scholarly journals Role of Non-Invasive Mechanical Ventilation for Acute Respiratory Failure in Cancer Patients

2020 ◽  
Vol 3 (1) ◽  
pp. 298-301
Author(s):  
Madindra Bahadur Basnet ◽  
Krishna Prasad Acharya ◽  
Deepak Adhikari
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Cancer Patients ◽  
Invasive Mechanical Ventilation ◽  
Invasive Ventilation ◽  
Timely Initiation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Introduction: Acute respiratory failure is a common cause of Intensive care Unit admission for cancer patients. Non-invasive ventilation comes in between the two extreme situations: either provide only oxygen or ventilate invasively. This study was done to find the usefulness and efficacy of non-invasive ventilation in a cancer patient. Materials and Methods: A cross-sectional study was done at Nepal Cancer Hospital. Data analysis of patients requiring non-invasive ventilation at the Intensive care Unit from April 14, 2018, to April 13, 2019, were included. Results: Among 68 studied patients, the primary reason for the initiation of non-invasive ventilation sepsis (16.32%), pneumonia (10.88%), and lung cancer (10.2%). Postoperative atelectasis, pulmonary edema, and morphine overdose were associated with good respiratory improvement and Intensive care Unit survival (100%, 75% and 66.67% respectively). Respiratory failure with carcinoma lung, lung fibrosis, acute respiratory distress syndrome, terminally ill patients, and patients with low Glasgow Coma Scale had high failure rates (Survival: 13.33%, 14.29%, 16.67%, 0%, and 20% respectively). Conclusions: Non-invasive ventilation seems to be an effective way of ventilation for cancer patients. The selection of patients and timely initiation of non-invasive ventilation is of utmost importance for a better outcome.  

Non-invasive ventilation in intensive care unit: yesterday, today, tomorrow (literature review)

2021 ◽  
pp. 42-51
Author(s):  
A. V. Vlasenko ◽  
A. G. Koryakin ◽  
E. A. Evdokimov ◽  
I. S. Klyuev
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Negative Effects ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
The One

The development of medical technologies and the emergence of new methods of respiratory support with extensive capabilities to control positive pressure on the inhale and exhale made it possible to implement non-invasive ventilation. The integration of microprocessors in modern respiratory interfaces, on the one hand, and a deeper understanding of the mechanisms of the pathogenesis of respiratory failure, on the other hand, made it possible to improve and implement various methods of non-invasive respiratory support in everyday clinical practice. The experience gained in recent decades with the use of non-invasive ventilation made it possible to widely use this method of respiratory support in a wide variety of clinical situations. However, the selection of patients for mask ventilation, the choice of method and algorithm for its application, prognosis of effectiveness, prevention of negative effects, as before, remain relevant. This dictates the need to continue studying the clinical efficacy of non-invasive ventilation in patients with respiratory failure of various origins. The review presents the possibilities and limitations of the use of non-invasive respiratory support in patients with respiratory failure in the intensive care unit.

scholarly journals Clinical scoring for the failure of non-invasive ventilation in acute respiratory failure patients in the Emergency Department.

2020 ◽  
Author(s):  
Wijittra liengswangwong ◽  
Chaiyaporn Mahidol Yuksen ◽  
Tipanun Thepkong ◽  
Pornita Nakasint ◽  
Chetsadakon Jenpanitpong
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Serum Lactate ◽  
Multivariable Logistic Regression Analysis ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Scoring

Abstract Background Non-invasive mechanical ventilation (NIV) has become an alternative to an invasive artificial airway for the management of acute respiratory failure (ARF). NIV failure causes delayed intubation, which eventually has been associated with increased morbidity and mortality. This study aimed to develop the clinical scoring system of NIV failure in ARF patients. Methods This study was a diagnostic, retrospectively cross-sectional, and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between February 2017 and December 2017. We included all of the acute respiratory failure patients aged >18 years and received non-invasive ventilation (NIV). Clinical factors associated with NIV failure were recorded. The predictive model and prediction score for NIV failure were developed by multivariable logistic regression analysis. Result A total of 329 acute respiratory failure patients have received NIV success (N = 237) and failure (N = 92). This study showed that NIV failure was associated with heart rate > 110 bpm, systolic BP < 110 mmHg, SpO2 < 90%, arterial pH < 7.30 and serum lactate. The clinical scores were classified into three groups: low, moderate, and high. Conclusion We suggested that the novel clinical scoring of the NIV failure in this study may use as a good predictor for NIV failure in the emergency room.

scholarly journals Outcome of Non-Invasive Ventilation in Patients of Acute Respiratory Failure.

