scholarly journals Negative pressure ventilation as a bridge to lung transplant

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
María D P Martínez ◽  
Francisco G Alvarez ◽  
Jorge M Mallea ◽  
Sadia Z Shah ◽  
Si M Pham ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Negative Pressure ◽  
Lung Transplant ◽  
Ventilatory Support ◽  
Respiratory Support ◽  
Mechanical Ventilatory Support ◽  
Negative Pressure Ventilation ◽  
Less Invasive ◽  
Non Invasive ◽  
Allocation Strategies

ABSTRACT Recent years have witnessed evolution of lung allocation strategies to prioritize sicker recipients. In the pre-transplant period, this has translated into increased utilization of invasive extracorporeal or mechanical ventilatory support as a bridge to lung transplantation. The morbidity associated with these strategies warrants consideration to less invasive respiratory support modalities. Herein, we present a case highlighting successful bridge to lung transplantation with a relatively non-invasive negative pressure ventilator.

scholarly journals Negative pressure patient isolation device to enable non-invasive respiratory support for COVID-19 and beyond

2020 ◽  
pp. bmjinnov-2020-000551
Author(s):  
Auriel August ◽  
Mariel Bolhouse ◽  
Brian Rice ◽  
James Kennedy Wall
Keyword(s):  
Negative Pressure ◽  
Respiratory Support ◽  
Patient Isolation ◽  
Non Invasive ◽  
Isolation Device

scholarly journals Prolonged non-invasive respiratory support in a COVID-19 patient with severe acute hypoxemic respiratory failure

2021 ◽  
Author(s):  
Andrea Lanza ◽  
Maurizio Sommariva ◽  
Sara Mariani ◽  
Gabriela Ferreyra ◽  
Giuliana Enrica Stagni ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Ventilatory Support ◽  
Respiratory Support ◽  
Low Flow ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Non Invasive ◽  
High Dependency ◽  
Non Invasive Ventilation ◽  
Experienced Team

A pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 was declared in 2020. Severe cases were characterized by the development of acute hypoxemic respiratory failure (AHRF) requiring advanced respiratory support. However, intensive care units (ICU) were saturated, and many patients had to be treated out of ICU. This case describes a 75-year-old man affected by AHRF due to Coronavirus Disease 2019 (COVID-19), hospitalized in a high-dependency unit, with PaO2/FiO2 <100 for 28 consecutive days. An experienced team with respiratory physiotherapists was in charge of the noninvasive ventilatory support (NIVS). The patient required permanent NIVS with continuous positive airway pressure, non-invasive ventilation, high flow nasal oxygen and body positioning. He was weaned from NIVS after 37 days and started exercise training afterwards. The patient was discharged at home with low-flow oxygen therapy. This case represents an example of a successful treatment of AHRF with the still controversial noninvasive respiratory support in one patient with COVID-19.

scholarly journals Failure of non-invasive respiratory support after 6 hours from initiation is associated with ICU mortality

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0251030
Author(s):  
Mitsuaki Nishikimi ◽  
Kazuki Nishida ◽  
Yuichiro Shindo ◽  
Muhammad Shoaib ◽  
Daisuke Kasugai ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Lung Diseases ◽  
Ventilatory Support ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Icu Mortality ◽  
Failure Group ◽  
Non Invasive ◽  
Significant Difference

A previous study has shown that late failure (> 48 hours) of high-flow nasal cannula (HFNC) was associated with intensive care unit (ICU) mortality. The aim of this study was to investigate whether failure of non-invasive respiratory support, including HFNC and non-invasive positive pressure ventilation (NPPV), was also associated with the risk of mortality even if it occurs in the earlier phase. We retrospectively analyzed 59 intubated patients for acute respiratory failure due to lung diseases between April 2014 and June 2018. We divided the patients into 2 groups according to the time from starting non-invasive ventilatory support until their intubation: ≤ 6 hours failure and > 6 hours failure group. We evaluated the differences in the ICU mortality between these two groups. The multivariate logistic regression analysis showed the highest mortality in the > 6 hours failure group as compared to the ≤ 6 hours failure group, with a statistically significant difference (p < 0.01). It was also associated with a statistically significant increased 30-day mortality and decreased ventilator weaning rate. The ICU mortality in patients with acute respiratory failure caused by lung diseases was increased if the time until failure of HFNC and NPPV was more than 6 hours.

