scholarly journals Extracorporeal CO2 Removal in Acute Exacerbation of COPD Not Responding to Non-Invasive Ventilation: a Single Center Experience

2021 ◽  
Author(s):  
Mathilde Azzi ◽  
Jerome Aboab ◽  
Sophie Alviset ◽  
Daria Ushmorova ◽  
Luis Ferreira ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Control Group ◽  
Complication Rates ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Copd Patients ◽  
Non Invasive Ventilation ◽  
The Mean ◽  
And Control ◽  
Mean Time

Abstract Background: Acute exacerbation of chronic obstructive pulmonary disease (ae-COPD) has a gold standard treatment: non-invasive ventilation (NIV). However, this treatment sometime fails, and an invasive mechanical ventilation (IMV) is required. The extracorporeal CO₂ removal (ECCO₂R) device can be an alternative to intubation. The aim of the study is to evaluate ECCO₂R efficiency and safety and enlighten ECCO₂R benefit/risk compared to IMV.Methods: Consecutive ae-COPD patients for whom NIV failed were retrospectively analyzed during two periods: before and after the ECCO₂R device implementation in our ICU in 2015. We considered the before period as standard of care and patients were treated with IMV. The ECCO₂R device was a pump-driven veno-venous system (Xenios AG).Results: The two groups (ECCO₂R n = 26 and Control group n = 25) were comparable at baseline except for the BMI which was significantly higher in the ECCO₂R group (30kg/m² versus 25kg/m²). The pH and PaCO₂ improved significantly in both groups. The mean time on ECCO₂R was 5,4 days whereas IMV lasted 27 days in the control group. Four patients needed IMV in the ECCO₂R group (of which 3 occurred after ECCO₂R weaning). There were 7 major bleeding events with ECCO₂R and 3 led to premature termination of ECCO₂R. In the control group, there were 8 ventilator associated pneumonia, 25 haemodynamic instability and 6 self extubations. The mean time in ICU and hospital stay in the ECCO₂R and control groups were 18 vs 30 days, 29 vs 49 days, respectively and the 90-day mortality rates were 15% vs 28%.Conclusions: ECCO₂R brings significant improvement on pH and PaCO₂ in ae-COPD patients failing NIV therapy and permit to avoid intubation in 85% with low complication rates compared to IMV. These results have yet to be proven in a larger randomized study.Trial registration: ClinicalTrials.gov, NCT04882410. Date of registration May 12th 2021, Retrospectively registered.https://www.clinicaltrials.gov/ct2/show/NCT04882410

scholarly journals Extracorporeal CO2 removal in acute exacerbation of COPD unresponsive to non-invasive ventilation

2021 ◽  
Vol 8 (1) ◽  
pp. e001089
Author(s):  
Mathilde Azzi ◽  
Jerome Aboab ◽  
Sophie Alviset ◽  
Daria Ushmorova ◽  
Luis Ferreira ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Invasive Mechanical Ventilation ◽  
Control Group ◽  
Co2 Removal ◽  
Complication Rates ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Link Type ◽  
Non Invasive Ventilation ◽  
Mean Time