2021 ◽  
Vol 4 (1) ◽  
pp. 21-26
Author(s):  
Anusmriti Pal ◽  
Manoj Kumar Yadav ◽  
Chiranjeevi Pant
Keyword(s):  
Intensive Care Unit ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Face Mask ◽  
Invasive Ventilation ◽  
Failure Group ◽  
Non Invasive ◽  
Arterial Blood ◽  
Copd Patients ◽  
Non Invasive Ventilation

Introduction: Non-invasive ventilation (NIV) is a method of ventilator support or delivery of positive pressure into the lungs usually through a face mask, mostly initiated before severe acidosis occurs. NIV failure requiring invasive mechanical ventilation in decompensated chronic obstructive pulmonary disease (COPD) patients is low, but, in critical patients, it is as high as 60%. Acute respiratory failure (ARF) is the common reason for admission to the intensive care unit. This study assesses the outcome of NIV among patients with acute respiratory failure, the duration of use, stay in ICU, and failure rate of NIV. Such type of study result is scarce in our country. Methods:  Arterial blood gases were assessed prior, after, and at discontinuation of NIV. NIV was delivered by ventilator via face mask. All patients above age 15 years who presented to the hospital, diagnosed to have ARF by ABG were included and admitted to Medical Intensive Care Unit (MICU). . Appropriate statistical tests (Chi-square) were performed and the statistical significance of the results was assessed. Results: 35 patients with the median age of 73 years (range: 39- 89 years), of 60.0 % females among which 74.3 % were current smokers. Arterial blood pH prior to admission ranged from 7.11-7.39 and 7.06-7.41 among NIV success and failure, respectively. Similarly, PCo2 ranged from 54.0-127.5 and 29.5-105.9 among them, respectively. Two hours after ventilation pH ranged from 7.12-7.43 and 7.05-7.30 respectively in the success and failure group. The most common disease condition requiring NIV was 77.1% COPD.  Out of NIV failure group (n=19) ,57.8 % were intubated and 42.1% patients left the intervention.  Conclusions: Usage of NIV among ARF patients was associated with lower intubation and ICU mortality rate. COPD patients showed the most benefit with NIV, whereas patients suffering from interstitial lung disease, lung cancer had less benefit.

scholarly journals Non-invasive ventilation for SARS-CoV-2 acute respiratory failure: a subanalysis from the HOPE COVID-19 registry

2021 ◽  
Vol 38 (5) ◽  
pp. 359-365
Author(s):  
Maurizio Bertaina ◽  
Ivan J Nuñez-Gil ◽  
Luca Franchin ◽  
Inmaculada Fernández Rozas ◽  
Ramón Arroyo-Espliguero ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Primary Endpoint ◽  
Significant Proportion ◽  
Composite Endpoint ◽  
Hospital Death ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

BackgroundThe COVID-19 pandemic has seriously challenged worldwide healthcare systems and limited intensive care facilities, leading to physicians considering the use of non-invasive ventilation (NIV) for managing SARS-CoV-2-related acute respiratory failure (ARF).MethodsWe conducted an interim analysis of the international, multicentre HOPE COVID-19 registry including patients admitted for a confirmed or highly suspected SARS-CoV-2 infection until 18 April 2020. Those treated with NIV were considered. The primary endpoint was a composite of death or need for intubation. The components of the composite endpoint were the secondary outcomes. Unadjusted and adjusted predictors of the primary endpoint within those initially treated with NIV were investigated.Results1933 patients who were included in the registry during the study period had data on oxygen support type. Among them, 390 patients (20%) were treated with NIV. Compared with those receiving other non-invasive oxygen strategy, patients receiving NIV showed significantly worse clinical and laboratory signs of ARF at presentation. Of the 390 patients treated with NIV, 173 patients (44.4%) met the composite endpoint. In-hospital death was the main determinant (147, 37.7%), while 62 patients (15.9%) needed invasive ventilation. Those requiring invasive ventilation had the lowest survival rate (41.9%). After adjustment, age (adjusted OR (adj(OR)) for 5-year increase: 1.37, 95% CI 1.15 to 1.63, p<0.001), hypertension (adj(OR) 2.95, 95% CI 1.14 to 7.61, p=0.03), room air O2 saturation <92% at presentation (adj(OR) 3.05, 95% CI 1.28 to 7.28, p=0.01), lymphocytopenia (adj(OR) 3.55, 95% CI 1.16 to 10.85, p=0.03) and in-hospital use of antibiotic therapy (adj(OR) 4.91, 95% CI 1.69 to 14.26, p=0.003) were independently associated with the composite endpoint.ConclusionNIV was used in a significant proportion of patients within our cohort, and more than half of these patients survived without the need for intubation. NIV may represent a viable strategy particularly in case of overcrowded and limited intensive care resources, but prompt identification of failure is mandatory to avoid harm. Further studies are required to better clarify our hypothesis.Trial registration numbersNCT04334291/EUPAS34399.

