Real-time measurement of transcutaneous PCO2vs arterial/venous PCO2in subjects with severe respiratory failure undergoing non-invasive ventilation on the emergency department – An observational study

2015 ◽  
Author(s):  
Christian Horvath ◽  
Martin Brutsche ◽  
Florent Baty ◽  
Jochen Rüdiger
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Observational Study ◽  
Real Time ◽  
Time Measurement ◽  
Severe Respiratory Failure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Real Time Measurement ◽  
Non Invasive Ventilation

scholarly journals The impact of non-invasive respiratory support techniques on the lethal outcome frequency in adult with severe respiratory failure caused by the new coronavirus infection

2021 ◽  
Vol 18 (1) ◽  
pp. 47-56
Author(s):  
К. A. Tsygankov ◽  
I. N. Grachev ◽  
Vladimir I. Shatalov ◽  
А. V. Schegolev ◽  
D. A. Аveryanov ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Oxygen Therapy ◽  
High Flow ◽  
Severe Respiratory Failure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen ◽  
Coronavirus Infection ◽  
Group 2

The objective: to evaluate the effect of high-flow oxygen and non-invasive ventilation on the mortality rate in adults with severe respiratory failure caused by the new coronavirus infection in the intensive care unit (ICU).Subjects and methods. A one-center retrospective study was conducted. Electronic medical files of patients treated in the ICU from April 1 to May 25, 2020, were analyzed. Totally, 101 medical files were selected, further, they were divided into two groups. Group 1 (n = 49) included patients who received oxygen insufflation, and should it fail, they received traditional artificial ventilation. No non-invasive respiratory therapy was used in this group. Group 2 (n = 52) included patients who received high-flow oxygen therapy and non-invasive ventilation. The mortality rate in the groups made a primary endpoint for assessing the impact of high-flow oxygen therapy and non-invasive ventilation. The following parameters were also analyzed: drug therapy, the number of patients in whom non-invasive techniques were used taking into account the frequency of cases when these techniques failed, and the number of patients in whom artificial ventilation was initiated.Results. In Group 2, non-invasive methods of respiratory therapy were used in 31 (60%) cases. High-flow oxygen therapy was used in 19 (36%) of them; in 13 cases this method allowed weaning them from the high flow. Non-invasive ventilation was used in 18 cases, in 12 patients it was used due to progressing severe respiratory failure during humidified oxygen insufflation, in 6 patients – after the failed high-flow oxygen therapy. In Group 1, 25 (51%) patients were intubated and transferred to artificial ventilation, in Group 2, 10 (19.2%) underwent the same. The lethal outcome was registered in 23 (47%) cases in Group 1, and in 10 (19.2%) in Group 2 (p = 0.004). Analysis of drug therapy in the groups revealed the difference in the prescription of pathogenetic therapy. Logistic regression demonstrated the effectiveness of the combination of tocilizumab + a glucocorticoid in reducing the frequency of lethal cases (p = 0.001).Conclusion. The use of non-invasive respiratory support in adults with severe respiratory failure caused by the new coronavirus infection combined with therapy by tocilizumab + a glucocorticoid can reduce the incidence of lethal cases.

scholarly journals Effectiveness and applicability of Non-Invasive Ventilation (NIV) in the Emergency Department in acute respiratory failure due to Sars-CoV-2 pneumonia

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
Federico Lari ◽  
Fabrizio Giostra ◽  
Stefania Guerrini
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
De Novo ◽  
Correct Identification ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Radiological Features ◽  
Non Invasive Ventilation ◽  
Hypoxic Respiratory Failure

Treatment of de novo acute hypoxic respiratory failure is not recommended by current Non-Invasive Ventilation (NIV) guidelines as it does not seem to improve patients outcome. Many cases of acute hypoxic respiratory failure associated with Sars-Cov2 infection (SARI) have been observed during Sars-Cov2 pandemic. So far, data are missing regarding the use of NIV, but a correct identification of subgroups of patients based on different clinical, patho-physiological and radiological features, might be helpful for stratifying patients and choosing the correct respiratory support (invasive versus non-invasive). In case of NIV appliance, risk of environmental virus dispersion is particularly elevated; therefore, extreme attention by operators is required.

scholarly journals A Clinical Study of Role of Noninvasive Ventilation in Community Acquired Pneumonia Patients with Acute Respiratory Failure – A Prospective Observational Study from Telangana, India

2021 ◽  
Vol 10 (22) ◽  
pp. 1686-1691
Author(s):  
Pampana Eshwaramma ◽  
Gaddam Ramulu Yadav ◽  
Vankayala Veena Reddy ◽  
Tarigopula Pramod Kumar ◽  
Mandapakala Gopala Krishna Murthy ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Observational Study ◽  
Acute Respiratory Failure ◽  
Antibiotic Therapy ◽  
Prospective Observational Study ◽  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

BACKGROUND Community-Acquired Pneumonia (CAP) is defined as “an acute infection of the pulmonary parenchyma. The most important complication of CAP is Acute Respiratory Failure (ARF) and some of them may require Invasive Mechanical Ventilation (IMV) to manage hypoxia and hypoventilation along with appropriate antibiotic therapy. A number of studies, however, indicate that IMV is associated with high rates of serious complications and mortality in patients with ARF. For this reason Non-Invasive Ventilation (NIV) has been used for ARF of diverse aetiologies.The most important rationale for using NIV in early stages of respiratory failure is to decrease the workload on respiratory muscles and improve ventilation by applying positive airway pressure. This may help to overcome an episode of severe ARF without the need for MV. In this study we evaluated the efficacy of NIV in patients with ARF and compare the outcome of using NIV in CAP with ARF patients with and without comorbidities. METHODS This prospective observational study was done on 150 CAP patients in acute respiratory failure who received NIV. It was conducted in the Department of Respiratory Medicine in Gandhi Hospital, Secunderabad, for a period of one year and six months. A comparative analysis of the outcome of using NIV in CAP with ARF patients with and without co-morbidities was carried out. RESULTS In the current study 150 CAP patients with ARF who needed NIV, were treated initially with NIV, antibiotic therapy and other supportive measures as per the American Thoracic Society (ATS) guidelines 32. 95 (63.3 %) of 150 patients were continuously treated with NIV. Apart from these, 55 (36.7 %) patients required MV. In patients with continued NIV, 93 (98 %) recovered, remaining 2 died with sudden cardiac arrest. In patients who were gone for MV, 12 (22 %) survived. CONCLUSIONS Early intervention by NIV in CAP patients suffering from acute respiratory failure secondary to community acquired pneumonia was found to be successful in avoiding mechanical ventilation and its attendant morbidity and mortality31. Early intervention with NIV, identifying risk factors for NIV failure, addressing associated co-morbid conditions will go in a long way in effectively managing these patients by significantly minimizing the ICU and hospital stay. Patients with co-morbidities have more chances of NIV failures. Patients with co morbidities on NIV stayed significantly more number of days in the hospital than patients without co-morbidities. The current study suggests that co morbid patients require more monitoring as compared to patients without co morbidities on NIV. KEY WORDS Community-Acquired Pneumonia (CAP), Non-Invasive Ventilation (NIV), Mechanical Ventilation (MV), Acute Respiratory Failure (ARF), Arterial Blood Gas Analysis (ABG), Intensive Care Unit (ICU), Intubation

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