scholarly journals A New Device for Managing Refractory Epistaxis in ICU Patients with COVID-19

2021 ◽  
pp. 1-2
Author(s):  
Olivier Choussy ◽  
Olivier Choussy ◽  
Nicolas Viault ◽  
Wahib Ghanem ◽  
Antoine Dubray Vautrin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Oxygen Therapy ◽  
High Flow ◽  
Severe Respiratory Failure ◽  
Disease Treatment ◽  
Icu Patients ◽  
New Device ◽  
Therapeutic Anticoagulation ◽  
Severe Epistaxis ◽  
Systemic Anticoagulation

Epistaxis is a common and a well-known symptom. Nasal packing is an effective treatment in most cases [1]. The COVID-19 disease treatment includes conventional or high flow nasal oxygen therapy and systemic anticoagulation [2]. Patients in intensive care unit may require therapeutic anticoagulation for venous thromboembolism, hyperinflammatory status, extracorporeal membrane oxygenation (ECMO) and multiple other pathologies. The use of therapeutic anticoagulation increases risk of nose bleeding, and its management may be challenging. CAVI-T (Figures 1 & 2) is a new asymmetrical low-pressure balloon that have shown promising results to control epistaxis in emergency. We report herein the management of severe epistaxis in two COVID-19 patients admitted to ICU for severe respiratory failure.

scholarly journals Comparison of high-flow nasal oxygen therapy and non-invasive ventilation in ICU patients with acute respiratory failure and a do-not-intubate orders: a multicentre prospective study OXYPAL

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045659
Author(s):  
René Robert ◽  
Denis Frasca ◽  
Julie Badin ◽  
C Girault ◽  
Christophe Guitton ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Therapy ◽  
High Flow ◽  
Invasive Ventilation ◽  
Clinical Practices ◽  
Icu Patients ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Registration Number

IntroductionA palliative approach to intensive care unit (ICU) patients with acute respiratory failure and a do-not-intubate order corresponds to a poorly evaluated target for non-invasive oxygenation treatments. Survival alone should not be the only target; it also matters to avoid discomfort and to restore the patient’s quality of life. We aim to conduct a prospective multicentre observational study to analyse clinical practices and their impact on outcomes of palliative high-flow nasal oxygen therapy (HFOT) and non-invasive ventilation (NIV) in ICU patients with do-not-intubate orders.Methods and analysisThis is an investigator-initiated, multicentre prospective observational cohort study comparing the three following strategies of oxygenation: HFOT alone, NIV alternating with HFOT and NIV alternating with standard oxygen in patients admitted in the ICU for acute respiratory failure with a do-not-intubate order. The primary outcome is the hospital survival within 14 days after ICU admission in patients weaned from NIV and HFOT. The sample size was estimated at a minimum of 330 patients divided into three groups according to the oxygenation strategy applied. The analysis takes into account confounding factors by modelling a propensity score.Ethics and disseminationThe study has been approved by the ethics committee and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03673631

scholarly journals The impact of non-invasive respiratory support techniques on the lethal outcome frequency in adult with severe respiratory failure caused by the new coronavirus infection

2021 ◽  
Vol 18 (1) ◽  
pp. 47-56
Author(s):  
К. A. Tsygankov ◽  
I. N. Grachev ◽  
Vladimir I. Shatalov ◽  
А. V. Schegolev ◽  
D. A. Аveryanov ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Oxygen Therapy ◽  
High Flow ◽  
Severe Respiratory Failure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen ◽  
Coronavirus Infection ◽  
Group 2

