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Mechanical Ventilation

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49 papers 100 to 500 followers
Daniele De Luca, Valentina Dell'Orto
Non-invasive high-frequency oscillatory ventilation (NHFOV) consists of the application of a bias flow generating a continuous distending positive pressure with superimposed oscillations, which have constant frequency and active expiratory phase. NHFOV matches together the advantages of high-frequency ventilation (no need for synchronisation, high efficacy in removing CO2) and nasal continuous positive airway pressure (CPAP) (non-invasive interface, increase in functional residual capacity allowing oxygenation to improve)...
June 28, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Mohamed S El-Chimi, Hisham A Awad, Tarek M El-Gammasy, Ola G El-Farghali, Mohamed T Sallam, Dina M Shinkar
AIM: To evaluate efficacy and safety of delivery room (DR) sustained lung inflation (SLI) in resuscitation of preterm neonates. METHODS: Randomized Controlled Trial including 112 preterm infants randomized to either SLI (n = 57) using T-piece resuscitator [maximum three inflations with maximum pressure of 30 cmH2O for 15 s followed by continuous positive airway pressure (CPAP) of 5-7 cmH2O] or conventional bag/mask inflation (CBMI) (n = 55) using traditional self-inflating bag (maximum pressure of 40 cmH2O at a rate of 40-60 per min)...
August 2, 2016: Journal of Maternal-fetal & Neonatal Medicine
Dustin D Flannery, Elizabeth O'Donnell, Mike Kornhauser, Kevin Dysart, Jay Greenspan, Zubair H Aghai
Objective The objective of this study was to determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in very low-birth-weight (VLBW) infants managed successfully on continuous positive airway pressure (CPAP) versus mechanical ventilation on the first day of life (DOL). Study Design This is a retrospective analysis of the Alere neonatal database for infants born between January 2009 and December 2014, weighing ≤ 1,500 g. Baseline demographics, clinical characteristics, and outcomes were compared between the two groups...
August 2016: American Journal of Perinatology
Sasivimon Soonsawad, Numtip Tongsawang, Pracha Nuntnarumit
BACKGROUND: Heated humidified high-flow nasal cannula (HHHFNC) therapy has been widely used in preterm infants. However, evidence to support its use as a continuous positive airway pressure (CPAP) weaning method is still controversial. OBJECTIVES: We aimed to compare time to wean directly off CPAP vs. weaning by using HHHFNC. METHODS: Infants with a gestational age (GA) of <32 weeks who met the predefined criteria for weaning off CPAP, i...
2016: Neonatology
Dalal K Taha, Michael Kornhauser, Jay S Greenspan, Kevin C Dysart, Zubair H Aghai
OBJECTIVE: To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). STUDY DESIGN: This is a retrospective data analysis from the Alere Neonatal Database for infants born between January 2008 and July 2013, weighing ≤1000 g at birth, and received HFNC or CPAP. Baseline demographics, clinical characteristics, and neonatal outcomes were compared between the infants who received CPAP and HFNC, or HFNC ± CPAP...
June 2016: Journal of Pediatrics
Clyde J Wright, Richard A Polin, Haresh Kirpalani
No abstract text is available yet for this article.
June 2016: Journal of Pediatrics
Corrado Moretti, Camilla Gizzi, Francesco Montecchia, Caterina Silvia Barbàra, Fabio Midulla, Manuel Sanchez-Luna, Paola Papoff
Although mechanical ventilation via an endotracheal tube has undoubtedly led to improvement in neonatal survival in the last 40 years, the prolonged use of this technique may predispose the infant to development of many possible complications including bronchopulmonary dysplasia. Avoiding mechanical ventilation is thought to be a critical goal, and different modes of noninvasive respiratory support beyond nasal continuous positive airway pressure, such as nasal intermittent positive pressure ventilation and synchronized nasal intermittent positive pressure ventilation, are also available and may reduce intubation rate...
