NIV in Type 2 (Hypercapnic) Acute Respiratory Failure

2017 ◽  
pp. 229-238 ◽  
Author(s):  
Shaden O. Qasrawi ◽  
Ahmed S. BaHammam
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Hypercapnic Acute Respiratory Failure

Effect of thermal helium oxygen mixture оn сentral hemodynamics and oxygen transport in patients with acute hypercapnic respiratory failure with chronic obstructive pulmonary disease

2020 ◽  
Vol 30 (4) ◽  
pp. 421-426
Author(s):  
L. V. Shogenova ◽  
A. G. Chuchalin ◽  
A. A. Panin
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Partial Pressure ◽  
Oxygen Transport ◽  
Venous Blood ◽  
High Flow ◽  
Oxygen Mixture ◽  
Arterial Blood ◽  
High Flow Oxygen ◽  
Hypercapnic Acute Respiratory Failure

The aim of this study is to assessment of the rapid effects of t-He/O2 in comparison with the effective level of high-flow oxygen therapy (HPO) on the main indicators of oxygen transport, central and pulmonary hemodynamics in patients with chronic obstructive pulmonary disease (COPD) with hypercapnic acute respiratory failure.Methods. A total of 33 (29 male, 4 female) patients were included in a randomized, comparative study with exacerbation of COPD and acute respiratory failure, admitted to the department of anesthesiology and intensive care of D.D.Pletnev City Teaching Hospital, Moscow Healthcare Department, between March and May 2017. Patients were divided into two groups: the 1st group – 18 patients (15 male, 3 female) receiving t-He/O2 (He – 70%, O2 – 30% at a temperature of 70 °C; the 2nd group – 15 patients (14 male, 1 female) receiving high-flow oxygen therapy with FiO2 – 30% through a Venturi mask for the treatment of ODN against the background of basic therapy of the underlying disease, according to the recommendations of GOLD 2016. Assessment of oxygen transport, central and pulmonary hemodynamics was carried out through the definition of indicators: saturation of hemoglobin of arterial blood with oxygen (SaO2), saturation of venous blood hemoglobin with oxygen (SvO2), partial pressure of arterial blood oxygen (РaO2), partial pressure of arterial blood carbon dioxide (РaCO2), partial pressure of mixed venous blood oxygen (РvO2), partial pressure of mixed venous blood carbon dioxide (РvCO2),mean pulmonary artery pressure (MPAP), cardiac output (SV), heart index (CI), pulmonary vascular resistance (RVRI), impact volume index (SVI), pulmonary vascular resistance index (RVRI), left ventricular shock index (LVSW), right ventricular shock index (RVSW), system speed of oxygen delivery (DO2), the coeffiCIent of extraction of oxygen (ExO2), shunt fractions (venous mixing) (Qs / Qt)).Results. Short-term inhalation with a thermal helium-oxygen mixture in patients with COPD with hypercapnic acute respiratory failure is accompanied by an increase in SaO2 94,1 (92,8; 97,5) initially 86,1 (85,9; 88,1), РаО2 (78,1 (74,8; 80,1) initially 55,2 (52,5; 65,3)), decline РаСО2 (57,4 (54,2; 66.4) initially 65,4 (58,1; 67,2)). Thermal helium-oxygen mixture leads to stabilization of hemodynamics, improving the work of the right and left heart: decline MPAP 28,2 (24,3; 32,8) initially 43,3 (40,1; 49,5), RVRI (285,3 (258,4; 362,7) initially 592,1 (498,2; 623,5)), RVSW (16,2 (14,1; 21,4) initially 25,8 (21,8; 32)), HR 91,1 (86,4; 98,7) initially 115 ((105; 118) to increase LVSW (58,2 (49,8; 62,4) initially 35,5 (28,9; 42,1)), SVI 36,2 (31,8; 42,1) initially 31,5 (28,4; 36,2). Elimination of arterial hypoxemia and a positive effect on hemodynamics ensures adequate oxygen transport to tissues, which is expressed in the normalization of DO2 values DO2 (980,4 (858,45; 1208) initially 280,3 (270,34; 387,4)) и ExO2 (27,8 (25,6; 34,5) initially 32,1 (30,7; 39,8) and decline Qs/Qt. (28,7 (18,6; 35,4) initially 42,8 (39,2; 49,1).Conclusion. Short-term therapy of patients with COPD with hypercapnic acute respiratory failure using the t-He/O2 method, in comparison with high-flow oxygen therapy, improves blood oxygenation and hemodynamics. Elimination of arterial hypoxemia and a positive effect on hemodynamics made it possible to ensure adequate oxygen transport to tissues, which was expressed in the normalization of transport values, oxygen delivery, and a decrease in the shunt fraction.

