Prevention and Treatment of Gastrointestinal Complications in Patients on Mechanical Ventilation

2003 ◽  
Vol 2 (5) ◽  
pp. 395-411 ◽  
Author(s):  
Gökhan M. Mutlu ◽  
Ece A. Mutlu ◽  
Phillip Factor
Keyword(s):  
Mechanical Ventilation ◽  
Gastrointestinal Complications ◽  
Prevention And Treatment

31 Noninvasive high-frequency oscillatory ventilation in preterm infants: Safe and effective

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e24-e25
Author(s):  
Laurence Soucy-Giguère ◽  
Christine Drolet ◽  
Bruno Piedboeuf ◽  
Audrey Hébert
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
High Frequency ◽  
High Frequency Oscillatory Ventilation ◽  
Neurodevelopmental Outcomes ◽  
Gastrointestinal Complications ◽  
Oscillatory Ventilation ◽  
Significant Difference ◽  
Baseline Characteristics ◽  
High Frequency Oscillatory

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Mechanical ventilation is frequently used in preterm infants for various indications, but is associated with multiple complications, including bronchopulmonary dysplasia and poorer neurodevelopmental outcomes. Noninvasive high-frequency oscillatory ventilation (nHFOV) is a noninvasive ventilation (NIV) strategy used to avoid mechanical ventilation and associated complications. However, its effectiveness remains controversial, and its safety has not been established. Objectives The objectives were to evaluate the effectiveness of nHFOV to prevent intubations and support adequate ventilation in preterm infants, and to assess its safety profile. Design/Methods This was a retrospective crossover case study including 24 infants and 30 nHFOV instances between May 2018 and June 2020. Infants were included if they were placed on nHFOV for at least one hour; each nHFOV trial contributed as one instance. Data was collected from health records. Effectiveness outcomes were: successful transition to another NIV mode without requiring intubation, and variations in CO2, FiO2, and number of spells. Safety outcomes were: apparition of intraventricular hemorrhage (IVH), gastrointestinal complications, nasal cutaneous trauma, and comfort as assessed with the Neonatal Pain, Agitation and Sedation Scale (N-PASS). Descriptive statistics were used for baseline characteristics. Nonparametric and semiparametric tests were used to compare outcomes pre- and during nHFOV. Results Baseline characteristics are presented in Table 1. At initiation of nHFOV, mean chronological age and weight were 24 days (95% CI: 20 – 28) and 1119 grams (95% CI: 1038 – 1200) respectively. The most frequent indication for nHFOV was spells (56.7%), and the mean duration of nHFOV instances was 3.9 days (95% CI: 2.7 – 5.1) (Table 1). In 18 (60%) cases, infants transitioned successfully to another NIV mode without requiring intubation. Levels of CO2 and number of spells were significantly lower during nHFOV than pre-nHFOV. There was no significant difference in FiO2 pre-nHFOV and during nHFOV. No apparition or progression of IVH was observed following the use of nHFOV. There was no significant difference in N-PASS, nasal trauma, and gastrointestinal complications pre-nHFOV and during nHFOV (Table 2). Conclusion This study suggests that nHFOV is an effective ventilation method to avoid intubation and to decrease spells in preterm infants, without increasing complications.

scholarly journals Respiratory and Gastrointestinal systems; friends or foes?

2021 ◽  
Vol 2 (1) ◽  
pp. 33-33
Author(s):  
ehab daoud
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Gastrointestinal Tract ◽  
Respiratory System ◽  
Gastrointestinal Complications ◽  
Critical Care Patients

The article by Obeidat andRandhawain this issue “Gastrointestinal complications in critical care patients and effects of mechanical ventilation on the gastrointestinal tract”1is a great reminder of this important topicand a must read for ICU clinicians. The interaction between the gastro-intestinal system and the respiratory system is a tight yet not fully understoodcomplex one, and unfortunately gets overlooked.

scholarly journals Gastrointestinal complications in critical care patients and effects of mechanical ventilation on the gastrointestinal tract

2021 ◽  
Vol 2 (1) ◽  
pp. 17-32
Author(s):  
Adham Obeidat ◽  
Sandeep Randhawa
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Acalculous Cholecystitis ◽  
Multiple Organ ◽  
Critically Ill Patient ◽  
Gastrointestinal Complications ◽  
Increased Risk ◽  
Liver And Pancreas ◽  
Almost All ◽  
Gastro Intestinal Tract

