Flexible bronchoscopy and mechanical ventilation in managing Mounier-Kuhn syndrome: a case report

ABSTRACT CONTEXT: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support. CASE REPORT: The patient was a 60-year-old male with recurrent hospital admission. He was admitted in this case due to dyspnea, cough and sputum production. An arterial blood sample revealed decompensated respiratory acidosis with moderate hypoxemia. A chest computed tomography (CT) scan showed dilatation of the trachea and bronchi, tracheal diverticula and bronchiectasis. Flexible bronchoscopy was performed, which revealed enlarged airways with expiratory collapse. Furthermore, orifices of tracheal diverticulosis were also detected. Non-invasive positive pressure ventilation (NPPV) was added, along with long-term oxygen therapy. At control visits, the patient’s clinical and laboratory findings were found to have improved. CONCLUSION: Flexible bronchoscopy can be advocated for establishing the diagnosis and non-invasive mechanical ventilation can be used with a high success rate, for clinical wellbeing in Mounier-Kuhn syndrome.

Download Full-text

Ambulatory care of non-invasive mechanical ventilation in COPD patients with global decompensated respiratory acidosis

Pneumologie ◽

10.1055/s-0037-1598429 ◽

2017 ◽

Vol 71 (S 01) ◽

pp. S1-S125

Author(s):

EJ Soto Hurtado ◽

P Gutiérrez Castaño ◽

JJ Torres ◽

MD Jiménez Fernández ◽

M Pérez Soriano ◽

...

Keyword(s):

Mechanical Ventilation ◽

Ambulatory Care ◽

Invasive Mechanical Ventilation ◽

Respiratory Acidosis ◽

Non Invasive ◽

Copd Patients

Download Full-text

Non-Invasive Positive Pressure Ventilation Compared To Invasive Mechanical Ventilation Among Patients With COPD Exacerbations In An Inner City MICU – Predictors Of NPPV Use

The Internet Journal of Pulmonary Medicine ◽

10.5580/284f ◽

2010 ◽

Vol 12 (1) ◽

Cited By ~ 1

Keyword(s):

Mechanical Ventilation ◽

Inner City ◽

Positive Pressure Ventilation ◽

Invasive Mechanical Ventilation ◽

Positive Pressure ◽

Copd Exacerbations ◽

Non Invasive

Download Full-text

Use of Non Invasive Ventilation in Patients with Respiratory Failure in Nepal

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i4.6340 ◽

2012 ◽

Vol 9 (4) ◽

pp. 256-259 ◽

Cited By ~ 1

Author(s):

R Pandey ◽

R Chokhani ◽

N B K C

Keyword(s):

Respiratory Failure ◽

Invasive Mechanical Ventilation ◽

Respiratory Acidosis ◽

Gas Analysis ◽

Chronic Obstructive ◽

Invasive Ventilation ◽

Non Invasive ◽

Arterial Blood ◽

Non Invasive Ventilation

Background Non-invasive ventilation (NIV) has become an integral tool in the management of acute and chronic respiratory failure. Studies have shown that use of NIV decreases the length of hospital stay, improves symptoms and also reduces the need for invasive mechanical ventilation in patients with respiratory failure. However, NIV is not used sufficiently in our country. Objective To find out the outcome of Non Invasive Ventilation in Respiratory failure in Nepal. Methods Retrospective analysis of data of 28 patients in between June 2010- November 2010 was done. All the patients selected had respiratory failure. Records were analysed for documentation of clinical diagnosis. Arterial blood gases were assessed prior to, after starting and after discontinuation of NIV. The outcome of NIV and the need for domiciliary oxygen was evaluated at discharge. Results Thirty four patients received NIV out of which 6 were excluded from the study due to insufficient documentation. Out of these 28 patients, 27 received bi-level and one patient received Continuous Positive Airway Pressure. Mean age of patients was 66.5 years and ranged from 42-87 years. Majority (19, 79%) were from age group 60-80 years. Most common cause for the use of bi-level ventilation was chronic obstructive pulmonary disease with type 2 respiratory failure in 19 patients (67.8%). Others included obesity hypoventilation syndrome two, acute interstitial pneumonia two, cardiogenic pulmonary oedema two, Interstitial lung disease one, bronchogenic carcinoma one, and bronchiectasis one. Arterial blood gas analysis was done on admission and 12 hours or earlier after the onset of bi-level ventilation. At the time of admission, 89.3% of the patients had type 2 respiratory failure, of which 60.6% had respiratory acidosis and 67.9% of patients had pCO2 above 60 mm Hg. Arterial blood pH prior to admission ranged from 7.19 to 7.50. Twelve hours after bi-level ventilation, only 21.3% had pH <7.35 and 42.8% had pCO2 above 60 mm Hg. Non invasive ventilation was successful in 27 patients (96.4%). All patients were advised domiciliary oxygen and all patients had respiratory follow up arranged. Conclusions COPD patients with type 2 respiratory failure were seen to benefit most with NIV. It is a very cost effective and safe method of treatment and should be used first in patients with COPD with type 2 respiratory failure.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6340 Kathmandu Univ Med J 2011;9(4):256-59