Non-invasive ventilation

2007 ◽  
pp. 287-292
Keyword(s):  
Ventilatory Support ◽  
Upper Airway ◽  
Positive Pressure ◽  
Nasal Mask ◽  
Invasive Ventilation ◽  
Acute Setting ◽  
Negative Pressure Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Volume Controlled

Non-invasive ventilation 288 Non-invasive ventilation (NIV) refers to the delivery of ventilatory support via the upper airway using a face or nasal mask. In this chapter NIV refers to non-invasive positive pressure ventilation; negative pressure ventilation (e.g. external cuirass) is not used in the acute setting and will not be discussed. Ventilators can be either pressure or volume controlled, but bi-level pressure support ventilators are by far the most commonly used....

scholarly journals The importance of the interface in the management of acute respiratory failure

2020 ◽  
Vol 23 (81) ◽  
pp. 8-11
Author(s):  
Jelena Vojnović ◽  
Sanja Hromiš
Keyword(s):  
Side Effects ◽  
Ventilatory Support ◽  
Basic Knowledge ◽  
Invasive Ventilation ◽  
Skin Damage ◽  
Mechanical Ventilatory Support ◽  
Non Invasive ◽  
Poor Patient ◽  
Non Invasive Ventilation ◽  
Different Types

Non-invasive ventilation is a form of mechanical ventilatory support that doesn't require endotracheal intubation of the patient. The interface (mask) is a connection between the device and the patient that allows the set pressure gradient supplied by the ventilator to be transmitted to the airways. Today, there are different types of interfaces, which differ in shape, size, mechanical properties, and comfort. Despite the wide of different mask, common reasons for poor patient adaptation to NIV are related to side effects of the interface such as air loss, skin damage, and mask discomfort. We can prevent these side effects with a basic knowledge of the principles of handling and selecting the optimal interface.

scholarly journals CNS Demyelinating Attacks Requiring Ventilatory Support With Myelin Oligodendrocyte Glycoprotein or Aquaporin-4 Antibodies

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012599
Author(s):  
Hannah H. Zhao-Fleming ◽  
Cristina Valencia Sanchez ◽  
Elia Sechi ◽  
Jery Inbarasu ◽  
Eelco F. Wijdicks ◽  
...  
Keyword(s):  
Mayo Clinic ◽  
Ventilatory Support ◽  
Acute Disseminated Encephalomyelitis ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Aquaporin 4 ◽  
Respiratory Support ◽  
Mri Findings ◽  
Black Race ◽  
Non Invasive ◽  
Aqp4 Antibody

