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 Use of Nasal Non-Invasive Ventilation with a RAM Cannula in the Outpatient Home Setting

2017 ◽  
Vol 11 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Wilfredo De Jesus Rojas ◽  
Cheryl L. Samuels ◽  
Traci R. Gonzales ◽  
Katrina E. McBeth ◽  
Aravind Yadav ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Lung Disease ◽  
Chest Wall ◽  
Chronic Respiratory Failure ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Successful Implementation ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Background: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings. Objective: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure. Methods: We performed a retrospective case series of 18 children (4 months to 19 years old) using the Nasal NIV/RAM Cannula in the Pediatric Pulmonary Clinic at the McGovern Medical School, UTHealth (2014-16). Consideration for Nasal NIV/RAM Cannula utilization included: inability to wean-off in-patient respiratory support, comfort for dyspnea, intolerability of conventional mask interfaces and tracheostomy avoidance. Results: Average age was 7 years. 50% were Caucasian, 38% African-American and 11% Hispanics. Pulmonary disorders included: chest wall weakness (38%), central control abnormalities (33%), obstructive lung disease (16%) and restrictive lung disease (11%). Indications for Nasal NIV/RAM Cannula initiation included: CPAP/BPAP masks intolerability (11%), dyspnea secondary to chest wall weakness (38%) and tracheostomy avoidance (50%). Average length of use of Nasal NIV/RAM Cannula was 8.4 months. Successful implementation of Nasal NIV/Ram Cannula was 94%. One patient required a tracheostomy following the use of Nasal NIV/RAM Cannula. Significant decrease in arterial PaCO2 pre and post Nasal NIV/RAM cannula initiation was notable (p=0.001). Conclusion: Outpatient use of Nasal NIV/RAM Cannula may prove to be a feasible and save treatment alternative for children with chronic respiratory failure, chest wall weakness, dyspnea and traditional nasal/face mask intolerance to avoid tracheostomy.

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.  

Barotrauma during non-invasive ventilation for acute respiratory distress syndrome caused by COVID-19: a balance between risks and benefits

2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

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.

Predicting the success of non-invasive ventilation in preventing intubation and re-intubation in the paediatric intensive care unit

2011 ◽  
Vol 37 (12) ◽  
pp. 1994-2001 ◽  
Author(s):  
Christopher S. James ◽  
Christopher P. J. Hallewell ◽  
Dominique P. L. James ◽  
Angie Wade ◽  
Quen Q. Mok
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation
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