From Continuous Positive-pressure Breathing to Ventilator-induced Lung Injury

2004 ◽  
Vol 101 (4) ◽  
pp. 1015-1017 ◽  
Author(s):  
Henning Pontoppidan ◽  
Srinivasa N. Raja
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Arterial Oxygen Tension ◽  
Intermittent Positive Pressure Ventilation ◽  
Arterial Oxygen ◽  
Positive Pressure ◽  
Residual Capacity ◽  
The Mean ◽  
Continuous Positive Pressure

Continuous positive-pressure ventilation in acute respiratory failure. By Kumar A, Falke KJ, Geffin B, Aldredge CF, Laver MB, Lowentein E, Pontoppidan H. N Engl J Med 1970; 283:1430-6. Reprinted with permission. Continuous positive-pressure ventilation was used in eight patients with severe acute respiratory failure. Cardiac output and lung function were studied during continuous positive-pressure ventilation (mean end-expiratory pressure, 13 cm H2O) and a 30-min interval of intermittent positive-pressure ventilation. Although the mean cardiac index increased from 3.6 to 4.5 l/min per square meter of body surface area, the mean intrapulmonary shunt increased by 9% with changeover to intermittent positive-pressure ventilation. Satisfactory oxygenation was maintained in all patients during continuous positive-pressure ventilation with 50% inspired oxygen or less. With intermittent positive-pressure ventilation, arterial oxygen tension promptly fell by 161 mm of mercury, 79% occurring within 1 min. Prevention of air-space collapse during expiration and an increase in functional residual capacity probably explain improved oxygenation with continuous positive-pressure ventilation. In four patients, subcutaneous emphysema or pneumothorax developed. Weighed against the effects of prolonged hypoxemia, these complications were not severe enough to warrant cessation of continuous positive-pressure ventilation.

Continuous Positive-Pressure Ventilation in Acute Respiratory Failure

1970 ◽  
Vol 283 (26) ◽  
pp. 1430-1436 ◽  
Author(s):  
Anil Kumar ◽  
Konrad J. Falke ◽  
Bennie Geffin ◽  
Carolyn F. Aldredge ◽  
Myron B. Laver ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Continuous Positive Pressure

CONTINUOUS POSITIVE-PRESSURE VENTILATION IN ACUTE RESPIRATORY FAILURE

1972 ◽  
Vol 16 (2) ◽  
pp. 103???104
Author(s):  
A. Kumar ◽  
K. J. Falke ◽  
B. Geffin ◽  
C. F. Aldredge ◽  
M. B. Laver ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Continuous Positive Pressure

Ventilation in Emergency Situations and During Transport

1987 ◽  
Vol 3 (1) ◽  
pp. 33-36
Author(s):  
D. Paravicini ◽  
U. Hartenauer ◽  
P. Lawin
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Nursing Staff ◽  
Physical Condition ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Emergency Situations ◽  
Emergency Equipment

In acute respiratory failure, an immediate restoration of respiratory functions is imperative. Depending upon the available equipment and the qualifications of the physician and nursing staff, the most suitable ventilation procedure should be selected. In every case, accurate ventilation is accomplished by Intermittent Positive Pressure Ventilation (IPPV). If emergency equipment is not available, the simplest method of achieving this is mouth-to-mouth or mouth-to-nose breathing. The efficacy of this method is limited by the low FiO2 (about 17%) and by the physical condition of the first aider; after 30 minutes of resuscitation, even an experienced and well conditioned emergency rescuer will be exhausted.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

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