Patients in the intensive care unit (ICU) especially those who require mechanical ventilation are at increased risk for developing gastrointestinal (GI) complications such as bleeding, infection, and motility dysfunction. It is estimated that the prevalence of GI complications in those patients is approximately 50-80% and lots of those go undiagnosed. Complications can affect different parts of the GI system, including the esophagus, stomach, small intestine, large intestine, liver, and pancreas. Effects might include dysmotility, diarrhea, inflammation, infection, direct mucosal injuries, ulcerations, and bleeding, and it can be associated with high mortality rates. Moreover, it is believed that the GI tract has a significant contribution in the development of multiple organ dysfunction syndrome (MODS) in critically ill patients. Mechanical ventilation either alone or in association with other critical illness may have a multitude of effects on almost all the organs of the gastro-intestinal tract. Attention of those interaction and side effects can improve outcomes and potentially mortality. In this review, we describe the mechanisms proposed for mechanical ventilation induced GI complications and different GI complications which can affect the critically ill patient. Keywords: PEEP, Prone position, Dysmotility, GERD, GI bleeding, Ileus, Aspiration, Acalculous cholecystitis

scholarly journals Microbiota Against SARS CoV-2: Case Reports and a Model for Stopping the COVID-19 Pandemic

2020 ◽  
pp. 1-2
Author(s):  
Goran Belojevic ◽  
Goran Belojevic
Keyword(s):  
Mechanical Ventilation ◽  
Case Reports ◽  
Elisa Test ◽  
Symptomatic Therapy ◽  
Biological Plausibility ◽  
Night Temperature ◽  
Prevention And Treatment ◽  
Successful Prevention ◽  
At Home

Background: The aim of this work is to present two case reports of successful prevention and treatment of the COVID-19 and to propose a model for stopping the COVID-19 pandemic with probiotics. Material and Methods: We present two case reports during the COVID-19 epidemic in Serbia in which probiotics were used for the prevention and treatment of the COVID-19. Based on the biological plausibility we propose a model for stopping the COVID-19 pandemic with probiotics. Results: In Case 1, a female (75), chain smoker, asthmatic, gets a fever (38.5ºC), and a pronounced weakness. Treated at home with paracetamol. The next morning fever (39.0ºC), more pronounced weakness. We advise to stop with paracetamol and to take a probiotic, 3x1 tablet (4x10exp9 CFU Lactobacillus and Bifidobacterium spec.) during a meal. The same night temperature falls and remains at 36.9ºC, weakness disappears. Feeling healthy and strong ever since. Negative on the ELISA test for the COVID-19. In Case 2, a male, (63), hypertensive, has got infected from a colleague at work who was treated for the COVID-19 in a hospital. Did not take probiotics as prevention. Treated at home with a symptomatic therapy for two weeks, with the symptoms of fever, dry cough, and pronounced weakness. Positive on the ELISA test for the COVID-19. His wife (57), who had been taking one probiotic daily regularly, has felt healthy ever since, although they have slept together. We propose a model for stopping the COVID-19 pandemic. Advice the whole population to take one capsule of probiotics Lactobacillus and Bifidobacterium, during a meal. Those with COVID-19 one capsule three times daily. Those who are on mechanical ventilation- two capsules three times daily. Conclusion: Based on case reports and the biological plausibility we propose a model for stopping the COVID-19 pandemic with probiotics.

Prevention of Gastrointestinal Complications in the Critically Ill Patient

2007 ◽  
Vol 18 (2) ◽  
pp. 158-166
Author(s):  
Beth Martin
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Critically Ill ◽  
Patient Characteristics ◽  
Critically Ill Patient ◽  
Preventive Strategies ◽  
Patient Risk ◽  
Gastrointestinal Complications ◽  
Missed Diagnosis ◽  
Supportive Interventions

Common pathophysiologic changes associated with critical illness directly contribute to the development of gastrointestinal (GI) complications. In addition, supportive interventions such as mechanical ventilation and vasopressors increase the risk of GI complications. Early, specific signs of GI complications are rarely present; therefore, because of late or missed diagnosis, morbidity and mortality related to these complications can be high. This article aims to review the pathophysiology of GI dysfunction and describe an approach to evaluate the abdomen in the critically ill patient. Risk can be limited by understanding individual patient characteristics, thoughtfully evaluating the risk-benefit profile of all interventions, and implementing preventive strategies.

Prevention and treatment of skin lesions associated with non-invasive mechanical ventilation. Recommendations of experts

2017 ◽  
Vol 28 (1) ◽  
pp. 31-41 ◽  
Author(s):  
M. Raurell-Torredà ◽  
A. Romero-Collado ◽  
M. Rodríguez-Palma ◽  
M. Farrés-Tarafa ◽  
J.D. Martí ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Skin Lesions ◽  
Non Invasive ◽  
Prevention And Treatment
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