2016: Neonatology
Carmen Salum Thomé Silveira, Kamila Maia Leonardi, Ana Paula Carvalho Freire Melo, José Eduardo Zaia, Marisa Afonso Andrade Brunherotti
BACKGROUND: Noninvasive ventilation (NIV) in preterm infants is currently applied using intermittent positive pressure (2 positive-pressure levels) or in a conventional manner (one pressure level). However, there are no studies in the literature comparing the chances of failure of these NIV methods. The aim of this study was to evaluate the occurrence of failure of 2 noninvasive ventilatory support systems in preterm neonates over a period of 48 h. METHODS: A randomized, prospective, clinical study was conducted on 80 newborns (gestational age < 37 weeks, birthweight < 2,500 g)...
December 2015: Respiratory Care
Selma Aktas, Sezin Unal, Meltem Aksu, Ebru Ozcan, Ebru Ergenekon, Canan Turkyilmaz, Ibrahim Hirfanoglu, Yildiz Atalay
Non-invasive ventilation has been used increasingly in recent years to reduce the duration of endotracheal ventilation and its complications, especially bronchopulmonary dysplasia. Nasal continuous positive airway pressure and nasal intermittent positive pressure ventilation are the most common non-invasive modalities, and nasal high-frequency oscillatory ventilation (n-HFOV) is relatively new but it seems effective and feasible. We present three premature cases who were ventilated with n-HFOV with Neotech RAM Cannula as interphase...
April 2016: Journal of Tropical Pediatrics
Hai-Feng Tao, Min Tao, Na Cai, Wei Liao
OBJECTIVE: To study the clinical efficacy of nasal synchronous intermittent mandatory ventilation (nSIMV) in premature infants with severe respiratory distress syndrome (RDS) after extubation. METHODS: A retrospective analysis on the clinical date of 126 premature infants with severe RDS who were hospitalized in the NICU between January 2013 and May 2015 was performed. Sixty-one premature infants who were hospitalized in the NICU between January 2013 and March 2014 received nasal continuous positive airway pressure (nCPAP) (nCPAP group) and 65 premature infants who were hospitalized in the NICU between April 2014 and May 2015 received nSIMV (nSIMV group)...
January 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Alireza Sadeghnia, Behzad Barekateyn, Zohre Badiei, Seyyed Mohsen Hosseini
BACKGROUND: Nowadays, establishment of nCPAP and surfactant administration is considered to be the first level of intervention for newborns engaged in the process of Respiratory Distress Syndrome (RDS). In order to decrease the side effects of the nCPAP management placed in noninvasive-non-cycled respiratory support. Noninvasive-cycled respiratory support mechanism have been developed such as N-BiPAP. Therefore, we compared N-BiPAP with Bubble-CPAP in a clinical trial. MATERIALS AND METHODS: This research was done as an on newborns weighing less than 1500 grams affiliated with RDS...
2016: Advanced Biomedical Research
Brett J Manley, Lex W Doyle, Louise S Owen, Peter G Davis
OBJECTIVES: To identify variables that predict extubation success in extremely preterm infants born <28 weeks gestational age (GA), and to compare outcomes between those who had successful or failed extubation. STUDY DESIGN: A secondary analysis of data from a randomized trial of postextubation respiratory support that included 174 extremely preterm infants. "Extubation success" was defined as not requiring reintubation within 7 days, and "extubation failure" the converse...
June 2016: Journal of Pediatrics
Stamatia Alexiou, Howard B Panitch
Non-invasive ventilation (NIV) is used in neonates to treat extrathoracic and intrathoracic airway obstruction, parenchymal lung disease and disorders of control of breathing. Avoidance of airway intubation is associated with a reduction in the incidence of chronic lung disease among preterm infants with respiratory distress syndrome. Use of nasal continuous positive airway pressure (nCPAP) may help establish and maintain functional residual capacity (FRC), decrease respiratory work, and improve gas exchange...