The objective: to evaluate the effect of high-flow oxygen and non-invasive ventilation on the mortality rate in adults with severe respiratory failure caused by the new coronavirus infection in the intensive care unit (ICU).Subjects and methods. A one-center retrospective study was conducted. Electronic medical files of patients treated in the ICU from April 1 to May 25, 2020, were analyzed. Totally, 101 medical files were selected, further, they were divided into two groups. Group 1 (n = 49) included patients who received oxygen insufflation, and should it fail, they received traditional artificial ventilation. No non-invasive respiratory therapy was used in this group. Group 2 (n = 52) included patients who received high-flow oxygen therapy and non-invasive ventilation. The mortality rate in the groups made a primary endpoint for assessing the impact of high-flow oxygen therapy and non-invasive ventilation. The following parameters were also analyzed: drug therapy, the number of patients in whom non-invasive techniques were used taking into account the frequency of cases when these techniques failed, and the number of patients in whom artificial ventilation was initiated.Results. In Group 2, non-invasive methods of respiratory therapy were used in 31 (60%) cases. High-flow oxygen therapy was used in 19 (36%) of them; in 13 cases this method allowed weaning them from the high flow. Non-invasive ventilation was used in 18 cases, in 12 patients it was used due to progressing severe respiratory failure during humidified oxygen insufflation, in 6 patients – after the failed high-flow oxygen therapy. In Group 1, 25 (51%) patients were intubated and transferred to artificial ventilation, in Group 2, 10 (19.2%) underwent the same. The lethal outcome was registered in 23 (47%) cases in Group 1, and in 10 (19.2%) in Group 2 (p = 0.004). Analysis of drug therapy in the groups revealed the difference in the prescription of pathogenetic therapy. Logistic regression demonstrated the effectiveness of the combination of tocilizumab + a glucocorticoid in reducing the frequency of lethal cases (p = 0.001).Conclusion. The use of non-invasive respiratory support in adults with severe respiratory failure caused by the new coronavirus infection combined with therapy by tocilizumab + a glucocorticoid can reduce the incidence of lethal cases.

scholarly journals Home Management of Patients with Moderate or Severe Respiratory Failure Secondary to COVID-19, Using Remote Monitoring and Oxygen with or without HFNC

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 413
Author(s):  
Anna Annunziata ◽  
Antonietta Coppola ◽  
Novella Carannante ◽  
Francesca Simioli ◽  
Maurizia Lanza ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Clinical Experience ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
Home Treatment ◽  
Severe Respiratory Failure ◽  
High Flow Nasal Cannula ◽  
Lung Failure ◽  
At Home

Background: Home treatment of patients affected by COVID-19 is still a matter of daily debate. During the clinical evolution of the disease, there are high risks of lung failure, which requires oxygen therapy. Here, we report our clinical experience with at-home treatment using high-flow nasal cannula in non-hospitalised patients with confirmed COVID-19. Patients and methods: In this study, 18 patients with moderate-to-severe respiratory failure secondary to COVID-19 were monitored at home daily for temperature and SpO2 measurements. Other parameters such as saturation of peripheral oxygen (SpO2), SpO2/FiO2 (fraction of inspired oxygen), temperature, and lung performance were monitored periodically. Depending on oxygen requirements, the patients also received either standard oxygen via a face mask or, if higher FiO2 required, high-flow nasal cannula (HFNC). Results: All 18 patients had favourable outcomes and recovered from COVID-19. No death was recorded in this group. Conclusion: Our clinical experience proves that high-flow nasal cannula oxygen therapy may be considered for at-home treatment of COVID-19 patients with moderate lung failure. This could be useful for further treatment during the pandemic and may also be considered in future epidemics.

scholarly journals Comparison between high-flow nasal oxygen cannula and conventional oxygen therapy after extubation in pediatric intensive care unit

2018 ◽  
Vol 60 (2) ◽  
pp. 126 ◽  
Author(s):  
Başak Akyıldız ◽  
Sedat Öztürk ◽  
Nazan Ülgen-Tekerek ◽  
Selim Doğanay ◽  
Süreyya Burcu Görkem
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Oxygen Therapy ◽  
Pediatric Intensive Care ◽  
High Flow

Pre-oxygenation with high-flow nasal cannula oxygen therapy and non-invasive ventilation for intubation in the intensive care unit

2016 ◽  
Vol 42 (8) ◽  
pp. 1291-1292 ◽  
Author(s):  
Emmanuel Besnier ◽  
Kévin Guernon ◽  
Michael Bubenheim ◽  
Philippe Gouin ◽  
Dorothée Carpentier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
Invasive Ventilation ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Non Invasive Ventilation
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