BackgroundThe gold-standard treatment for acute exacerbation of chronic obstructive pulmonary disease (ae-COPD) is non-invasive ventilation (NIV). However, NIV failures may be observed, and invasive mechanical ventilation (IMV) is required. Extracorporeal CO₂ removal (ECCO₂R) devices can be an alternative to intubation. The aim of the study was to assess ECCO₂R effectiveness and safety.MethodsPatients with consecutive ae-COPD who experienced NIV failure were retrospectively assessed over two periods of time: before and after ECCO₂R device implementation in our ICU in 2015 (Xenios AG).ResultsBoth groups (ECCO₂R: n=26, control group: n=25) were comparable at baseline, except for BMI, which was significantly higher in the ECCO₂R group (30 kg/m² vs 25 kg/m²). pH and PaCO₂ significantly improved in both groups. The mean time on ECCO₂R was 5.4 days versus 27 days for IMV in the control group. Four patients required IMV in the ECCO₂R group, of whom three received IMV after ECCO₂R weaning. Seven major bleeding events were observed with ECCO₂R, but only three led to premature discontinuation of ECCO₂R. Eight cases of ventilator-associated pneumonia were observed in the control group. Mean time spent in the ICU and mean hospital stay in the ECCO₂R and control groups were, respectively, 18 vs 30 days, 29 vs 49 days, and the 90-day mortality rates were 15% vs 28%.ConclusionsECCO₂R was associated with significant improvement of pH and PaCO₂ in patients with ae-COPD failing NIV therapy. It also led to avoiding intubation in 85% of cases, with low complication rates.Trial registration numberClinicalTrials.gov, NCT04882410. Date of registration 12 May 2021, retrospectively registered.https://www.clinicaltrials.gov/ct2/show/NCT04882410.

Five-year outcome in COPD patients after their first episode of acute exacerbation treated with non-invasive ventilation

Respirology ◽  
2010 ◽  
Vol 15 (7) ◽  
pp. 1084-1091 ◽  
Author(s):  
Li Ping CHUNG ◽  
Peta WINSHIP ◽  
Scott PHUNG ◽  
Fiona LAKE ◽  
Grant WATERER
Keyword(s):  
Acute Exacerbation ◽  
First Episode ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Copd Patients ◽  
Non Invasive Ventilation

scholarly journals Application Effect and Nursing of Non-Invasive Ventilation in Acute Exacerbation of Chronic Obstruction Pulmonary Disease Patients

2015 ◽  
Vol 4 (4) ◽  
pp. 8
Author(s):  
Zongying Li
Keyword(s):  
Acute Exacerbation ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Control Group ◽  
Blood Gas ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Significant Difference ◽  
Experimental Group

<p><strong>Objective:</strong> To study the application methods, summarize the nursing experience and discuss the clinical effect of non-invasive ventilation in acute exacerbation of chronic obstructive pulmonary disease (COPD). <strong>Methods:</strong> 152 cases of AECOPD patients, who received treatment in our hospital from January 2011 to December 2013, were selected and divided into the experimental group and control group randomly. Patients in control group received conventional treatment, whereas besides conventional treatment, experimental group received non-invasive positive pressure ventilation and relevant nursing management. The changes in arterial blood gas and clinical indicators before and after treatment for both groups were observed. <strong>Results:</strong> After 7 days treatment, all the results of blood gas analysis were significantly improved (<em>p</em> &lt; 0.05). For the respiratory status (based on Borg scale), two groups were significantly improved after treatment, however, experimental group shown better than control group (<em>p</em> &lt; 0.05). The two groups had statistically significant difference (<em>p</em> &lt; 0.05) in the aspects of prognosis, endotracheal intubation and hospitalization time. As for the death index, there was no significant difference between two groups. No special treatment was needed for adverse reactions, they would be relieved slowly. <strong>Conclusion:</strong> Non-invasive positive pressure ventilation able to improve the recovery rate and quality of life of patients with acute exacerbation of COPD.</p>

scholarly journals Noninvasive Ventilation in patients with Sleep Apnea syndrome complicated with GERD.

2020 ◽  
Vol 27 (01) ◽  
pp. 120-124
Author(s):  
Umar Usman ◽  
Mohsin Riaz Askri ◽  
Shumyala Maqbool
Keyword(s):  
Sleep Apnea ◽  
Statistical Difference ◽  
Control Group ◽  
Clinical Effects ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Study Results ◽  
And Control ◽  
Experimental Group

