The impact of the COVID-19 pandemic on a domiciliary non-invasive ventilation (D-NIV) service referral

2021 ◽  
Author(s):  
Stephanie K. Mansell ◽  
Swapna Mandal
Keyword(s):  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
The Impact ◽  
Service Referral

Predicting the impact of Non-Invasive Ventilation in ED Patients with CAP

2018 ◽  
Vol 36 (4) ◽  
pp. 720 ◽  
Author(s):  
Amjad Al-Rajhi ◽  
Jason Shahin ◽  
Anwar Murad ◽  
P.Z. Li
Keyword(s):  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
The Impact

scholarly journals Changes in Respiratory Management and the Impact on Bronchopulmonary Dysplasia

2021 ◽  
Author(s):  
Jane Chung ◽  
Anjali Iyengar ◽  
Laura Santry ◽  
Eric Swanson ◽  
Jonathan M Davis ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Bronchopulmonary Dysplasia ◽  
Clinical Course ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Respiratory Management ◽  
Wide Range ◽  
Surfactant Administration ◽  
The Impact

Objective: Non-invasive respiratory support has reduced the need for mechanical ventilation and surfactant administration in very premature neonates. We sought to determine how the increased use of non-invasive ventilation and less surfactant instillation has impacted the development of bronchopulmonary dysplasia (BPD) and compared BPD outcome applying four currently used definitions. Study Design: This is a retrospective, single center cohort study of neonates born at less than 28 weeks gestation between 2010 and 2018. A respiratory practice change (less surfactant and more non-invasive ventilation) occurred in 2014 following participation in the SUPPORT trial. Therefore, patients were divided into 2 epochs to compare postnatal respiratory and clinical course and BPD outcomes across four currently relevant definitions (VON, NICHD, Canadian, NRN). Results: Clinical and demographic variables were similar between epochs. Despite significant differences in maternal and infant characteristics and clinical course, the incidence of BPD was not significantly different between the 2 epochs regardless of the BPD definition utilized. There was a wide range in the incidence of BPD depending on the definition used. Conclusions: Despite decreased use of invasive mechanical ventilation and surfactant administration between the two epochs, the incidence of BPD did not change and there was wide variation depending on the definition used. A better understanding of the risk factors associated with BPD and a consensus definition is urgently needed in order to facilitate the conduct of clinical trials and the development of novel therapeutic interventions to improve outcome.

scholarly journals P15 The impact of COVID-19 on response times for acute non-invasive ventilation set-ups

2021 ◽  
Author(s):  
A Watson ◽  
H Barnard ◽  
P Antoine-Pitterson ◽  
B Jones ◽  
A Turner ◽  
...  
Keyword(s):  
Response Times ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
The Impact

scholarly journals Experiences and views of patients, carers and healthcare professionals on using modems in domiciliary non-invasive ventilation (NIV): a qualitative study

2020 ◽  
Vol 7 (1) ◽  
pp. e000510
Author(s):  
Stephanie K Mansell ◽  
Cherry Kilbride ◽  
Martin J Wood ◽  
Francesca Gowing ◽  
Swapna Mandal
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Well Being ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Registration Number ◽  
The Impact

BackgroundAdvances in technology means that domiciliary non-invasive ventilation (NIV) devices can be remotely monitored via modems in patients’ homes. Possible benefits and challenges of modem technology have yet to be established. This study explored the perspectives and experiences of patients, their carers and healthcare professionals (HCPs) on the addition of modem technology in managing home NIV.MethodsA qualitative study using a combination of focus groups for HCPs and interviews for carers/patients was undertaken. 12 HCPs and 22 patients/carers participated. These focus groups and interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsFive main themes were identified. ‘Surveillance: a paradox of findings’: HCPs were concerned about unduly scrutinising patients’ lives, potentially impacting on HCP patient relationships. Conversely, patients welcomed modem monitoring and did not express concerns regarding invasion of privacy. ‘Sanctions’: HCPs reported the modem increased access to care and allowed appropriate assessment of ongoing treatment. ‘Complacency and ethics’: HCPs expressed concerns patients may become complacent in seeking help due to expectations of modem monitoring, as well as being concerned regarding the ethics of modems. There was a suggestion patients and carers' expectations of monitoring were different to that of clinical practice, resulting in complacency in some cases. ‘Increased time for patient focused care’: HCPs in the focus groups described a number of ways in which using modems was more efficient. ‘Confidence: can be improved with technology’: patients and carers were positive about the impact of the modems on their health and well-being, particularly their confidence.ConclusionHCPs expressed concerns about surveillance were not corroborated by patients, suggesting acceptability of remote monitoring. Data suggests a need for increased clarity to patients/carers regarding clinical practice relating to responsiveness to modem data. The issue of complacency requires further consideration. Modem technology was acceptable and considered a useful addition by HCPs, patients and carers.Trial registration numberNCT03905382

scholarly journals The DELUX study: development of lung volumes during extubation of preterm infants

2021 ◽  
Author(s):  
Leonie Plastina ◽  
Vincent D. Gaertner ◽  
Andreas D. Waldmann ◽  
Janine Thomann ◽  
Dirk Bassler ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Functional Residual Capacity ◽  
Adhesive Tape ◽  
List Type ◽  
Invasive Ventilation ◽  
Lung Volumes ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Residual Capacity ◽  
The Impact

Abstract Objective To measure changes in end-expiratory lung impedance (EELI) as a marker of functional residual capacity (FRC) during the entire extubation procedure of very preterm infants. Methods Prospective observational study in preterm infants born at 26–32 weeks gestation being extubated to non-invasive respiratory support. Changes in EELI and cardiorespiratory parameters (heart rate, oxygen saturation) were recorded at pre-specified events during the extubation procedure compared to baseline (before first handling of the infant). Results Overall, 2912 breaths were analysed in 12 infants. There was a global change in EELI during the extubation procedure (p = 0.029). EELI was lowest at the time of extubation [median (IQR) difference to baseline: −0.30 AU/kg (−0.46; −0.14), corresponding to an FRC loss of 10.2 ml/kg (4.8; 15.9), padj = 0.004]. The biggest EELI loss occurred during adhesive tape removal [median change (IQR): −0.18 AU/kg (−0.22; −0.07), padj = 0.004]. EELI changes were highly correlated with changes in the SpO2/FiO2 ratio (r = 0.48, p < 0.001). Forty per cent of FRC was re-recruited at the tenth breath after the initiation of non-invasive ventilation (p < 0.001). Conclusions The extubation procedure is associated with significant changes in FRC. This study provides novel information for determining the optimal way of extubating a preterm infant. Impact This study is the first to examine the development of lung volumes during the entire extubation procedure including the impact of associated events. The extubation procedure significantly affects functional residual capacity with a loss of approximately 10 ml/kg at the time of extubation. Removal of adhesive tape is the major contributing factor to FRC loss during the extubation procedure. Functional residual capacity is regained within the first breaths after initiation of non-invasive ventilation and is further increased after turning the infant into the prone position.

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