Download Full-text

428 The use of non-invasive mechanical ventilation in the patient with deformity of the thoracic spine – case report

10.1136/archdischild-2021-europaediatrics.428 ◽

2021 ◽

Author(s):

Iva Hižar ◽

Maja Bosanac ◽

Ivan Pavić ◽

Jadranka Sekelj Fureš

Keyword(s):

Mechanical Ventilation ◽

Case Report ◽

Thoracic Spine ◽

Invasive Mechanical Ventilation ◽

Non Invasive ◽

Spine Case

Download Full-text

Outcome of ventilation in patients with hypercapnic respiratory failure in IPF patients: A prospective study

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i9.37155 ◽

2021 ◽

Vol 12 (9) ◽

pp. 111-115

Author(s):

Manjunath Hunasenahalli Krishnappa ◽

Prasanna Kumar Thimmarayappa ◽

Vivek Nangia ◽

Rajat Chatterji

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Complete Blood Count ◽

Invasive Mechanical Ventilation ◽

Arterial Blood Gas ◽

Non Invasive ◽

Arterial Blood ◽

Diffuse Parenchymal Lung Disease ◽

Gas Measurements

Background: Diffuse parenchymal lung disease (DPLD) is the inflammation and fibrosis of lung interstitium, resulting in respiratory failure. The rate of hypoxic respiratory failure is high as the disease progresses. In idiopathic pulmonary fibrosis (IPF) patients, acute deterioration leads to type 2 respiratory failure, etiology and management of which remains to be completely understood. Aims and Objectives: To identify the causes of type 2 respiratory failure and assess the outcome of invasive and non-invasive ventilation in patients with IPF. Materials and Methods: This prospective single center study included >18-year-old 44 patients with IPF. History of patients, complete blood count, chest radiograph, urine routine, spirometry with bronchodilator reversibility, DLCO (diffusing capacity for carbon monoxide) testing, arterial blood gas measurements, and antinuclear antibody (ANA) test were evaluated. Results: Fourteen (31.8%) patients developed type 2 respiratory failure (within 1.5–6 years from the time of onset of illness). Causes of respiratory failure included acute exacerbation of IPF (35.71%), infections (14.29%), heart failure (14.29%), ischemic heart disease (14.29%), pulmonary embolism (21.43%), pneumothorax (7.14%), and surgical lung biopsy (7.14%). Patients were initiated on non-invasive mechanical ventilation (NIV) (64.29%) and invasive mechanical ventilation (IMV) (35.71%). Eight (88.89%) out of 9 patients on NIV survived, whereas all 5 patients (100%) on IMV expired. Conclusion: Considering the higher mortality rate associated with IMV, NIV is a better technique than IMV for improving patient outcome and management. NIV may be effectively implemented for improving the treatment outcome in patients with IPF and avoiding any aggressive therapeutic approaches.