Objectives: The access the clinical effects of non-invasive ventilation in patients with obstructive sleep apnea (OSA) accompanied with GERD. Study Design: Randomized Controlled Trial. Setting: DHQ Teaching Hospital Faisalabad Material. Periods: January 2018 to December 2018. Material & Methods: As Stated in sleep study results, 100 patients with OSA were divided into three different groups according to the disease severity that is mild, moderate, and severe groups. Gastroscopy was performed in all the patients and underwent GERD assessment. Twenty-three patients with OSA accompanied with GERD were segregated into an experimental group and control group, who were given omeprazole (40 mg/time per day) combined with non-invasive ventilation therapy and omeprazole (40 mg/time per day) alone, respectively, for eight weeks. After that, they Underwent gastroscopy and GERD assessment. Results: Among all the 100 patients with OSA, 48 were in the mild group, 33 in the moderate group, and 19 in the severe group. Their GERD scores were 8.26 ± 1.11, 9.87 ± 1.79, and 12.34 ± 2.02, respectively, with a statistical difference (P = 0.004). Out of 23 patients with OSA associated with GERD were divided into The Experimental Group, which included 12 patients, and Control Group, which included. 11 patients. The gastroscopy efficacy rates for inflammation management were 86.53% and 53.09%, respectively, with a statistical difference (P = 0.011). The ΔGERD scores for the two groups also differed significantly (5.11 ± 1.54 vs 2.35 ± 0.72, P = 0.034). Conclusion: Patients having severe OSA were associated with a high incidence rate of GERD than those with moderate or mild OSA. Those who were treated with non-invasive ventilation combined with PPI shown much better results than PPI alone in respect of clinical effects in patients with OSA associated with GERD.

Effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration in preterm infants using non-invasive ventilation

MedPharmRes ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 46-51
Author(s):  
Chau Vu Bao Nguyen ◽  
Tinh Thu Nguyen ◽  
Tam Thi Thanh Pham ◽  
Sen Thi Hong Lam ◽  
Le An Pham ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Nasal Cannula ◽  
The Other ◽  
Control Group ◽  
Invasive Ventilation ◽  
Nasal Bridge ◽  
Non Invasive ◽  
Hydrocolloid Dressing ◽  
Non Invasive Ventilation

Background: The use of non-invasive ventilation (NIV) in preterm infants is becoming increasingly common. The use of cannula in NIV can cause ulceration of the nasal bridge with the current practices using the thin foam patches. This study aims to evaluate the effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration comparing to that of the thin foam patches. Methods: A prospective cohort study using hydrocolloid dressing pads (1 November to 30 April 2020) was compared to that of a historical control group using thin foam dressing (1 April to 15 October 2019) to evaluate the effectiveness of hydrocolloid dressing pads. All participants were preterm infants (less than 37 weeks of gestational age) and used nasal cannula NIV at the Department of Neonatal Intensive Care (NICU), Children's Hospital 1. Results: 71 infants used hydrocolloid dressing pads, and 42 used ordinary thin foam nasal dressings. In the hydrocolloid dressings group, two infants (2.8%) had nasal ulcers; among them, one was mild, and the other was moderate. In comparison, ten infants (23.8%) using thin foam dressings developed ulcers, of which seven were mild, two were moderate, and one was severe. Using hydrocolloid nasal dressings significantly reduced nasal ulceration compared to thin foam dressings (OR = 0.09, 95%CI = 0.02 – 0.45). Conclusion: Using hydrocolloid nasal dressings for preterm infants on nasal cannula NIV significantly reduced nasal ulceration compared to ordinary thin foam dressings.

Walking with Non-Invasive Ventilation Does Not Prevent Exercise-Induced Hypoxaemia in Stable Hypercapnic COPD Patients

2015 ◽  
Vol 12 (5) ◽  
pp. 546-551 ◽  
Author(s):  
David Johannes Walker ◽  
Stephan Walterspacher ◽  
Emelie Ekkernkamp ◽  
Jan Hendrik Storre ◽  
Wolfram Windisch ◽  
...  
Keyword(s):  
Invasive Ventilation ◽  
Non Invasive ◽  
Copd Patients ◽  
Non Invasive Ventilation ◽  
Exercise Induced
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