IMPACT OF NONINVASIVE VENTILATION IN THE TREATEMENT OF ACUTE HYPOXIC RESPIRATORY FAILURE DURING COVID-19 PANDEMIC: RETROSPECTIVE STUDY AT A COMMUNITY TEACHING HOSPITAL IN CHICAGO

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.

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Nasal high-flow oxygen in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and noninvasive ventilation

Critical Care ◽

10.1186/cc10743 ◽

2012 ◽

Vol 16 (S1) ◽

Cited By ~ 1

Author(s):

R Riessen ◽

N Schwabbauer ◽

B Berg ◽

G Blumenstock ◽

M Haap ◽

...

Keyword(s):

Respiratory Failure ◽

Noninvasive Ventilation ◽

Oxygen Therapy ◽

High Flow ◽

Respiratory Parameters ◽

High Flow Oxygen ◽

Hypoxic Respiratory Failure

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Association between increased nonaerated lung weight and treatment failure in patients with de novo acute respiratory failure: Difference between high-flow nasal oxygen therapy and noninvasive ventilation in a multicentre retrospective study

Journal of Critical Care ◽

10.1016/j.jcrc.2021.06.025 ◽

2021 ◽

Vol 65 ◽

pp. 221-225

Author(s):

Yasutaka Koga ◽

Kotaro Kaneda ◽

Nao Fujii ◽

Ryo Tanaka ◽

Takashi Miyauchi ◽

...

Keyword(s):

Retrospective Study ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Treatment Failure ◽

Noninvasive Ventilation ◽

Oxygen Therapy ◽

De Novo ◽

High Flow ◽

Lung Weight ◽

Multicentre Retrospective Study

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Noninvasive Ventilation in Patients With Hematologic Malignancy: A Retrospective Study

Journal of Intensive Care Medicine ◽

10.1177/0885066617690725 ◽

2017 ◽

Vol 34 (3) ◽

pp. 197-203 ◽

Cited By ~ 5

Author(s):

Jiajia Liu ◽

Conor Bell ◽

Vagia Campbell ◽

Julian DeBacker ◽

Erik Tamberg ◽

...

Keyword(s):

Retrospective Study ◽

Respiratory Failure ◽

Acute Leukemia ◽

Acute Respiratory Failure ◽

Noninvasive Ventilation ◽

Hematologic Malignancy ◽

Mount Sinai Hospital ◽

Failure Group ◽

First Line Therapy ◽

Vasopressor Use

Introduction: Noninvasive ventilation (NIV) is commonly used as first-line therapy for immunocompromised patients with acute respiratory failure. However, it may not be appropriate for all patients, as failure of NIV and delayed endotracheal intubation (ETI) may increase mortality. We report our center’s experience and outcomes for patients with active hematologic malignancy (HM) treated with NIV. Methods: We conducted a retrospective study of consecutive patients with HM who were admitted to the intensive care unit (ICU) of Mount Sinai Hospital for acute respiratory failure between January 1, 2010, and May 31, 2015, and were initially treated with NIV. We compared the characteristics of patients who were successfully treated with NIV and avoided intubation and those who failed NIV. Results: Seventy-nine patients (mean age 56 ± 14 years, mean Acute Physiology and Chronic Health Evaluation II score 27 ± 5) with HM were treated with NIV for acute respiratory failure. The etiology of respiratory failure was multifactorial in 31 (39%) patients, with features of pneumonia in 61 (77%) patients, severe sepsis or septic shock in 33 (42%) patients, and pulmonary edema in 24 (30%) patients. The majority of patients were admitted with acute leukemia (n = 60, 76%), 8 (10%) with lymphoma, and 11 (14%) with chronic leukemia, multiple myeloma, or myelodysplastic syndrome. Of the 79 patients treated with NIV, 44 (56%) failed NIV and required ETI, 7 (9%) had a do-not-intubate (DNI) order and died, and 28 (35%) avoided ETI. Compared with patients who avoided ETI, those who failed NIV or had a DNI order and died were more likely to have acute leukemia (84% vs 61%; P = .02) and at baseline had higher Paco2 (39 vs 30; P = .038), higher fraction of inspired oxygen (Fio2) requirements (0.6 vs 0.4; P = .002), and more vasopressor use (31% vs 11%; P = .059). The ICU mortality was 42%; 3-month mortality was 57% overall and was significantly lower in the NIV success patients compared with the NIV failure group (21% vs 74%; P < .001). Conclusion: Two-thirds of patients with HM and respiratory failure failed NIV and required ETI, and had high subsequent mortality. Patients who failed NIV had higher Paco2, higher Fio2, and a trend toward more vasopressor use.

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