scholarly journals The Effect of Foot Reflection Massage on the Reduction of Respiratory Distress Syndrome in Premature Infants Under Non-Invasive Ventilation in the Neonatal Intensive Care Unit

2021 ◽  
Vol 29 (2) ◽  
pp. 113-125
Author(s):  
Neda Jamali Soltani ◽  
Akram Peyman ◽  
Tahere Ashk Torab ◽  
Kiyarash Saatchi ◽  
Neda Alimohamadi ◽  
...  
2020 ◽  
Vol 13 (10) ◽  
pp. e235243
Author(s):  
Syed Muhammad Tahir Nasser ◽  
Madan Narayanan

Proning intubated patients with acute respiratory distress syndrome (ARDS) is an established practice to improve oxygenation temporarily. We present two cases of patients on our intensive care unit with ARDS, on non-invasive ventilation (NIV), in whom proning improved oxygenation at a stage when intubation was the next step. We discuss the mechanisms by which proning improves oxygenation as well as the potential risks proning on NIV brings, for which we make specific recommendations.


Scire Salutis ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 43-53
Author(s):  
Simone Amancio Teles ◽  
Marineth Ferreira de Carvalho Teixeira ◽  
Daniela Maristane Vieira Lopes Maciel

A Síndrome do Desconforto Respiratório (SDR) é um distúrbio que acomete principalmente os recém-nascidos prematuros pela imaturidade pulmonar, resultante da deficiência ou inativação do surfactante. O surfactante é uma substância lipoprotéica produzida pelas células pneumócitos tipo II e armazenado nos corpos lamelares para, posteriormente, ser liberado no espaço alveolar, sintetizado a partir da 20º semana de gestação, com pico de produção por volta da 35º semana. A função do surfactante é diminuir a tensão superficial dos alvéolos, evitando o colabamento na expiração. Quanto menor a idade gestacional de nascimento, maior o risco de desenvolver a SDR. A prematuridade e a imaturidade do sistema respiratório levam à maior necessidade de suporte ventilatório invasivo, oxigenioterapia, assistência fisioterapêutica e internação na unidade de terapia intensiva neonatal. A fisioterapia respiratória tem papel importante na manutenção da permeabilidade das vias aéreas, prevenção de complicações respiratórias, promoção da higiene brônquica, otimização da reexpansão pulmonar, posicionamento adequado e vigilância nos ajustes dos parâmetros da ventilação mecânica invasiva e não invasiva. Este estudo tem o objetivo de realizar uma revisão bibliográfica para identificar as estratégias terapêuticas respiratórias utilizadas pelo fisioterapeuta na assistência ao recém-nascido prematuro com Síndrome do Desconforto Respiratório. Para este fim, fizemos um levantamento de artigos científicos em bases de dados eletrônicos como SciELO, LILACS, Google Acadêmico e PubMed, através dos cognatos ‘Síndrome do Desconforto Respiratório’, ‘prematuros’, ‘unidade de terapia intensiva neonatal’, ‘fisioterapia’ e ‘ventilação mecânica’, e seus correlatos em inglês ‘Respiratory Distress Syndrome’, ‘premature infants’, ‘neonatal intensive care unit’, e ‘physical therapy and mechanical ventilation’. A assistência fisioterapêutica a neonatos prematuros com SDR na UTIN é imprescindível para o sucesso da terapêutica e melhora progressiva da função pulmonar até a alta. O fisioterapeuta deve exercer um plano de tratamento integral e humanizado indo desde o ajuste ventilatório invasivo e não invasivo a execução de manobras terapêuticas, posicionamento e cuidados com a ocorrência de sequelas como hemorragia intraperiventricular e displasia broncopulmonar que podem comprometer o desenvolvimento neuropsicomotor e qualidade de vida após alta hospitalar.


2021 ◽  
Vol 20 (3) ◽  
pp. 92-99

Objective. To assess the effectiveness of differentiated approach and the safety of non-invasive ventilation in the DuoPAP mode in infants with respiratory distress syndrome and extremely low birth weight in the early neonatal period. Patients and methods. A retrospective and prospective analysis in the period from January 2018 to April 2020. 80 children were included in the study (46 girls and 34 boys), who were born prematurely at the gestational age of 24 to 29 weeks with a body weight of 700 to 999 grams and with the main clinical nosology of the early neonatal period – respiratory distress syndrome (68.7%; n = 55) and congenital pneumonia (31.3%; n = 25). Results. The clinical manifestations and features of the diagnosis of respiratory distress syn-drome in premature infants with extremely low body weight in the early neonatal period were studied. A differentiated approach to the tactics of conducting initial respiratory therapy in the ventilation mode with biphasic positive airway pressure was presented. Indications, contraindications and clinical and laboratory predictors of the effective and safe implementation of initial respiratory support in the DuoPAP mode (analogous to the BiPAP regimen) in premature infants with respiratory distress syndrome were formed. Conclusion. Generation of indications, contraindications and timely developed clinical and laboratory predictors make it possible to personify the initial tactics of respiratory therapy in premature infants with extremely low body weight in the conditions of neonatal intensive care unit. A differentiated approach to initial non-invasive ventilation in infants with respiratory distress syndrome is an important preventive tool to minimize ventilator-associated lung injury and intraventricular hemorrhage in the early neonatal period. Key words: premature birth, premature infants, extremely low body weight, respiratory support, respiratory distress syndrome in infants, non-invasive mechanical ventilation, surfactant


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arash Malakian ◽  
Mohammad Reza Aramesh ◽  
Mina Agahin ◽  
Masoud Dehdashtian

Abstract Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002). Conclusions In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group. Trial registration IRCT20180821040847N1, Approved on 2018-09-10.


