An analysis of the treatment effect of two modes of oxygenation on patients with radiation pneumonia complicated by respiratory failure

BACKGROUND: Stereotactic radiotherapy (SBRT) is widely used in the treatment of thoracic cancer. OBJECTIVE: To evaluate the efficacy of a non-rebreather mask (NRBM) and high-flow nasal cannula (HFNC) in patients with radiation pneumonia complicated with respiratory failure. METHODS: This was a single-center randomized controlled study. Patients admitted to the EICU of the Fourth Hospital of Hebei Medical University were selected and divided into NRBM and HFNC group. Arterial blood gas analysis, tidal volume, respiratory rates and the cases of patients receiving invasive assisted ventilation were collected at 0, 4, 8, 12, 24, 48, and 72 h after admission. RESULTS: (1) The PaO2/FiO2, respiratory rates, and tidal volume between the two groups at 0, 4, 8, 12, 24, 48, and 72 h were different, with F values of 258.177, 294.121, and 134.372, all P< 0.01. These indicators were different under two modes of oxygenation, with F values of 40.671, 168.742, and 55.353, all P< 0.01, also varied with time, with an F value of 7.480, 9.115, and 12.165, all P< 0.01. (2) The incidence of trachea intubation within 72 h between HFNC and NRBM groups (23 [37.1%] vs. 34 [54.0%], P< 0.05). The transition time to mechanical ventilation in the HFNC and NRBM groups (55.3 ± 3.2 h vs. 45.9 ± 3.6 h, P< 0.05). (3) The risk of intubation in patients with an APACHE-II score > 23 was 2.557 times than score ⩽ 23, and the risk of intubation in the NRBM group was 1.948 times more than the HFNC group (P< 0.05). CONCLUSION: Compared with the NRBM, HFNC can improve the oxygenation state of patients with radiation pneumonia complicated with respiratory failure in a short time, and reduce the incidence of trachea intubation within 72 h.

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The Use of Exogenous Lung Surfactant (Poractant Alfa) in Acute Respiratory Failure by Drowning

Case Reports in Critical Care ◽

10.1155/2020/9270791 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Mario Pezzi ◽

Francesco Givigliano ◽

Ottorino Perrone ◽

Annamaria Scozzafava ◽

Pietro Maglio ◽

...

Keyword(s):

Respiratory Failure ◽

Acute Respiratory Failure ◽

Respiratory Distress ◽

Lung Surfactant ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Lung Damage ◽

Arterial Blood Gas ◽

Natural Surfactant ◽

Arterial Blood

Drowning is an acute respiratory failure as a result from immersion or submersion of the airways in a liquid medium (predominantly water). Inhalation of water causes severe lung damage due to the destruction of pulmonary surfactant, resulting in decreased lung elasticity, alveolar collapse, alteration of ventilation-perfusion ratio, intrapulmonary blood shunting, hypoxia, acute lung injury, and Acute Respiratory Distress Syndrome (ARDS). Poractant alfa (Curosurf®), a natural surfactant effective in the treatment of newborn respiratory distress, has been used in various forms of ARDS, but in drowning syndromes, experience is still poor. We describe a series of nine clinical cases of drowning, six adults and three children, treated in our Intensive Care Unit (ICU) with endobronchial administration of poractant alfa. After 24 and 48 hours of administration in all cases, there was an improvement in arterial blood gas analysis (ABG) parameters and imaging. All patients were discharged without clinical consequences.

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A Study on the Efficacy and Safety of a New Endoscopic Nasal Mask for Intravenous Anaesthesia With Respiratory Retention: a Randomized Controlled Trial

10.21203/rs.3.rs-254489/v1 ◽

2021 ◽

Author(s):

Bin Yu ◽

Mengying Wang ◽

Xinyu Cheng ◽

Haiyue Ma ◽

Shuqi Xie

Keyword(s):

Blood Gas Analysis ◽

Day Surgery ◽

Assisted Ventilation ◽

Gas Analysis ◽

Control Group ◽

Nasal Mask ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Arterial Blood Gas Analysis ◽

Experimental Group

Abstract Background: General anaesthesia is the most common choice for day surgery, and a laryngeal mask airway is the most commonly used airway management method in general anaesthesia. Many of the complications of laryngeal mask airways are not conducive to a rapid recovery and discharge. The main purpose of this study was to verify the effectiveness and safety of a new endoscopic nasal mask for anaesthesia for a short surgery.Methods: This is a randomized controlled study of 96 patients who were scheduled to undergo hysteroscopy, breast mass resection or great saphenous vein lesion resection. They were randomly divided into two groups. After entering the operating room, 48 patients in the control group were treated with LMA-assisted ventilation, and 48 patients in the experimental group were subjected to assisted ventilation with the new endoscopic nasal mask. Both groups were given dexmedetomidine combined with sufentanil, propofol, dexamethasone, parecoxib sodium, dezocine and ramosetron to complete the intravenous general anaesthesia.The main observation indexes included the occurrence of hypoxemia (SpO2<90%) after anaesthesia induction; the occurrence of hypercapnia (PetCO2>50 mmHg) due to respiratory depression and changes in the PaO2 and PaCO2 values in the arterial blood gas analysis (ABG) results.Results: The occurrence of hypoxemia (SPO2<90%) in the experimental group and the control group was not significantly different (P>0.05). The occurrence of hypercapnia (PetCO2>50 mmHg) in the experimental group was significantly reduced compared to that in the control group (P<0.05), and the difference was statistically significant. According to the results of the preoperative and postoperative arterial blood gas analysis, there was no statistically significant difference in PaO2 and PaCO2 between the two groups (P>0.05). Conclusion: Both methods are safe and effective for anaesthesia during a short operation. The new endoscopic nasal mask can quickly and effectively provide effective ventilation . It is convenient for anaesthesia airway management for clinical short day surgery.Trial registration: Trial Registration: www.chictr.org.cn; registration no.: ChiCTR2000032548; date of registration: 3rd May 2020

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