Background and Objective:Severe attacks of myelin oligodendrocyte glycoprotein (MOG)-antibody-associated disorder (MOGAD) and aquaporin-4 (AQP4)-antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) may require ventilatory support but data on episodes is limited, particularly for MOGAD. We sought to compare the frequency, characteristics, and outcomes of MOGAD and AQP4-NMOSD attacks requiring ventilatory support.Methods:This retrospective descriptive study identified Mayo Clinic patients (1/1/1996-12/1/2020) with MOGAD or AQP4-NMOSD and an attack requiring non-invasive or invasive ventilation at Mayo Clinic or an outside facility by searching for relevant terms in their electronic medical record. Inclusion criteria were: 1) Attack-related requirement for non-invasive (BiPAP or CPAP) or invasive respiratory support (mechanical ventilation); 2) MOG or AQP4 antibody positivity with fulfillment of MOGAD and AQP4-NMOSD clinical diagnostic criteria, respectively; 3) Sufficient clinical details. We collected data on demographics, co-morbidities, indication for and duration of respiratory support, MRI findings, treatments, and outcomes. The race of those with attacks requiring respiratory support were compared to those without such attacks in MOGAD and AQP4-NMOSD.Results:Attacks requiring ventilatory support were similarly rare in MOGAD (8/279, 2.9%) and AQP4-NMOSD patients (11/503, 2.2%) (p=0.63). The age at attack (median years [range]) (MOGAD, 31.5[5-47] vs AQP4-NMOSD, 43[14-65]; p=0.01) and percentage of female sex (MOGAD, 3/8[38%] vs AQP4-NMOSD, 10/11[91%]; p=0.04) differed. The reasons for ventilation differed between MOGAD (inability to protect airway from seizure, encephalitis or encephalomyelitis with attacks of: acute disseminated encephalomyelitis, 5[62.5%]; or unilateral cortical encephalitis, 3[37.5%]) and AQP4-NMOSD (inability to protect airway from cervical myelitis, 9[82%]; rhombencephalitis, 1[9%]; or combinations of both, 1[9%]). Median ventilation duration for MOGAD was 2 days (range, 1-7) versus 19 days (range, 6-330) for AQP4-NMOSD (p=0.01). All MOGAD patients recovered, but 2/11 (18%) of AQP4-NMOSD died from the attack. For AQP4-NMOSD, Black race was over-represented with attacks requiring ventilatory support versus those without these episodes (5/11[45%] versus 88/457[19%]; p=0.045).Discussion:Ventilatory support is rarely required for MOGAD and AQP4-NMOSD attacks and the indications differ. When compared to MOGAD, these attacks in AQP4-NMOSD may have higher morbidity and mortality and those of Black race were more predisposed, which we suspect may relate to socially mediated health inequality.

Utilisation of RAM cannula for non-invasive respiratory support for infants in the cardiac ICU

2021 ◽  
pp. 1-7
Author(s):  
Ashish Saini ◽  
Kevin O. Maher ◽  
Shriprasad R. Deshpande
Keyword(s):  
Ventilatory Support ◽  
Respiratory Support ◽  
Pulmonary Insufficiency ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Additional Burden ◽  
Chest X Ray ◽  
One Year

Abstract Background: Children with CHD carry an additional burden of pulmonary insufficiency, often necessitating prolonged ventilatory support, especially in the peri-operative phase. There has been an increase in the utilisation of non-invasive ventilatory support for these children. The objective of this study was to evaluate the utilisation, safety, and outcomes of RAM cannula as a tool for escalation and de-escalation of respiratory support in paediatric cardiac patients less than one year of age. Methods: A single-centre retrospective cohort study of patients supported with RAM cannula. Results: A total of 275 instances of RAM use were included in the study, 81.1% being post-operative. Patients were stratified into escalation and de-escalation cohorts based on the indication of non-invasive ventilation. The success rate of using RAM cannula was 69.5% overall, 66.1% in the escalation group, and 72.8% in the de-escalation group. At baseline, age at cardiac ICU admission >30 days, FiO2 ≤ 40%, PaCO2 ≤ 50 mmHg; and after 12 hours of non-invasive ventilation support respiratory rate ≤ 60/min, PaO2 ≥ 50 mmHg, PaCO2 ≤ 50 mmHg; and absence of worsening on follow-up chest X-ray predicted the success with a sensitivity of 95% in the logistic regression model. Successful support was associated with a significantly shorter unit stay. Conclusions: RAM cannula can be safely used to provide non-invasive support to infants in the cardiac ICU for escalation and de-escalation of respiratory support. Factors associated with success can be used to make decisions about candidacy and appropriate timing of non-invasive ventilation use to maximise effectiveness.

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