scholarly journals Noninvasive ventilation for acute respiratory failure: state of the art (II part)

2013 ◽  
pp. 6-15
Author(s):  
Federico Lari ◽  
Fabrizio Giostra ◽  
Gianpaolo Bragagni ◽  
Nicola Di Battista
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Rate ◽  
Blood Gases ◽  
Correct Selection ◽  
Positive Pressure ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Selection Of Patients ◽  
Selection Of

Background: In the last years Non-Invasive Ventilation (NIV) has been playing an important role in the treatment of Acute Respiratory Failure (ARF). Prospective randomised controlled trials have shown improvements in clinical features (respiratory rate, neurological score), pH and arterial blood gases and in particular clinical conditions (Acute Cardiogenic Pulmonary Edema, ACPE, and acute exacerbation of Chronic Obstructive Pulmonary Disease, COPD) systematic reviews and metha-analysis confirm a reduction in the need for intubation and in-hospital mortality compared to standard medical treatment. Methods: The most important techniques of ventilation in spontaneous breathing are: Continuous Positive Airway Pression (CPAP), usually performed with Venturi-like flow generators, and bi-level positive pressure ventilation (an high inspiratory pressure and a low expiratory pressure), performed with ventilators. Facial mask rather than nasal mask is used in ARF: the helmet is useful for prolonged treatments. Results: NIV’s success seems to be determined by early application, correct selection of patients and staff training. Controindications to NIV are: cardiac or respiratory arrest, a respiratory rate < 12 per minute, upper airway obstruction, hemodynamic instability or unstable cardiac arrhythmia, encephalopathy (Kelly score > 3), facial surgery trauma or deformity, inability to cooperate or protect the airway, high risk of aspiration and an inability to clear respiratory secretions. Conclusions: Bi-level ventilation for ARF due to COPD and CPAP or bi-level bentilation for ARF due to ACPE are feasible, safe and effective also in a General Medical ward if the selection of patients, the staff’s training and the monitoring are appropriate: they improve clinical parameters, arterial blood gases, prevent ETI, decrease mortality and hospitalisation. This should encourage the diffusion of NIV in this specific setting.

scholarly journals Noninvasive ventilation for acute respiratory failure: state of the art (I part)

2013 ◽  
pp. 201-211
Author(s):  
Federico Lari ◽  
Fabrizio Giostra ◽  
Gianpaolo Bragagni ◽  
Nicola Di Battista
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Blood Gases ◽  
Chronic Obstructive ◽  
Arterial Blood Gases ◽  
Early Application ◽  
Acute Cardiogenic Pulmonary Edema ◽  
General Medical Ward ◽  
Arterial Blood ◽  
Clinical Conditions

Background: In the last years Non-Invasive Ventilation (NIV) has been playing an important role in the treatment of Acute Respiratory Failure (ARF). A lot of trials have shown improvements in clinical features (respiratory rate, neurological score), pH and arterial blood gases. Methods: In particular clinical conditions, such as Acute Cardiogenic Pulmonary Edema (ACPE) and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD), systematic reviews and meta-analysis show a reduction in the need for intubation and in-hospital mortality compared to standard medical treatment. In other clinical conditions, such as acute asthma, Acute Lung Injury (ALI)/Acute Respiratory Distress Syndrome (ARDS) and severe pneumonia, NIV does not show significant improvements in term of avoided intubations or mortality rate. Although the first important data on NIV comes from studies performed in Intensive Care Units (ICUs), subsequently these methodologies of ventilation have been used with increasing frequency in Emergency Departments (ED) and medical wards. Results: Studies developed in ICU sometimes report slightly worse outcomes compared to studies performed in general wards due to the need to treat more severe patients in ICU. Aetiology remains one of the most important factor determining prognosis: different pathological mechanisms substain different clinical conditions and not in all cases the application of positive pressures to the airways is useful. NIV for ARF due to COPD and ACPE is feasible, safe and effective also in a general medical ward if selection of patients, staff training and monitoring are appropriate: its early application improves clinical parameters, arterial blood gases, prevents endotracheal intubation, decreases mortality and hospitalisation. This should encourage the diffusion of NIV in this specific setting.

scholarly journals Effect of Controlled Oxygen Therapy on Arterial Blood Gases in Acute Respiratory Failure

BMJ ◽  
1970 ◽  
Vol 2 (5707) ◽  
pp. 452-455 ◽  
Author(s):  
D. A. Warrell ◽  
R. H. T. Edwards ◽  
S. Godfrey ◽  
N. L. Jones
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Therapy ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood

TRACHEOSTOMY IN ACUTE RESPIRATORY FAILURE: EFFECTS ASSESSED BY ARTERIAL BLOOD GASES

1968 ◽  
Vol 16 (8) ◽  
pp. 930-942
Author(s):  
Oscar Neufeld ◽  
Basil D. Anagnost ◽  
J. Robert Navarre ◽  
P. Dziad ◽  
Taylor A. Osten ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood

