THE EARLY USE OF NON-INVASIVE VENTILATION FOR ACUTE RESPIRATORY FAILURE IN ICU

2018 ◽  
Vol 8 (4) ◽  
pp. 23-27
Author(s):  
Ha Vo Viet ◽  
Minh Nguyen Van ◽  
Thinh Tran Xuan

Background: The noninvasive ventilation (NIV) can prevent the need for intubation and the mortality associated with episodes of chronic obstructive pulmonary disease (COPD), pneumonia, asthma... The aim of this study was to find whether the introduction of NPPV early after the admission was effective at reducing the need for intubation and the mortality rate. Methods: Patients were recruited from 9/2017 to 5/2018. CPAP mode delivered through a face mask may be used. Blood gas was tested after 3 hrs. Results: 31 patients were recruited, The use of NIV significantly reduced the need for intubation. The failure rate must set an local management in the research group is 19,8%. Conclusions: The early use of NIV in ICU improved arterial blood gas, decreases the rate of need for intubation and reduces the mortality in patients with moderate respiratory failure. Key words: noninvasive ventilation (NIV), failure in ICU

Author(s):  
Victoria Stacey

Asthma - Chronic obstructive pulmonary disease (COPD) - Non-invasive ventilation - Venous thromboembolism - Pneumonia - Spontaneous pneumothorax - Respiratory failure and oxygen therapy - Arterial blood gas analysis - SAQs


2020 ◽  
Vol 3 (2) ◽  
pp. 338-342
Author(s):  
Santosh Gautam ◽  
Shiva Raj KC ◽  
Milesh Jung Sijapati ◽  
Purnima Gyawali ◽  
Geetika KC ◽  
...  

Background: The outcome of Chronic Obstructive Pulmonary Disease depends upon the partial pressure of oxygen and carbon dioxide This study was aimed to find the role of arterial blood gas parameters during the length of hospital stay among patients admitted for Chronic Obstructive Pulmonary Diseasewith acute exacerbation. Materials and Methods: This was an observational study conducted in KIST Medical College Teaching Hospital from February 2017 to August 2019. Patients admitted with the chronic obstructive pulmonary disease were evaluated. Demographic data as well as oxygen saturation (SPO2), pulmonary function test, and arterial blood gas analysis were recorded and analyzed. Results: Among 112 patients, the female to male ratio was 1.38: 1 with 84.8% over 60 years of age. One-third of patients (n=38) had exposure to both tobacco smoking and biomass and of them, 86.8% were females. Mean SpO2 was 75.9% and mean FEV1 was 0.92 L (SD=0.295) and significant association was found (p<0.001) between them. Furthermore, 70 (62.5%) patients had type I respiratory failure and 42 patients (37.5%) had type II respiratory failure. Patients with type II respiratory failure and hypercapnic patients had prolonged hospital stay with significant p-value (p<0.001). Similarly, significance was observed in the p-value for acidic blood pH, which was <0.05. Conclusions: Increased length of hospital stay is seen in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease with type II respiratory failure. Hence, aggressive early management to correct hypercapnia may lead to decreased hospital stay along with a better outcome. Thus hypercapnia should be considered as one of the important criteria to flag the patient and manage accordingly. 


2020 ◽  
Author(s):  
Santosh Gautam ◽  
Shiva Raj K C ◽  
Milesh Jung Sijapati ◽  
Purnima Gyawali ◽  
Geetika KC ◽  
...  

Abstract Introduction: The outcome of Chronic Obstructive Pulmonary Disease depends upon the partial pressure of oxygen and carbon dioxide This study was aimed to find the role of arterial blood gas parameters during the length of hospital stay among patients admitted for COPD with acute exacerbation. Materials and Methods: This was an observational study conducted in KIST Medical College Teaching Hospital from February 2017 to August 2019. Patients admitted with chronic obstructive pulmonary disease were evaluated. Demographic data as well as SPO2, pulmonary function test, and arterial blood gas analysis were recorded and analyzed. Results: Among 112 patients, the female to male ratio was 1.38: 1 with 84.8% over 60 years of age. One-third of patients (n = 38) had exposure to both tobacco smoking and biomass and of them, 86.8% were females. Mean SpO2 was 75.9% and mean FEV1 was 0.92 L (SD = 0.295) and significant association was found (p < 0.001) between them. Furthermore, 70 (62.5%) patients had type I respiratory failure and 42 patients (37.5%) had type II respiratory failure. Patients with type II respiratory failure and hypercapnic patients had prolonged hospital stay with significant p-value (p < 0.001). Similarly, significance was observed in the p-value for blood pH, which was < 0.05. Conclusions: Increased length of hospital stay is seen in patients with AECOPD with type II respiratory failure. Hence, aggressive early management to correct hypercapnia may lead to decreased hospital stay along with a better outcome. Thus hypercapnia should be considered as one of the important criteria to flag the patient and manage accordingly.


