CLINICAL CHARACTERISTICS, LABORATORY TESTS AND TREATMENT OUTCOME IN PATIENTS WITH ACUTE RESPIRATORY FAILURE REQUIRING INVASIVE MECHANICAL VENTILATOR IN INTENSIVE CARE UNIT AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2020 ◽  
pp. 99-105
Author(s):  
Ha Vo Viet ◽  
Quan Phan Van Minh
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Treatment Failure ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
Ventilator Associated Pneumonia ◽  
Invasive Ventilation ◽  
History Of ◽  
The Mean

Ojectives: 1. To describe the clinical and subclinical characteristics of patients with acute respiratory failure requiring invasive ventilation. 2. To evaluate the outcome of acute respiratory failure treatment with invasive ventilation and factors related to treatment failure. Materials and Method: 51 patients diagnosed with acute respiratory failure requiring invasive mechanical ventilation in ICU at Hue University of Medicine and Pharmacy Hospital. The prospective cohort study. Results: The mean age was 69.6 ± 16.4. Tachypnea and agitation were the most common sign (51%). The mean APACHE II score was 20.2 ± 3.3. The mortality rate was 33.3%. The variables associated with treatment failure were age ≥ 70 tuổi (RR = 2.7; p < 0.05), history of chronic kidney disease (RR = 2.9; p < 0.05), sepsis as a cause of mechanical ventilation (RR = 2.5; p < 0.05), ventilator-associated pneumonia (RR = 2.4; p < 0.05) and renal dysfunction during treatment (RR =2.4; p < 0.05). Conclusion: The clinical characteristics of ARF patients requiring IMV were various and the mortality rate remained high. Risk factors for treatment failure included age ≥ 70, history of chronic kidney disease, sepsis as a cause of mechanical ventilation, ventilator-associated pneumonia and renal dysfunction during treatment. Keywords: acute respiratory failure, invasive ventilation, invasive mechanical ventilation

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

scholarly journals Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 65
Author(s):  
Zara Steinmeyer ◽  
Sara Vienne-Noyes ◽  
Marc Bernard ◽  
Armand Steinmeyer ◽  
Laurent Balardy ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Final Analysis ◽  
Geriatric Syndromes ◽  
Global Pandemic ◽  
Clinical Presentations ◽  
The Mean

(1) Background: COVID-19 has become a global pandemic and older patients present higher mortality rates. However, studies on the characteristics of this population set are limited. The objective of this study is to describe clinical characteristics and outcomes of older patients hospitalized with COVID-19. (2) Methods: This retrospective cohort study was conducted from March to May 2020 and took place in three acute geriatric wards in France. Older patients hospitalized for COVID-19 infections were included. We collected clinical, radiological, and laboratory outcomes. (3) Results: Ninety-four patients were hospitalized and included in the final analysis. Mean age was 85.5 years and 55% were female. Sixty-four (68%) patients were confirmed COVID-19 cases and 30 (32%) were probable. A majority of patients were dependent (77%), 45% were malnourished, and the mean number of comorbidities was high in accordance with the CIRS-G score (12.3 ± 25.6). The leading causes of hospitalization were fever (30%), dyspnea (28%), and geriatric syndromes (falls, delirium, malaise) (18%). Upon follow-up, 32% presented acute respiratory failure and 30% a geriatric complication. Frailty and geriatric characteristics were not correlated with mortality. Acute respiratory failure (p = 0.03) and lymphopenia (p = 0.02) were significantly associated with mortality. (4) Conclusions: Among older patients hospitalized with COVID-19, clinical presentations were frequently atypical and complications occurred frequently. Frailty and geriatric characteristics were not correlated with mortality.

scholarly journals Non-Invasive Oxygenation Strategies in Adult Patients with Acute Respiratory Failure: A Protocol for a Systematic Review and Network Meta-analysis

2020 ◽  
Author(s):  
Bruno Leonel Ferreyro ◽  
Federico Angriman ◽  
Laveena Munshi ◽  
Lorenzo del Sorbo ◽  
Niall D Ferguson ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Non Invasive

Abstract Background: Acute hypoxemic respiratory failure is one of the leading causes of intensive care unit admission and associated with high mortality. Non-invasive oxygenation strategies such as high flow nasal cannula, standard oxygen therapy and non-invasive ventilation (delivered by either face mask or helmet interface) are widely available interventions applied in these patients. It remains unclear which of these interventions are more effective in decreasing rates of invasive mechanical ventilation and mortality. The primary objective of this network meta-analysis is to summarize the evidence and compare the effect of non-invasive oxygenation strategies on mortality and need for invasive mechanical ventilation in patients with acute hypoxemic respiratory failure. Methods: We will search key databases for randomized controlled trials assessing the effect of non-invasive oxygenation strategies in adult patients with acute hypoxemic respiratory failure. We will exclude studies in which the primary focus is either acute exacerbations of chronic obstructive pulmonary disease or cardiogenic pulmonary edema. The primary outcome will be all-cause mortality (longest available up to 90 days). The secondary outcomes will be receipt of invasive mechanical ventilation (longest available up to 30 days). We will assess the risk of bias for each of the outcomes using the Cochrane Risk of Bias Tool. Bayesian network meta-analyses will be conducted to obtain pooled estimates of head-to-head comparisons. We will report pairwise and network meta-analysis treatment effect estimates as risk ratios and 95% credible intervals. Subgroup analyses will be conducted examining key populations including immunocompromised hosts. Sensitivity analyses will be conducted by excluding those studies with high risk of bias and different etiologies of acute respiratory failure. We will assess certainty in effect estimates using GRADE methodology. Discussion : This study will help to guide clinical decision making when caring for adult patients with AHRF and improve our understanding of the limitations of the available literature assessing noninvasive oxygenation strategies in acute hypoxemic respiratory failure.

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