scholarly journals High flow nasal cannula oxygenation successfully used as bridge therapy for systemic thrombolysis in COVID-19 associated intermediate-high risk pulmonary embolism

2021 ◽  
pp. 101000
Author(s):  
María F. Aguilar-Piedras ◽  
Mateo Porres-Aguilar ◽  
Debabrata Mukherjee ◽  
Guillermo Cueto-Robledo ◽  
Ernesto Roldan-Valadez ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Systemic Thrombolysis ◽  
Bridge Therapy

Readiness Assessment for Extubation Planning in the Intensive Care Unit: A Quality Improvement Initiative

2021 ◽  
Vol 41 (3) ◽  
pp. 42-48
Author(s):  
Jace D. Johnny
Keyword(s):  
High Risk ◽  
Failure Rate ◽  
Noninvasive Ventilation ◽  
Extubation Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Prophylactic Measure ◽  
High Risk Patients ◽  
Risk Patients

Background Extubation failure is the reintubation of patients meeting criteria for weaning from mechanical ventilation. Extubation failure is correlated with mortality, prolonged mechanical ventilation, and longer hospital stays. Noninvasive ventilation or high-flow nasal cannula oxygen therapy after extubation is recommended to prevent extubation failure in high-risk patients. Local Problem The extubation failure rate is unknown. Prophylactic measures (noninvasive ventilation or high-flow nasal cannula) after extubation are not commonly used and vary among clinicians. The objective was to assess extubation planning readiness by determining extubation failure rate, identifying high-risk patients, and determining prophylactic measure compliance. Methods A quality improvement initiative included an evidence-based extubation failure risk assessment that identified high-risk patients and determined prophylactic measure compliance. A 2-year retrospective medical record review was used to determine baseline patient characteristics and extubation failure rate. Results Extubation failure rate within the retrospective cohort was 13 of 146 patients (8.9%). Extubation failure did not correlate with previously identified risk factors; however, 150 identified patients were excluded from analysis. During risk assessment integration, the extubation failure rate was 3 of 37 patients (8.1%) despite identifying 24 high-risk patients (65%). Few high-risk patients received prophylactic measures (noninvasive ventilation, 17%; high-flow nasal cannula, 12%). Conclusions Extubation failure should be routinely measured because of its effects on patient outcomes. This project reveals the multifactorial nature of extubation failure. Further research is needed to assess patients’ risk and account for acute conditions. This project used best practice guidelines for routine patient care and added transparency to a previously unmeasured event.

Prognostic factors for extubation failure in high risk patients using high-flow nasal cannula

2019 ◽  
Author(s):  
Paulina Ezcurra ◽  
María Sofia Venuti ◽  
Emiliano Gogniat ◽  
Marcela Ducrey ◽  
Jose Dianti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Extubation Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High-Risk Patients

JAMA ◽  
2016 ◽  
Vol 316 (15) ◽  
pp. 1565 ◽  
Author(s):  
Gonzalo Hernández ◽  
Concepción Vaquero ◽  
Laura Colinas ◽  
Rafael Cuena ◽  
Paloma González ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Risk ◽  
Noninvasive Ventilation ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals High-flow nasal cannula to prevent postextubation respiratory failure in high-risk non-hypercapnic patients: a randomized multicenter trial

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Rafael Fernandez ◽  
Carles Subira ◽  
Fernando Frutos-Vivar ◽  
Gemma Rialp ◽  
Cesar Laborda ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Risk ◽  
Multicenter Trial ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

Severe pulmonary embolism managed with high-flow nasal cannula oxygen therapy

2017 ◽  
Vol 24 (3) ◽  
pp. 230-232 ◽  
Author(s):  
Jonathan Messika ◽  
Philippe Goutorbe ◽  
David Hajage ◽  
Jean-Damien Ricard
Keyword(s):  
Pulmonary Embolism ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula

scholarly journals High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial

2020 ◽  
Author(s):  
Venkatesan Thiruvenkatarajan ◽  
Ashok Dharmalingam ◽  
Gilberto Arenas ◽  
Medhat Wahba ◽  
Reinhard Steiner ◽  
...  
Keyword(s):  
High Risk ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Perioperative Complications ◽  
Supplemental Oxygen ◽  
High Flow ◽  
Nasal Cannula ◽  
Low Flow ◽  
High Flow Nasal Cannula ◽  
Endoscopic Retrograde ◽  
Study Results

Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) is an increasingly common intervention in the treatment of pancreatico-biliary disorders. Patients are often elderly with complex co-morbidities. While monitored anaesthesia care with sedation is commonly used for most cases, few would require general anaesthesia with an endotracheal tube. Both low flow and high flow nasal cannulas (HFNC) are established ways of delivering supplemental oxygen, but it is unclear whether one technique is better than the other. HFNC seems a promising tool for advanced procedures but evidence to support its application in high-risk ERCP cases is limited. The rate of oxygen desaturation during endoscopy has been reported to be as high as 11-50%, and the method of oxygen delivery for ERCP merits further study. Methods/design This is a prospective, randomised, multi-centre trial comparing the efficacy of oxygen supplementation through high flow nasal cannula versus low flow nasal cannula during ERCP, in a cohort of patients at risk of adverse respiratory events. A total of 132 patients will be recruited across three sites and randomly assigned to either the low flow or the HFNC group. The primary outcome is the proportion of patients experiencing hypoxia, defined by any event of SpO2 <90%. The secondary outcomes include parameters centred on oxygenation, requirement of airway manoeuvres, successful completion of procedure, perioperative complications, patient satisfaction, and cost analysis of the consumables. An intention-to-treat principle will be applied while analysing. Discussion The demand for ERCPs is likely to increase in the future with the aging population. Our study results may lead to improved outcomes and reduce airway related complications in patients undergoing ERCPs. The results will be presented at national and international meetings and published in per-reviewed journals.

scholarly journals High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial

2020 ◽  
Author(s):  
Venkatesan Thiruvenkatarajan ◽  
Ashok Dharmalingam ◽  
Gilberto Arenas ◽  
Medhat Wahba ◽  
Reinhard Steiner ◽  
...  
Keyword(s):  
High Risk ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Perioperative Complications ◽  
Supplemental Oxygen ◽  
High Flow ◽  
Nasal Cannula ◽  
Low Flow ◽  
High Flow Nasal Cannula ◽  
Endoscopic Retrograde ◽  
Study Results

Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) is an increasingly common intervention in the treatment of pancreatico-biliary disorders. Patients are often elderly with complex co-morbidities. While monitored anaesthesia care with sedation is commonly used for most cases, few would require general anaesthesia with an endotracheal tube. Both low flow and high flow nasal cannulas (HFNC) are established ways of delivering supplemental oxygen, but it is unclear whether one technique is better than the other. HFNC seems a promising tool for advanced procedures but evidence to support its application in high-risk ERCP cases is limited. The rate of oxygen desaturation during endoscopy has been reported to be as high as 11-50%, and the method of oxygen delivery for ERCP merits further study.Methods/design This is a prospective, randomised, multi-centre trial comparing the efficacy of oxygen supplementation through high flow nasal cannula versus low flow nasal cannula during ERCP, in a cohort of patients at risk of adverse respiratory events. A total of 132 patients will be recruited across three sites and randomly assigned to either the low flow or the HFNC group. The primary outcome is the proportion of patients experiencing hypoxia, defined by any event of SpO2 <90%. The secondary outcomes include parameters centred on oxygenation, requirement of airway manoeuvres, successful completion of procedure, perioperative complications, patient satisfaction, and cost analysis of the consumables. An intention-to-treat principle will be applied while analysing.Discussion The demand for ERCPs is likely to increase in the future with the aging population. Our study results may lead to improved outcomes and reduce airway related complications in patients undergoing ERCPs. The results will be presented at national and international meetings and published in per-reviewed journals.Trial registration: www.ANZCTR.org.au CTRN12619000397112, Registered on on March 12, 2019.

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