Download Full-text

Correlation of End-Tidal Carbon Dioxide with Arterial Carbon Dioxide in Mechanically Ventilated Neonates: A Scoping Review

Global Pediatric Health ◽

10.1177/2333794x211016790 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110167

Author(s):

Ingra Pereira Monti Martins ◽

Adriane Muller Nakato ◽

Paula Karina Hembecker ◽

Sérgio Ossamu Ioshii ◽

Percy Nohama

Keyword(s):

Carbon Dioxide ◽

Mechanical Ventilation ◽

Birth Weight ◽

Gestational Age ◽

Invasive Mechanical Ventilation ◽

Cochrane Library ◽

Non Invasive ◽

Arterial Carbon Dioxide ◽

Manual Search ◽

Arterial Blood

Monitoring CO2 levels in intubated neonates is highly relevant in the face of complications associated with altered CO2 levels. Thus, this review aims to present the scientific evidence in the literature regarding the correlation between arterial carbon dioxide measured by non-invasive methods in newborns submitted to invasive mechanical ventilation. The search was carried out from January 2020 to January 2021, in the Scopus, Medline, The Cochrane Library, Web of Science, CINAHL and Embase databases. Also, a manual search of the references of included studies was performed. The main descriptors used were: “capnography,” “premature infant,” “blood gas analysis,” and “mechanical ventilation.” As a result, 221 articles were identified, and 18 were included in this review. A total of 789 newborns were evaluated, with gestational age between 22.8 and 42.2 weeks and birth weight between 332 and 4790 g. Capnometry was the most widely used non-invasive method. In general, the correlation and agreement between the methods evaluated in the studies were strong/high. The birth weight did not influence the results. The gestational age of fewer than 37 weeks implied, in its majority, a moderate correlation and agreement. Therefore, we can conclude that there was a predominance of a strong correlation between arterial blood gases and non-invasive methods, although there are variations found in the literature. Even so, the results were promising and may provide valuable data for future studies, which are necessary to consolidate non-invasive methods as a reliable and viable alternative to arterial blood gasometry.

Download Full-text

UTILIZATION OF NON-INVASIVE POSITIVE PRESSURE VENTILATION COMPARED TO INVASIVE MECHANICAL VENTILATION AMONG PATIENTS WITH COPD IN AN UNIVERSITY AFFILIATED INNER CITY MICU: OUR LEAP FROG EXPERIENCE OVER A 3-YEAR PERIOD

CHEST Journal ◽

10.1378/chest.134.4_meetingabstracts.p101003 ◽

2008 ◽

Vol 134 (4) ◽

pp. 101P

Author(s):

Sonal Rachmale ◽

Arias Alejandro Sixto ◽

Sushmita Srivatsava ◽

Raghu Loganathan ◽

Balavenkatesha Kanna ◽

...

Keyword(s):

Mechanical Ventilation ◽

Inner City ◽

Positive Pressure Ventilation ◽

Invasive Mechanical Ventilation ◽

Positive Pressure ◽

Non Invasive

Download Full-text

Nanomembrane-Based Therapeutic Plasmapheresis after Non-Invasive Ventilation Failure for Treatment of a Patient with Acute Respiratory Distress Syndrome and Myasthenia Gravis: A Case Report

Blood Purification ◽

10.1159/000502078 ◽

2019 ◽

Vol 48 (4) ◽

pp. 382-384 ◽

Cited By ~ 2

Author(s):

Yordanka Yamakova ◽

Viktoria Asenova Ilieva ◽

Rosen Petkov ◽

Georgi Yankov

Keyword(s):

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Case Report ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Myasthenia Gravis ◽

Distress Syndrome ◽

Invasive Mechanical Ventilation ◽

Bioactive Molecules ◽

Non Invasive

Acute respiratory distress syndrome (ARDS) is characterized by a widespread inflammation of the lungs, causing severe hypoxemia. Several mediators have been associated with it and almost all of them are small enough to be filtrated through a nanomembrane. We present a case report of a 41-year-old man with myasthenia gravis in remission; he developed ARDS caused by pneumonia. Although he performed well on both non-invasive and invasive mechanical ventilation, his oxygenation continued to deteriorate. As a last resort of treatment, we decided to apply nanomembrane-based apheresis to cleanse his plasma from the harmful inflammatory mediators. After 3 sessions of plasmapheresis, his condition improved and he was successfully weaned from mechanical ventilation. The obtained results gave us ground to assume that the removal of bioactive molecules can be a useful adjunct to protective mechanical ventilation in ARDS.

Download Full-text

Ventilação não invasiva em idosos após o acidente vascular cerebral

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i7a231357p2031-2038-2018 ◽

2018 ◽

Vol 12 (7) ◽

pp. 2031

Author(s):

Maria Aquino Gouveia ◽

Maria Fernanda Vinagre ◽

Émerson Soares Pontes ◽

Carlos Eduardo Porto da Silva ◽

Ivana Araújo Pereira ◽

...

