scholarly journals THE INFLUENCE OF DIFFERENT VENTILATION PATTERNS ON TREATMENT OF PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

2017 ◽  
Author(s):  
O. V. Oliynyk ◽  
B. O. Pereviznyk ◽  
A. Shlifirchyk
Keyword(s):  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Lung Ventilation ◽  
Respiratory Support ◽  
Volume Control ◽  
Forced Ventilation

Background. Respiratory support is a vital method for temporary compensation of external breathing function in patients with severe traumatic brain injury. However, it is not always possible to deal with severe respiratory dysfunction even with the usage of up-to-date respiratory technologies. This work is aimed to find an answer how different pattern of mechanical ventilation influence on a treatment of patients with severe traumatic brain injury. Objective. The influence of respiratory support, as a main method for temporary compensation of external breathing function, on treatment result for patients with severe traumatic brain injury.Methods. Treatment results of 253 patients with severe traumatic brain injury of Ternopil University Hospital were evaluated due to the type of respiratory support used. The results were separately evaluated in alive and dead patients.Results. Mortality rate of patients depended on the type of mechanical ventilation that was used. The highest mortality (58.69 %) was in the group, when a patient was transferred to forced ventilation a volume control. The mortality rate was decreasing by 51.78% in case of adding PEEP. The strategy of using accessory lung ventilation patterns CPAP and BiPAP caused significant (in 1.48 times) decrease of mortality in this group of patients.Conclusion The survival of patients with severe traumatic brain injury, who were ventilated by the method of consistent combination of forced ventilation with pressure control (CРV) and 2 patterns of accessory lung ventilation: Constant Positive Airway Pressure (CPAP) and Biphasic positive airway pressure (BiPAP), is reliably higher than in the case of forced ventilation with volume control with Positive end-expiratory pressure.

scholarly journals The role of Continuous Positive Airway Pressure (CPAP) in Delaying or Avoiding Mechanical Ventilation in COVID-19 Respiratory Failure: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Allan Cameron ◽  
Sharif Fattah ◽  
Laura Knox ◽  
Pauline Grose
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Royal Infirmary ◽  
High Dependency ◽  
Number Of Patients

Abstract Background - During the winter of 2020-2021, the second wave of the COVID19 pandemic in the United Kingdom caused increased demand for intensive care unit (ICU) beds, and in particular, for invasive mechanical ventilation (IMV). To alleviate some of this pressure, some centres offered non-invasive continuous positive airway pressure (CPAP), delivered on specialised COVID high dependency units (cHDUs). However, this practice was based largely on anecdotal reports, and it is not clear from the literature how effective CPAP is at delaying or preventing IMV. Methods - This was a retrospective observational cohort study of consecutive patients admitted to a specialised cHDU at Glasgow Royal Infirmary between November 2020 and February 2021. Each patient had a continuous record of the level of respiratory support required, and was followed up to hospital discharge or death. We examined patient outcomes according to age, sex and maximum level of respiratory support, using logistic regression and time-to-event analysis. The number of patients who could not be oxygenated by standard oxygen facemask but could be oxygenated by CPAP was counted and compared to the number of patients admitted to ICU for IMV over the same period.Results - There were 152 admissions to cHDU over the study period. Of these, 125 received CPAP treatment. Of the patients who received support in cHDU, the overall mortality rate was 37.9% (95% CI 30.3% - 46.1%)). Odds of mortality were closely correlated with increasing age and oxygen requirement. Of the 152 patients, 44 patients (28.8%, 95% CI 22.0 – 36.9%) went on to require IMV in ICU. This represents 77.2% of the 57 COVID-19 admissions to ICU during the same period. However, there were also 41 patients who received levels of respiratory support on cHDU which would normally necessitate ICU admission but who never went to ICU, potentially reducing ICU admissions by 41.8% (95% CI 32.1 – 52.2%).Conclusion - Providing respiratory support in cHDU reduced the number of potential ICU admissions by 41.8%, as well as delaying IMV for over 75% of ICU admissions. This represents a significant sparing of ICU capacity at a time when IMV beds were in high demand.

scholarly journals Mechanical ventilation in patients with severe traumatic brain injury: modern guidelines review

2021 ◽  
Vol 17 (6) ◽  
pp. 28-34
Author(s):  
D.A. Krishtafor ◽  
O.M. Klygunenko ◽  
O.V. Kravets ◽  
V.V. Yekhalov ◽  
O.V. Liashchenko
Keyword(s):  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Distress Syndrome ◽  
Extubation Failure ◽  
Neurological Patients ◽  
Ventilation Modes ◽  
Common Group ◽  
Ventilation Strategies