June 2016: Seminars in Fetal & Neonatal Medicine
Rakesh Sahni, Maria Schiaratura, Richard A Polin
Progress in neonatal intensive care is closely linked to improvements in the management of respiratory failure in preterm infants. Current modalities of respiratory support range from the more benign continuous positive airway pressure (CPAP) to various modes of mechanical ventilation. Data from recent randomized control trials suggest that the use of nasal (n)CPAP as the initial mode of respiratory support in critically ill very low birth weight infants is associated with a lower incidence of chronic lung disease...
June 2016: Seminars in Fetal & Neonatal Medicine
Angela Kribs, Helmut Hummler
During recent decades, non-invasive respiratory support has become popular for treating neonates with respiratory failure. Several prospective randomized controlled trials have been performed to compare use of continuous positive airway pressure (CPAP) as primary respiratory support in preterm infants with respiratory distress syndrome (RDS) to endotracheal intubation, mechanical ventilation and surfactant therapy. Systematic reviews of these studies suggest that routine CPAP at delivery is efficacious in decreasing bronchopulmonary dysplasia (BPD), death, or both...
June 2016: Seminars in Fetal & Neonatal Medicine
Nicolas Bamat, Erik A Jensen, Haresh Kirpalani
Continuous positive airway pressure (CPAP) has been used for respiratory support in premature infants for more than 40 years and is now a cornerstone of modern neonatal care. Clinical research on CPAP has primarily focused on understanding which devices and pressure sources best implement this therapy. In contrast, less research has examined the optimal duration over which CPAP is administered. We review this aspect of CPAP therapy.
June 2016: Seminars in Fetal & Neonatal Medicine
Samir Gupta, Steven M Donn
Nasal continuous positive airway pressure (CPAP) is increasingly used for respiratory support in preterm babies at birth and after extubation from mechanical ventilation. Various CPAP devices are available for use that can be broadly grouped into continuous flow and variable flow. There are potential physiologic differences between these CPAP systems and the choice of a CPAP device is too often guided by individual expertise and experience rather than by evidence. When interpreting the evidence clinicians should take into account the pressure generation sources, nasal interface, and the factors affecting the delivery of pressure, such as mouth position and respiratory drive...
June 2016: Seminars in Fetal & Neonatal Medicine
Sandeep Shetty, Ann Hickey, Gerrard F Rafferty, Janet L Peacock, Anne Greenough
OBJECTIVE: To determine whether continuous positive airway pressure (CPAP) compared with heated humidified, high-flow nasal cannula (HHFNC) in infants with evolving or established bronchopulmonary dysplasia (BPD) reduced the work of breathing (WOB) and thoracoabdominal asynchrony (TAA) and improved oxygen saturation (SaO2). DESIGN: Randomised crossover study. SETTING: Tertiary neonatal unit. PATIENTS: 20 infants (median gestational age of 27...
September 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Burcin Iscan, Nuray Duman, Funda Tuzun, Abdullah Kumral, Hasan Ozkan
BACKGROUND: High-frequency oscillatory ventilation (HFOV) with volume guarantee (VG) is a new ventilation mode that allows the clinician to set a mean tidal volume to be delivered. OBJECTIVE: This study aimed to investigate whether HFOV with a VG option may result in constant tidal volume delivery and less fluctuant CO2 levels compared to HFOV alone in premature infants with respiratory distress syndrome (RDS). METHODS: Inborn infants at less than 32 weeks of gestation with RDS requiring invasive mechanical ventilation were eligible...
2015: Neonatology
Janneke Dekker, Enrico Lopriore, Monique Rijken, Esther Rijntjes-Jacobs, Vivianne Smits-Wintjens, Arjan Te Pas
BACKGROUND: There is no data available whether sedation should be given during minimally invasive surfactant therapy (MIST). OBJECTIVE: To compare the level of comfort of preterm infants receiving sedation versus no sedation for MIST. METHODS: A retrospective study of preterm infants receiving MIST was performed in Leiden University Medical Center in 2014. Sedation (propofol 1 mg/kg) was optional and left to the discretion of the caregiver...
2016: Neonatology
2016-03-08 05:47:39
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