Keyword(s):

Mechanical Ventilation ◽

Artificial Respiration ◽

Invasive Mechanical Ventilation ◽

The Elderly ◽

Positive Pressure ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Obstructive Sleep ◽

Number Of Publications ◽

Continuous Positive Pressure

RESUMOObjetivo: conhecer as publicações sobre o uso de ventilação mecânica não invasiva em idosos após o acidente vascular cerebral. Método: revisão integrativa nas bases de dados LILACS, MEDLINE, Portal CAPES e biblioteca SCIELO. Selecionaram-se artigos publicados em texto completo; nos idiomas português ou inglês; disponíveis na íntegra na internet e publicados no período de 2007-2016 obrigatoriamente constando os descritores “idoso” e “acidente vascular cerebral” e um dos descritores “ventilação mecânica não invasiva”, “respiração artificial” ou “respiração com pressão positiva”, sendo dez artigos selecionados. Foi realizada a leitura analítica utilizando roteiro estruturado. Os dados coletados foram organizados em tabela e submetidos à análise. Resultados: os artigos selecionados abordaram o acidente vascular cerebral e a apneia obstrutiva do sono. Em oito artigos, a modalidade ventilatória foi a pressão positiva contínua e houve maior quantitativo de publicações no ano de 2009. Conclusão: a ventilação não invasiva apresenta benefícios na otimização, manutenção e restabelecimento da função pulmonar do idoso após o acidente vascular cerebral. O número baixo de publicações e a ausência de protocolos reforçam a necessidade de construção de instrumento para esta temática. Descritores: Idosos; Acidente Vascular Cerebral; Respiração Artificial; Respiração Com Pressão Positiva; Ventilação Não Invasiva. ABSTRACT Objective: to get to know the publications about the use of non-invasive mechanical ventilation in the elderly after stroke. Method: integrative review in the databases LILACS, MEDLINE, CAPES Portal and SCIELO library. Selected articles were published in full text; in Portuguese or English; available in full on the internet and published in the 2007-2016 period, with the descriptors "elderly" and "stroke" and one of the descriptors "non-invasive mechanical ventilation", "artificial respiration" or "positive pressure breathing", being ten selected articles. The analytical reading was performed using a structured script. The collected data were organized in table and submitted to the analysis. Results: selected articles addressed stroke and obstructive sleep apnea. In eight articles, the ventilatory modality was continuous positive pressure and there were more publications in the year 2009. Conclusion: noninvasive ventilation presents benefits in the optimization, maintenance and reestablishment of the pulmonary function of the elderly after stroke. The low number of publications and the absence of protocols reinforce the need to build an instrument for this theme. Descriptors: Elders; Cerebrovascular Accident; Artificial Respiration; Positive Pressure Breathing; Non-Invasive Ventilation. RESUMEN Objetivo: conocer las publicaciones sobre el uso de ventilación mecánica no invasiva en ancianos post accidentes cerebrovasculares. Método: revisión integrativa en las bases de datos LILACS, MEDLINE, Portal CAPES y biblioteca SCIELO. Se seleccionaron artículos publicados en texto completo, en los idiomas portugués y / o inglés; disponibles en su totalidad en Internet y publicados en el período 2007-2016, obligatoriamente constando los descriptores "anciano" y "accidente cerebrovascular", y uno de los descriptores "ventilación mecánica no invasiva", "respiración artificial" o "respiración con presión positiva". Siendo diez artículos seleccionados. Se realizó la lectura analítica, utilizando guión estructurado. Los datos recolectados fueron organizados en tabla y sometidos al análisis. Resultados: los artículos seleccionados abordaron el accidente cerebrovascular y la apnea obstructiva del sueño. En ocho artículos, la modalidad ventilatoria fue la presión positiva continua y hubo mayor cuantitativo de publicaciones en el año 2009. Conclusión: la ventilación no invasiva presenta beneficios en la optimización, mantenimiento y restablecimiento de la función pulmonar del anciano después del accidente cerebrovascular. El número bajo de publicaciones y la ausencia de protocolos, refuerzan la necesidad de construir un instrumento para esta temática. Descriptores: Personas De Edad; Accidente Cerebrovascular; Respiración Artificial; Presión Positiva De Respiración; Ventilación no Invasiva.

Download Full-text