scholarly journals Non-invasive Respiratory Support in COVID-19: A Narrative Review

2022 ◽  
Vol 8 ◽  
Author(s):  
Manel Luján ◽  
Javier Sayas ◽  
Olga Mediano ◽  
Carlos Egea
Keyword(s):  
Oxygen Therapy ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Questions ◽  
Continuous Positive Pressure ◽  
Nasal Flow ◽  
Improvement Procedures

Acute respiratory failure secondary to COVID-19 pneumonia may require a variety of non-pharmacological strategies in addition to oxygen therapy to avoid endotracheal intubation. The response to all these strategies, which include high nasal flow, continuous positive pressure, non-invasive ventilation, or even prone positioning in awake patients, can be highly variable depending on the predominant phenotypic involvement. Deciding when to replace conventional oxygen therapy with non-invasive respiratory support, which to choose, the role of combined methods, definitions, and attitudes toward treatment failure, and improved case improvement procedures are directly relevant clinical questions for the daily care of critically ill COVID-19 patients. The experience accumulated after more than a year of the pandemic should lead to developing recommendations that give answers to all these questions.

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.

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 The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 883
Author(s):  
Kosmas Sarafidis ◽  
William Chotas ◽  
Eleni Agakidou ◽  
Paraskevi Karagianni ◽  
Vasiliki Drossou
Keyword(s):  
Invasive Mechanical Ventilation ◽  
Cost Benefit ◽  
Respiratory Support ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Future Challenges ◽  
Key Factor ◽  
The Cost ◽  
Administration Methods

Defining improvements in healthcare can be challenging due to the need to assess multiple outcomes and measures. In neonates, although progress in respiratory support has been a key factor in improving survival, the same degree of improvement has not been documented in certain outcomes, such as bronchopulmonary dysplasia. By exploring the evolution of neonatal respiratory care over the last 60 years, this review highlights not only the scientific advances that occurred with the application of invasive mechanical ventilation but also the weakness of the existing knowledge. The contributing role of non-invasive ventilation and less-invasive surfactant administration methods as well as of certain pharmacological therapies is also discussed. Moreover, we analyze the cost–benefit of neonatal care-respiratory support and present future challenges and perspectives.

scholarly journals Tracheal Diverticulum in SARS-CoV-2 Patients on Non-Invasive Ventilation A not so “Spontaneous” Cause of Pneumomediastinum? An imaging Pictorial Presentation of Two Cases with Review of Literature

2021 ◽  
Vol 28 (2) ◽  
pp. 19
Author(s):  
Veena Mariam Joseph ◽  
Donboklang Lynser ◽  
Iadarilang Tiewsoh ◽  
Kaustuv Dutta ◽  
Pranjal Phukan ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Non Invasive ◽  
Pictorial Presentation ◽  
Tracheal Diverticulum ◽  
Free Air ◽  
Non Invasive Ventilation ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous pneumomediastinum is a rare but potentially life-threatening condition, the incidence of which has showed an increase in patients with SARS-CoV-2 pneumonia, especially when they are on positive pressure ventilation. None of the reported cases of covid related pneumomediastinum had an associated tracheal diverticulum. Also, to the best of our knowledge, tracheal diverticulum has not been reported in patients on NIV. We report 2 cases of COVID-19 pneumonia on NIV with pneumomediastinum, which also had associated tracheal diverticulum, one of which developed after NIV. Though the establishment of causality needs further research, early detection of a tracheal diverticulum, which might be a harbinger of pneumomediastinum, can be a timely alarm to prompt titration of the pressure settings and judicious use of NIV. The role of inverted grey scale CT images in mediastinal window is a simple, yet hardly utilised radiological tool to increase detection of ‘mediastinal air’, let it be free air or air within a diverticulum. Through this case report, we would like to highlight the role of conventional and inverted CT imaging of pneumomediastinum and tracheal diverticulum in general and in SARS-CoV-2 pneumonia in particular, and to call for more objective research to throw light on the plausible relationship between pneumomediastinum and tracheal diverticulum.

scholarly journals Laryngeal closure impedes non-invasive ventilation at birth

2017 ◽  
Vol 103 (2) ◽  
pp. F112-F119 ◽  
Author(s):  
Jessica R Crawshaw ◽  
Marcus J Kitchen ◽  
Corinna Binder-Heschl ◽  
Marta Thio ◽  
Megan J Wallace ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Premature Infants ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Breathing Patterns ◽  
Laryngeal Function ◽  
Non Invasive ◽  
Laryngeal Closure ◽  
Non Invasive Ventilation

BackgroundNon-invasive ventilation is sometimes unable to provide the respiratory needs of very premature infants in the delivery room. While airway obstruction is thought to be the main problem, the site of obstruction is unknown. We investigated whether closure of the larynx and epiglottis is a major site of airway obstruction.MethodsWe used phase contrast X-ray imaging to visualise laryngeal function in spontaneously breathing premature rabbits immediately after birth and at approximately 1 hour after birth. Non-invasive respiratory support was applied via a facemask and images were analysed to determine the percentage of the time the glottis and the epiglottis were open.HypothesisImmediately after birth, the larynx is predominantly closed, only opening briefly during a breath, making non-invasive intermittent positive pressure ventilation (iPPV) ineffective, whereas after lung aeration, the larynx is predominantly open allowing non-invasive iPPV to ventilate the lung.ResultsThe larynx and epiglottis were predominantly closed (open 25.5%±1.1% and 17.1%±1.6% of the time, respectively) in pups with unaerated lungs and unstable breathing patterns immediately after birth. In contrast, the larynx and the epiglottis were mostly open (90.5%±1.9% and 72.3%±2.3% of the time, respectively) in pups with aerated lungs and stable breathing patterns irrespective of time after birth.ConclusionLaryngeal closure impedes non-invasive iPPV at birth and may reduce the effectiveness of non-invasive respiratory support in premature infants immediately after birth.

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