Traumatic brain injury is the most common group of injuries among victims admitted to the emergency departments. Up to 20 % of individuals with brain damage require endotracheal intubation and mechanical ventilation, the duration of which is significantly longer than in non-neurological patients. Such patients have a higher incidence of acute respiratory distress syndrome and ventilator-associated pneumonia, and weaning and extubation are associated with significant difficulties. However, patients with traumatic brain injury are often excluded from randomized trials, and international guidelines for the treatment of severe traumatic brain injury do not provide clear ventilation strategies. Analysis of the literature allowed us to identify modern principles of respiratory support in severe traumatic brain injury, which include: tracheal intubation in Glasgow coma scale score of ≤ 8 points; early mechanical ventilation; PaO2 in the range of 80–120 mm Hg (SaO2 ≥ 95 %), PaCO2 — 35–45 mm Hg; tidal volume ≤ 8 ml/kg; respiratory rate ≈ 20/min; PEEP ≥ 5 cm H2O; head elevation by 30°; sedation in poor synchronization with the respirator; weaning from the respirator through the use of support ventilation modes; extubation when reaching 3 points on the VISAGE scale; early (up to 4 days) tracheostomy in predicted extubation failure.

scholarly journals 0516 Positive Airway Pressure Compliance In Post-acute Stroke And Traumatic Brain Injury Patients

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A207-A207
Author(s):  
Stefanie Howell ◽  
Stephanie Robinson ◽  
Grace Griesbach
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Stroke ◽  
Airway Pressure ◽  
Positive Airway Pressure

An Evaluation of Continuous Positive Airway Pressure (CPAP) Therapy in the Treatment of Hypernasality Following Traumatic Brain Injury

2004 ◽  
Vol 19 (3) ◽  
pp. 241-253 ◽  
Author(s):  
Louise M. Cahill ◽  
Aimee B. Turner ◽  
Penelope A. Stabler ◽  
Paula E. Addis ◽  
Deborah G. Theodoros ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Cpap Therapy

A case of significant subcutaneous emphysema on non-invasive respiratory support in a late preterm infant

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Satyaranjan Pegu ◽  
Jaya P. Bodani ◽  
Bakul Deb
Keyword(s):  
Mechanical Ventilation ◽  
Subcutaneous Emphysema ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Late Preterm ◽  
Respiratory Support ◽  
Late Preterm Infant ◽  
Preterm Baby ◽  
Non Invasive ◽  
Premature Babies

Abstract Air leaks are known complications associated with mechanical ventilation, with a higher incidence in more premature babies. Pneumothorax and pneumomediastinum are the most common ones and the majority would resolve spontaneously without active intervention. Subcutaneous emphysema is very rare, with few reported cases in neonates. We report here a case of extensive subcutaneous emphysema, pneumothorax and pneumomediastinum in a late preterm baby developed while on nasal continuous positive airway pressure (nCPAP) respiratory support.

Treatment of Severe Traumatic Brain Injury in the Scandinavian Countries, with Special Emphasis on the Lund Concept

Neurotrauma ◽  
2018 ◽  
pp. 29-40
Author(s):  
Magnus Olivecrona ◽  
Per-Olof Grände
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Fluid Therapy ◽  
Cerebral Perfusion ◽  
Brain Perfusion ◽  
Brain Trauma ◽  
Volume Control ◽  
Brain Trauma Foundation ◽  
The Brain

The Lund concept (LC) and the Brain Trauma Foundation (BTF) guidelines are used in Scandinavia and the Nordic countries to treat severe brain trauma (s-TBI). In this chapter, the authors focus on the LC developed in Scandinavia. When introduced in 1992, it was a theoretical approach, based mainly on principles of brain volume control and of optimization of brain perfusion. The BTF guidelines presented in 1996 were based on meta-analytic approaches. The LC gives relatively strict outlines regarding cerebral perfusion pressure, fluid therapy, ventilation, sedation, nutrition, the use of vasopressors, and osmotherapy. The treatment is standardized, with less need for individualization.

Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting

2020 ◽  
Vol 39 (5) ◽  
pp. 410-413 ◽  
Author(s):  
Bentley Woods Curry ◽  
Steven Ward ◽  
Christopher J. Lindsell ◽  
Kimberly W. Hart ◽  
Jason T. McMullan
Keyword(s):  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Prehospital Setting
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