scholarly journals How should we monitor patients with acute respiratory failure treated with noninvasive ventilation?

2018 ◽  
Vol 27 (148) ◽  
pp. 170101 ◽  
Author(s):  
Begum Ergan ◽  
Jacek Nasiłowski ◽  
João Carlos Winck
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Noninvasive Ventilation ◽  
Clinical Status ◽  
Disease Type ◽  
General Ward ◽  
High Dependency ◽  
Support Methods ◽  
Hypercapnic Acute Respiratory Failure ◽  
New Onset

Noninvasive ventilation (NIV) is currently one of the most commonly used support methods in hypoxaemic and hypercapnic acute respiratory failure (ARF). With advancing technology and increasing experience, not only are indications for NIV getting broader, but more severe patients are treated with NIV. Depending on disease type and clinical status, NIV can be applied both in the general ward and in high-dependency/intensive care unit settings with different environmental opportunities. However, it is important to remember that patients with ARF are always very fragile with possible high mortality risk. The delay in recognition of unresponsiveness to NIV, progression of respiratory failure or new-onset complications may result in devastating and fatal outcomes. Therefore, it is crucial to understand that timely action taken according to monitoring variables is one of the key elements for NIV success. The purpose of this review is to outline basic and advanced monitoring techniques for NIV during an ARF episode.

scholarly journals Dose–response characteristics of noninvasive ventilation in acute respiratory failure

2020 ◽  
Vol 6 (1) ◽  
pp. 00041-2019 ◽  
Author(s):  
Craig Hukins ◽  
Michelle Murphy ◽  
Timothy Edwards
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Noninvasive Ventilation ◽  
Dose Response ◽  
Treatment Time ◽  
Tertiary Hospital ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Response Characteristics ◽  
High Dependency

Acute noninvasive ventilation (NIV) is a well-established therapy for acute respiratory failure but the dose–response characteristics of this therapy have not been defined. The aim of this study was to define this dose–response relationship.This study was a retrospective review of patients receiving NIV for acute respiratory failure in a tertiary hospital respiratory high-dependency unit between July 2012 and June 2017. Mask-on time (rather than the period that NIV was in use) as the “dose” was compared with hospital survival as the “response”.654 patients were included, 594 (91%) with hypercapnic respiratory failure (HCRF). NIV was used for a median (interquartile range (IQR)) duration of 2.74 (1.51–4.73) days and median (IQR) mask-on time was 34 (18–60) h (56.1% (41.2–69.5%) of treatment time). There was evidence of a dose–response relationship in the HCRF group up to a ceiling of 24 h mask-on time, but not in the hypoxaemic respiratory failure (HRF) group. There was a difference in survival with as little as 2 h mask-on time (92% compared with 73%; p<0.001). Patients requiring NIV for 80–100% of therapy time had lower survival.We conclude that there is evidence of a dose–response relationship between cumulative NIV usage (mask-on time) and survival from as little as 2 h to a ceiling of ∼24 h in HCRF, but not in HRF.

scholarly journals Determinants of Noninvasive Ventilation Success or Failure in Morbidly Obese Patients in Acute Respiratory Failure

PLoS ONE ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. e97563 ◽  
Author(s):  
Malcolm Lemyze ◽  
Pauline Taufour ◽  
Alain Duhamel ◽  
Johanna Temime ◽  
Olivier Nigeon ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Noninvasive Ventilation ◽  
Morbidly Obese ◽  
Obese Patients
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