scholarly journals Non-invasive Ventilation for Acute Respiratory Failure

2014 ◽  
Vol 5 (2) ◽  
pp. 81-103
Author(s):  
Rodolfo Ferrari ◽  
Fabrizio Giostra ◽  
Daniela Agostinelli ◽  
Mario Cavazza
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Close Monitoring ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Key Points ◽  
Essential Questions ◽  
The Right

Giant steps are what Non-Invasive Mechanical Ventilation (NIMV) has taken in the last decades for the treatment of Acute Respiratory Failure. NIMV is safe and effective when applied early to carefully selected patients not meeting criteria for invasive ventilation. A well-fitting interface, close monitoring, coaching and clear information provided to patients, and a trained and skilled team available throughout the 24-h period are crucial factors to get to the best outcome, to reduce morbility and mortality associated to endotracheal intubation. Moving from the essential questions, in this review we focused on the key points to know and understand NIMV in some lights and shadows. What is NIMV and what do we mean speaking about NIMV? Which kind of NIMV is it suitable? Why NIMV works? Who is the right patient, and who is the right doctor, for NIMV? When to start NIMV? Where to perform NIMV? How to carry out NIMV? How long to go on with NIMV?

scholarly journals Early detection of non-invasive ventilation failure among acute respiratory failure patients in the emergency department

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
W. Liengswangwong ◽  
C. Yuksen ◽  
T. Thepkong ◽  
P. Nakasint ◽  
C. Jenpanitpong
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Serum Lactate ◽  
Multivariable Logistic Regression Analysis ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Scoring

Abstract Background Non-invasive mechanical ventilation (NIV) has become an alternative to an invasive artificial airway for the management of acute respiratory failure (ARF). NIV failure causes delayed intubation, which eventually has been associated with increased morbidity and mortality. This study aimed to develop the clinical scoring system of NIV failure in ARF patients. Methods This study was a diagnostic, retrospectively cross-sectional, and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between February 2017 and December 2017. We included all of the acute respiratory failure patients aged > 18 years and received non-invasive ventilation (NIV). Clinical factors associated with NIV failure were recorded. The predictive model and prediction score for NIV failure were developed by multivariable logistic regression analysis. Result A total of 329 acute respiratory failure patients have received NIV success (N = 237) and failure (N = 92). This study showed that NIV failure was associated with heart rate >  110 bpm, systolic BP <  110 mmHg, SpO2 < 90%, arterial pH < 7.30 and serum lactate. The clinical scores were classified into three groups: low, moderate, and high. Conclusion We suggested that the novel clinical scoring of the NIV failure in this study may use as a good predictor for NIV failure in the emergency room.

scholarly journals Early detection of non-invasive ventilation failure among acute respiratory failure patients in the Emergency Department

2020 ◽  
Author(s):  
Wijittra liengswangwong ◽  
Chaiyaporn Mahidol Yuksen ◽  
Tipanun Thepkong ◽  
Pornita Nakasint ◽  
Chetsadakon Jenpanitpong
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Serum Lactate ◽  
Multivariable Logistic Regression Analysis ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Scoring

Abstract Background Non-invasive mechanical ventilation (NIV) has become an alternative to an invasive artificial airway for the management of acute respiratory failure (ARF). NIV failure causes delayed intubation, which eventually has been associated with increased morbidity and mortality. This study aimed to develop the clinical scoring system of NIV failure in ARF patients. Methods This study was a diagnostic, retrospectively cross-sectional, and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between February 2017 and December 2017. We included all of the acute respiratory failure patients aged >18 years and received non-invasive ventilation (NIV). Clinical factors associated with NIV failure were recorded. The predictive model and prediction score for NIV failure were developed by multivariable logistic regression analysis.Result A total of 329 acute respiratory failure patients have received NIV success (N = 237) and failure (N = 92). This study showed that NIV failure was associated with heart rate > 110 bpm, systolic BP < 110 mmHg, SpO2 < 90 %, arterial pH < 7.30 and serum lactate. The clinical scores were classified into three groups: low, moderate, and high.Conclusion We suggested that the novel clinical scoring of the NIV failure in this study may use as a good predictor for NIV failure in the emergency room.

Sign in / Sign up

Export Citation Format

Share Document