Use of volume-targeted non-invasive bilevel positive airway pressure ventilation in a patient with amyotrophic lateral sclerosis,

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease in which most patients die of respiratory failure. Although volume-targeted non-invasive bilevel positive airway pressure (BPAP) ventilation has been studied in patients with chronic respiratory failure of various etiologies, its use in ALS has not been reported. We present the case of a 66-year-old woman with ALS and respiratory failure treated with volume-targeted BPAP ventilation for 15 weeks. Weekly data downloads showed that disease progression was associated with increased respiratory muscle weakness, decreased spontaneous breathing, and increased use of non-invasive positive pressure ventilation, whereas tidal volume and minute ventilation remained relatively constant.

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Oxygenation failure after cardiac surgery: early re-intubation versus treatment by nasal continuous positive airway pressure (NCPAP) or non-invasive positive pressure ventilation (NPPV)

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2008.425 ◽

2016 ◽

Vol 70 (2) ◽

Author(s):

Muhammed Kurt ◽

Udo Boeken ◽

Jens Litmathe ◽

Peter Feindt ◽

Emmeran Gams

Keyword(s):

Cardiac Surgery ◽

Respiratory Failure ◽

Oxygen Transfer ◽

Airway Pressure ◽

Positive Pressure Ventilation ◽

Positive Airway Pressure ◽

Positive Pressure ◽

Non Invasive ◽

Group A ◽

Group B

Background: Due to an increasing incidence of respiratory failure after cardiac surgery we wanted to study whether nasal continuous positive airway pressure (NCPAP) may improve pulmonary oxygen transfer and may avoid reintubation after coronary operations. Additionally, we compared this protocol to non-invasive positive pressure ventilation (NPPV). Methods: For a period of 2 years we analyzed all patients that were extubated within 12 hours after coronary surgery, and in whom oxygen transfer (PaO2/FIO2) deteriorated without hypercapnia so that all these patients met predefined criteria for reintubation: group A=immediate reintubation (n=88), group B=NCPAP-treatment (n=173), group C=NPPV(n=18). Results: 25,4% of group B- and 22,2% of group C-patients were also intubated after a period of NCPAP or NPPV. All other patients of groups B and C could be weaned from these devices (B = 34.3 ± 5.9 hours; C = 26.4 ± 4.4 h; p<0.05) and were well oxygenated by face mask at ambient pressure (Ratio PaO2/FIO2: B, 138 ± 13; C, 140 ± 13). In group A we found a higher mortality (7.95%) compared to group B (4.04%) and group C (5.55%). NCPAP-patients suffered more frequently from an impaired sternal wound healing (A = 4.5%, B = 8.6%; p<0.05). Conclusions: We conclude that reintubation after cardiac operations should be avoided since NCPAP and NPPV are safe and effective to improve arterial oxygenation in most patients with non hypercapnic respiratory failure.

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A Retrospective Analysis of Feeding Practices and Complications in Patients with Critical Bronchiolitis on Non-Invasive Respiratory Support

Children ◽

10.3390/children8050410 ◽

2021 ◽

Vol 8 (5) ◽

pp. 410

Author(s):

Ariann Lenihan ◽

Vannessa Ramos ◽

Nichole Nemec ◽

Joseph Lukowski ◽

Junghyae Lee ◽

...

Keyword(s):

Respiratory Failure ◽

Enteral Nutrition ◽

Acute Respiratory Failure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Severity Of Illness ◽

Respiratory Support ◽

Early Enteral Nutrition ◽

Non Invasive ◽

Bilevel Positive Airway Pressure

Limited data exist regarding feeding pediatric patients managed on non-invasive respiratory support (NRS) modes that augment oxygenation and ventilation in the setting of acute respiratory failure. We conducted a retrospective cohort study to explore the safety of feeding patients managed on NRS with acute respiratory failure secondary to bronchiolitis. Children up to two years old with critical bronchiolitis managed on continuous positive airway pressure, bilevel positive airway pressure, or RAM cannula were included. Of the 178 eligible patients, 64 were reportedly nil per os (NPO), while 114 received enteral nutrition (EN). Overall equivalent in severity of illness, younger patients populated the EN group, while the NPO group experienced a higher incidence of intubation. Duration of stay in the pediatric intensive care unit and non-invasive respiratory support were shorter in the NPO group, though intubation eliminated the former difference. Within the EN group, ninety percent had feeds initiated within 48 h and 94% reached full feeds within 7 days of NRS initiation, with an 8% complication and <1% aspiration rate. Reported complications did not result in escalation of respiratory support. Notably, a significant improvement in heart rate and respiratory rate was noted after feeds initiation. Taken together, our study supports the practice of early enteral nutrition in patients with critical bronchiolitis requiring NRS.

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