Severe Acute Asthma (Status Asthmaticus)

2020 ◽  
Keyword(s):  
Oxygen Saturation ◽  
Magnesium Sulfate ◽  
Oxygen Therapy ◽  
Status Asthmaticus ◽  
Acute Asthma ◽  
High Flow ◽  
Key Points ◽  
High Flow Oxygen ◽  
Asthma Status ◽  
Severe Acute Asthma

Key Points Initiate high- flow oxygen therapy to maintain oxygen saturation of greater than 90%.Dexamethasone is as effective as methylprednisolone and should be given as soon as possible.Intravenous magnesium sulfate is a useful adjunct if therapy with β-agonists and anti-cholinergics are not effective initially.

Severe Acute Asthma (Status Asthmaticus)

2016 ◽  
pp. 2971-2976
Author(s):  
Alan R. Schroeder ◽  
David N. Cornfield
Keyword(s):  
Status Asthmaticus ◽  
Acute Asthma ◽  
Asthma Status ◽  
Severe Acute Asthma

scholarly journals Impact of high-flow oxygen therapy during exercise in idiopathic pulmonary fibrosis: a pilot crossover clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Diana Badenes-Bonet ◽  
Pilar Cejudo ◽  
Anna Rodó-Pin ◽  
Clara Martín-Ontiyuelo ◽  
Roberto Chalela ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Oxygen Saturation ◽  
Exercise Capacity ◽  
Oxygen Therapy ◽  
Supplemental Oxygen ◽  
Cardiopulmonary Exercise Test ◽  
High Flow ◽  
Rehabilitation Programs ◽  
High Flow Oxygen

Abstract Background Supplemental oxygen delivered with standard oxygen therapy (SOT) improves exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Although high-flow nasal cannula oxygen therapy (HFNC) improves oxygenation in other respiratory diseases, its impact on exercise performance has never been evaluated in IPF patients. We hypothesized that HFNC may improve exercise capacity in IPF subjects compared to SOT. Methods This was a prospective, crossover, pilot randomized trial that compared both oxygenation methods during a constant submaximal cardiopulmonary exercise test (CPET) in IPF patients with exertional oxygen saturation (SpO2) ≤ 85% in the 6-min walking test. The primary outcome was endurance time (Tlim). Secondary outcomes were muscle oxygen saturation (StO2) and respiratory and leg symptoms. Results Ten IPF patients [71.7 (6) years old, 90% males] were included. FVC and DLCO were 58 ± 11% and 31 ± 13% pred. respectively. Tlim during CPET was significantly greater using HFNC compared to SOT [494 ± 173 vs. 381 ± 137 s, p = 0.01]. HFNC also associated with a higher increase in inspiratory capacity (IC) [19.4 ± 14.2 vs. 7.1 ± 8.9%, respectively; p = 0.04], and a similar trend was observed in StO2 during exercise. No differences were found in respiratory or leg symptoms between the two oxygen devices. Conclusions This is the first study demonstrating that HFNC oxygen therapy improves exercise tolerance better than SOT in IPF patients with exertional desaturation. This might be explained by changes in ventilatory mechanics and muscle oxygenation. Further and larger studies are needed to confirm the benefits of HFNC in IPF patients and its potential usefulness in rehabilitation programs.

High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

2020 ◽  
Vol 5 (4) ◽  
pp. 1006-1010
Author(s):  
Jennifer Raminick ◽  
Hema Desai
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Oxygen Therapy ◽  
Respiratory Illness ◽  
High Flow ◽  
Oral Feeding ◽  
Respiratory Support ◽  
Acute Respiratory Illness ◽  
High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

scholarly journals Impact of flow and temperature on non‐dyspnoeic dogs' tolerance undergoing high‐flow oxygen therapy

2020 ◽  
Author(s):  
C. Harduin ◽  
B. Allaouchiche ◽  
J. Nègre ◽  
I. Goy‐Thollot ◽  
A. Barthélemy ◽  
...  
Keyword(s):  
Oxygen Therapy ◽  
High Flow ◽  
High Flow Oxygen
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