scholarly journals Glutaric aciduria type 2 presenting with acute respiratory failure in an adult

2015 ◽  
Vol 15 ◽  
pp. 92-94 ◽  
Author(s):  
Ebru Ortac Ersoy ◽  
Dorina Rama ◽  
Özlem Ünal ◽  
Serap Sivri ◽  
Arzu Topeli
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Glutaric Aciduria Type ◽  
Glutaric Aciduria

Acute respiratory failure

2020 ◽  
pp. 3867-3880
Author(s):  
Susannah Leaver ◽  
Jeremy Cordingley ◽  
Simon Finney ◽  
Mark Griffiths
Keyword(s):  
Respiratory Failure ◽  
Critical Illness ◽  
Acute Respiratory Failure ◽  
Critically Ill ◽  
System Failures ◽  
Life Saving ◽  
Delayed Recognition ◽  
Covert Infection

Acute respiratory failure is defined clinically by hypoxaemia with (type 2) or without (type 1) hypercapnia. It is one of the most common problems afflicting critically ill patients and is a common indication for transfer to an intensive care unit. Critical illness may be manifest solely as respiratory insufficiency, especially in patients with covert infection. Acute respiratory failure frequently coexists with other organ system failures in the critically ill, and delayed recognition of the condition adversely affects outcome. The signs of critical illness tend to be similar whatever the precipitating cause and are manifest in failure of the respiratory, cardiovascular, and neurological systems. Full and repeated physical examination may be required to assess the cause and severity of acute respiratory failure and its associated complications, but in severe cases should not delay the instigation of life-saving support and treatment.

scholarly journals Etiology, Clinical Profile and Outcome of Acute Respiratory Failure in Adults in Kashmir Valley (North India): A Hospital Based Prospective Study

2020 ◽  
Vol 5 (09) ◽  
pp. 407-411
Author(s):  
Dr. Abdul Ahad Wani ◽  
Dr. Manzoor Ahmad ◽  
Dr. Amir Shafi ◽  
Dr. Muzaffar Naik ◽  
Dr. Tariq Bhat ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress ◽  
Prospective Study ◽  
Acute Exacerbation ◽  
North India ◽  
Respiratory Pattern ◽  
Kashmir Valley

Background: A prospective study to evaluate the etiological factors, clinical features, treatment modalities and outcome of acute respiratory failure in adults (> 18 years age) in Kashmir valley north India is important to understand the epidemiological trends and the detailed disease manifestations. Methods: We conducted a hospital based prospective study which was conducted over a period of one and half year, initiated in January 2018 and concluded in 2019 in tertiary care hospital. 100 patients above the age of 18 years with acute respiratory failure were actively enrolled. Acute respiratory failure was identified by the defined criteria, in any patient presenting with respiratory arrest / respiratory failure/respiratory distress with SPO2 ≤92%, breathlessness of <2 weeks duration and altered respiratory pattern. The patients who fulfilled at least one of the following criteria of respiratory failure were included in the study. (I)Arterial PaO2<70mmHg, (II)Peripheral O2 saturation ≤92% breathing in room air (III) Arterial PaCO2 ≥45mmHg (IV) PH ≤7.35 with signs and symptoms of respiratory distress. Results: Of the total of 100 patients included in the study, the mean age of the cohort was 55 SD ± 19 years. The cause of respiratory failure were COPD with acute exacerbation (45%), sepsis with MODS (20%), acute O.P. poisoning (12%), massive ICH (4%), acute liver failure with respiratory failure(3%), ARDS(3%),acute opioid poisoning with respiratory failure (3%), acute LVF (2%),PTE (2%), anaphylaxis (2%), acute M.I. (1%), myasthenia crisis (2%) strangulation with asphyxia (1%) and fat embolism (1%). Type-2 respiratory failure was found in 45% while type-1 respiratory failure was found in 55% patients. 55 % patients needed invasive ventilation; 26% patients needed NIV. While 19% patients needed high flow oxygen with nasal cannula. Conclusion: Commonest cause of acute respiratory failure in adults is COPD with acute exacerbation (45%) followed by sepsis with MODS (20%). Type 2 respiratory failure accounted for 45% while type 1 accounted for 55% of acute respiratory failure in adults. In our study, COPD is the leading cause of death in acute respiratory failure followed by sepsis with MODS.

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