CPET, and laboratory tests...
September 7, 2018: Amyloid: the International Journal of Experimental and Clinical Investigation
Celal Satici, Burcu Arpinar Yigitbas, Baris Seker, Mustafa Asim Demirkol, Ayse Filiz Kosar
Domiciliary noninvasive mechanical ventilation (NIMV) is used for treating patients with hypercapnic chronic obstructive pulmonary disease (COPD). We aimed to evaluate the association between adherence to the treatment and subsequent hospitalizations and costs. Data from 54 (27 adherent; 27 non-adherent) patients with COPD who were undergoing NIMV treatment at home for 6 months. We assessed adherence based on digitally recorded data and checked hospital records for clinical and laboratory data, rehospitalization rates, and costs during the following 6 months...
September 6, 2018: COPD
Michael C Sklar, Martin Dres, Nuttapol Rittayamai, Brent West, Domenico Luca Grieco, Irene Telias, Detajin Junhasavasdikul, Michela Rauseo, Tai Pham, Fabiana Madotto, Carolyn Campbell, Elizabeth Tullis, Laurent Brochard
BACKGROUND: Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathing and improving breathing pattern in CF patients. Our objective was to compare the effects of HFNT versus NIV in terms of work of breathing, assessed noninvasively by the thickening fraction of the diaphragm (TFdi, measured with ultrasound), breathing pattern, transcutaneous CO2 (PtcCO2 ), hemodynamics, dyspnea and comfort...
September 5, 2018: Annals of Intensive Care
Kohei Hamada, Yoshitsugu Chigusa, Eiji Kondoh, Yusuke Ueda, Shunsuke Kawahara, Haruta Mogami, Akihito Horie, Tsukasa Baba, Masaki Mandai
Pulmonary edema caused by severe preeclampsia can be an indication for pregnancy termination. We aimed to investigate whether noninvasive positive-pressure ventilation (NPPV) was useful for preeclampsia-induced pulmonary edema. Three cases of preeclampsia-induced pulmonary edema managed with NPPV in our institute were reviewed retrospectively. A literature review was conducted regarding NPPV usage during pregnancy. NPPV was initiated at 30, 20, and 24 weeks of gestation in the 3 cases. In all cases, NPPV slowed the progression of pulmonary edema and succeeded in delaying pregnancy termination by 17 days on average...
2018: Case Reports in Obstetrics and Gynecology
Annia Schreiber, Barbara Fusar Poli, Lieuwe D Bos, Raffaella Nenna
A chronological account of some of the significant research into the application of NIV in acute hypercapnic respiratory failure over recent decades
September 2018: Breathe
Sandra L Leibel, Xiang Y Ye, Prakesh Shah, Vibhuti Shah
OBJECTIVE: To determine the incidence of chronic lung disease (CLD) in mechanically ventilated infants who were born at < 29 weeks' gestational age (GA), extubated to continuous positive airway pressure (CPAP) or nasal intermittent positive pressure ventilation (NIPPV), and treated with CPAP/NIPPV alone, changed to heated humidified high flow nasal cannula (HHHFNC), or exposed to a combination of CPAP/NIPPV and HHHFNC at ≤ 30 weeks' post menstrual age (PMA). STUDY DESIGN: Retrospective cohort study of infants born at < 29 weeks' GA admitted to tertiary Canadian neonatal intensive care units between 2011 and 2015...
September 3, 2018: Journal of Maternal-fetal & Neonatal Medicine
Claudia Brusasco, Guido Tavazzi, Chiara Robba, Gregorio Santori, Antonella Vezzani, Tullio Manca, Francesco Corradi
Objective: To test if splenic Doppler resistive index (SDRI) allows noninvasive monitoring of changes in stroke volume and regional splanchnic perfusion in response to fluid challenge. Design and Settin g. Prospective observational study in cardiac intensive care unit. Patients: Fifty-three patients requiring mechanical ventilation and fluid challenge for hemodynamic optimization after cardiac surgery. Interventions: SDRI values were obtained before and after volume loading with 500 mL of normal saline over 20 min and compared with changes in systemic hemodynamics, determined invasively by pulmonary artery catheter, and arterial lactate concentration as expression of splanchnic perfusion...
2018: BioMed Research International
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