2013 ◽  
Vol 20 (1) ◽  
pp. e5-e9 ◽  
Author(s):  
Douglas A McKim ◽  
Nadia Griller ◽  
Carole LeBlanc ◽  
Andrew Woolnough ◽  
Judy King

BACKGROUND: Almost all patients with Duchenne muscular dystrophy (DMD) eventually develop respiratory failure. Once 24 h ventilation is required, either due to incomplete effectiveness of nocturnal noninvasive ventilation (NIV) or bulbar weakness, it is common practice to recommend invasive tracheostomy ventilation; however, noninvasive daytime mouthpiece ventilation (MPV) as an addition to nocturnal mask ventilation is also an alternative.METHODS: The authors’ experience with 12 DMD patients who used 24 h NIV with mask NIV at night and MPV during daytime hours is reported.RESULTS: The mean (± SD) age and vital capacity (VC) at initiation of nocturnal (only) NIV subjects were 17.8±3.5 years and 0.90±0.40 L (21% predicted), respectively; and, at the time of MPV, 19.8±3.4 years and 0.57 L (13.2% predicted), respectively. In clinical practice, carbon dioxide (CO2) levels were measured using different methods: arterial blood gas analysis, transcutaneous partial pressure of CO2and, predominantly, by end-tidal CO2. While the results suggested improved CO2levels, these were not frequently confirmed by arterial blood gas measurement. The mean survival on 24 h NIV has been 5.7 years (range 0.17 to 12 years). Of the 12 patients, two deaths occurred after 3.75 and four years, respectively, on MPV; the remaining patients continue on 24 h NIV (range two months to 12 years; mean 5.3 years; median 3.5 years).CONCLUSIONS: Twenty-four hour NIV should be considered a safe alternative for patients with DMD because its use may obviate the need for tracheostomy in patients with chronic respiratory failure requiring more than nocturnal ventilation alone.


Nano LIFE ◽  
2020 ◽  
pp. 2050005
Author(s):  
Guangqing Duan ◽  
Kaixuan Lv ◽  
Lyu Juncheng ◽  
Na Tian ◽  
Lichun Zhang ◽  
...  

Background: The influence of coronary atherosclerosis and related treatment drugs on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) development requires in-depth study. The study investigated the effect of coronary artery calcification (CAC) and drugs for CAC on the development of AECOPD. Methods: This retrospective clinical study recruited subjects with AECOPD from May 2017 to May 2019. All subjects performed spirometry and coronary computed tomography (CT), and were divided into three groups according to whether coronary CT revealed CAC and whether they had received oral aspirin and statins: AECOPD group, AECOPD[Formula: see text]CAC nonmedication and AECOPD[Formula: see text]CAC medication. The t-test and nonparametric test were used for analyzing the lung function, arterial blood gas, routine blood and lipid between groups. Results: Compared with the AECOPD group, Lym% were significantly higher ([Formula: see text]) in both the AECOPD[Formula: see text]CAC nonmedication and the AECOPD[Formula: see text]CAC medication. The AECOPD[Formula: see text]CAC medication group also had significantly higher PaO2 ([Formula: see text]). WBC, Neu, and Neu% in the AECOPD[Formula: see text]CAC medication group were significantly lower ([Formula: see text]) compared to the AECOPD group. Conclusions: Aspirin and statins for the treatment of cardiovascular diseases may be linked to improving lung function, normalizing blood gas levels, and reducing inflammation in patients with AECOPD and CAC. Further, randomized controlled trials are needed to explore this topic.


1980 ◽  
Vol 58 (1) ◽  
pp. 105-106 ◽  
Author(s):  
P. D'A. Semple ◽  
G. H. Beastall ◽  
W. S. Watson ◽  
R. Hume

1. We have measured serum testosterone and arterial blood gas values in men with chronic obstructive airways disease. 2. Depression of serum testosterone concentrations was found. 3. The degree of testosterone depression was related to the severity of arterial hypoxia.


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