2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  

Ventilatory support is vital for the management of severe forms of COVID-19. Non-invasive ventilation is often used in patients who do not meet criteria for intubation or when invasive ventilation is not available, especially in a pandemic when resources are limited. Despite non-invasive ventilation providing effective respiratory support for some forms of acute respiratory failure, data about its effectiveness in patients with viral-related pneumonia are inconclusive. Acute respiratory distress syndrome caused by severe acute respiratory syndrome-coronavirus 2 infection causes life-threatening respiratory failure, weakening the lung parenchyma and increasing the risk of barotrauma. Pulmonary barotrauma results from positive pressure ventilation leading to elevated transalveolar pressure, and in turn to alveolar rupture and leakage of air into the extra-alveolar tissue. This article reviews the literature regarding the use of non-invasive ventilation in patients with acute respiratory failure associated with COVID-19 and other epidemic or pandemic viral infections and the related risk of barotrauma.


2020 ◽  
Vol 15 (6) ◽  
pp. 94-102
Author(s):  
O.V. Zavyalov ◽  
◽  
V.V. Marenkov ◽  
A.A. Dementyev ◽  
I.N. Pasechnik ◽  
...  

The aim of this study was to evaluate the efficacy of non-invasive respiratory therapy using the method of dual positive airway pressure (DuoPAP) via nasal prongs performed in the intensive care unit and neonatal intensive care unit in premature newborns with extremely low body weight and respiratory distress syndrome in the early neonatal period. We conducted a retrospective analysis of 55 medical records of premature newborns treated in the intensive care unit of the Perinatal Center at S.S. Yudin City Clinical Hospital during the first 7 days of their life. We included patients treated between January 2018 and December 2019. All newborns had extremely low body weight (850 ± 149 g); mean gestational age was 28 ± 4 weeks; Apgar score at the first minute of life varied between 3 and 6; Silverman Anderson score (severity of respiratory disorders) was between 3 and 5 s. Standard examination was performed in accordance with current protocols developed by Russian and foreign specialists in neonatal medicine. A specially developed clinical protocol of the study was approved by the local ethics committee. Study participants were divided into 3 groups according to their type of spontaneous respiratory efforts, target level of preductal saturation, and Silverman Anderson score. Patients in Group I received synchronized intermittent mandatory ventilation (SIMV); patients in Group II received ventilation using DuoPAP via nasal prongs (if it was ineffective, we considered SIMV via tube); patients in group III received ventilation using DuoPAP only. In this study, we have identified indications and contraindications for initial and prolonged respiratory therapy with DuoPAP and developed main practical recommendations for effective and safe application of DuoPAP. The efficacy and safety of non-invasive respiratory therapy with DuoPAP via nasal prongs in extremely premature infants with respiratory distress syndrome in the early neonatal period is primarily determined by the newborn’s readiness for active spontaneous and productive respiratory movements, but not only by the compensated parameters of the acid-base state and gas composition of the capillary blood. The assessment of feasibility and limitations of non-invasive respiratory therapy with DuoPAP is an important step towards developing a clinical protocol for respiratory therapy in the early neonatal period in a neonatal intensive care unit; it will help to reduce the use of invasive lung ventilation. Key words: premature newborns, non-invasive respiratory therapy, respiratory distress syndrome, extremely low body weight


2021 ◽  
pp. 18-21
Author(s):  
Ahmet Özdemir ◽  
Mustafa Ali Akın ◽  
Osman Baştug ◽  
Tamer Güneş

The aim of the present study was to compare the efficacy of leak compensated nasal SIMV (LCnSIMV) and leak synchronized nasal SIMV (LSnSIMV) modes in order to reduce the need for endotracheal intubation and associated complications in newborns with respiratory distress. This randomized, prospective study was conducted on 50 infants (25 per group) with gestational age below 34 weeks and/or below 2000 grams who have been admitted to NICU of Erciyes University Hospital because of respiratory distress syndrome (RDS) and need for mechanical ventilation. Infants with congenital heart disease, nasopharyngeal pathology (coanal atresia and cleft palate-lip) were excluded. Infants monitored on mechanical ventilator after surfactant were randomly assigned to LCnSIMV and LSnSIMV groups before extubation. SPO2/FiO2 (S/F), peak heart rate (PHR), respiration rate per minute (RRM), and arterial blood pressure (aBP) values of patients were recorded. Gestational age, birth weight, gender, RDS, patent ductus arteriosus (PDA) requiring treatment, presence of intraventricular bleeding (IVH), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) were recorded. The patients enrolled in the study were female by 48% and male by 52%. There was not any statistically significant difference between groups for gender, postnatal age and birth weight. There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for non-invasive ventilation period and re-intubation rate (p=0.04 and p=0.03, respectively). There was detected statistically significant difference between LCnSIMV and LSnSIMV groups for SpO2 and S/F rates at 60 minutes (p=0.03 and p=0.01, respectively). There was not any difference between groups for blood pressure, PDA, IVH, ROP, BPD, NEC, sepsis and air leak. It may be appropriate to prefer the LSnSIMV method in patients with respiratory distress syndrome who need non-invasive ventilation in the pre-extubation period by considering the patient-ventilator compliance for positive effect in terms of mechanical clinical variables.


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