Extracorporeal cardiopulmonary resuscitation for post-operative cardiac arrest: indications, techniques, controversies, and early results – what is known (and unknown)

2011 ◽  
Vol 21 (S2) ◽  
pp. 109-117 ◽  
Author(s):  
Paul J. Chai ◽  
Jeffrey P. Jacobs ◽  
Heidi J. Dalton ◽  
John M. Costello ◽  
David S. Cooper ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiac Disease ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Arterial Blood ◽  
Selection Of Patients ◽  
Selection Of

AbstractExtracorporeal cardiopulmonary resuscitation may be defined as the use of extracorporeal membrane oxygenation for the support of patients who do not respond to conventional cardiopulmonary resuscitation. Data from national and international paediatric databases indicate that the use of extracorporeal cardiopulmonary resuscitation is increasing. Guidelines from the American Heart Association suggest that any patient with refractory cardiopulmonary resuscitation and potentially reversible causes of cardiac arrest is a candidate for extracorporeal cardiopulmonary resuscitation. One possible framework for selection of patients for extracorporeal cardiopulmonary resuscitation includes dividing patients on the basis of favourable or unfavourable characteristics. Favourable characteristics include cardiac disease, witnessed event in the intensive care unit, ability to deliver effective cardiopulmonary resuscitation, active patient monitoring present, favourable arterial blood gases, and early institution of extracorporeal membrane oxygenation. Unfavourable characteristics potentially include non-cardiac disease, an unwitnessed cardiac arrest, ineffective cardiopulmonary resuscitation, and severely acidotic arterial blood gases. Considering the significant resources and cost involved in the use of extracorporeal cardiopulmonary resuscitation, its use needs to be critically examined to improve outcomes, assess neurological recovery and quality of life, and help identify populations and other factors that may help guide in the selection of patients for successful extracorporeal cardiopulmonary resuscitation.

Comparison of SVO2, SpO2, and clinical parameters with arterial blood gases during ventilatory weaning after cardiac surgery

1994 ◽  
Vol 3 (5) ◽  
pp. 353-355 ◽  
Author(s):  
ML Noll ◽  
JF Byers
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Artery Bypass ◽  
Arterial Oxygen Saturation ◽  
Bypass Graft ◽  
Blood Gases ◽  
Arterial Oxygen ◽  
Arterial Blood Gases ◽  
Arterial Blood Gas ◽  
Arterial Blood

Correlations of mixed venous and arterial oxygen saturation, heart rate, respiratory rate, and mean arterial pressure with arterial blood gas variables were computed for 57 sets of data obtained from 30 postoperative coronary artery bypass graft patients who were being weaned from mechanical ventilation. Arterial oxygen saturation and respiratory rate correlated significantly, although moderately, with blood gases.

Successful Treatment of Experimental Neonatal Respiratory Failure Using Extracorporeal Membrane Lung Assist

1986 ◽  
Vol 9 (6) ◽  
pp. 427-432 ◽  
Author(s):  
R. Fumagalli ◽  
T. Kolobow ◽  
P. Arosio ◽  
V. Chen ◽  
D.K. Buckhold ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Ventilation ◽  
Blood Gases ◽  
Blood Gas ◽  
Arterial Blood Gases ◽  
Arterial Blood Gas ◽  
Membrane Lung ◽  
Arterial Blood ◽  
Long Term Survivors

A total of 44 preterm fetal lambs at great risk of developing respiratory failure were delivered by Cesarean section, and were then managed on conventional mechanical pulmonary ventilation. Fifteen animals initially fared well, and 14 of these were long term survivors. Twenty-nine other lambs showed a progressive deterioration in arterial blood gases within 30 minutes of delivery, of which 10 lambs were continued on mechanical pulmonary ventilation (20% survival), while the remaining 19 lambs were placed on an extracorporeal membrane lung respiratory assist (79% survival). Extracorporeal membrane lung bypass rapidly corrected arterial blood gas values, and permitted the use of high levels of CPAP instead of the continuation of mechanical pulmonary ventilation at high peak airway pressures. Improvement in lung function was gradual, and predictable. Early institution of extracorporeal respiratory assist using a membrane artificial lung rapidly corrected arterial blood gas values and significantly improved on neonate survival.

scholarly journals Subarachnoidally administered hyperbaric morphine, buprenorphine, methadone, and 10% dextrose on cardiopulmonary function and behavior in horses

2006 ◽  
Vol 36 (5) ◽  
pp. 1444-1449
Author(s):  
Cláudio Corrêa Natalini ◽  
Renata Lehn Linardi ◽  
Alexandre da Silva Polydoro
Keyword(s):  
Blood Pressure ◽  
Body Temperature ◽  
Respiratory Rate ◽  
Motor Impairment ◽  
Blood Gases ◽  
Behavioral Changes ◽  
Control Group ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
And Behavior

The study was done to compare the heart rate, arterial blood pressure, arterial blood gases, respiratory rate, body temperature, and behavior after subarachnoid administration of hyperbaric morphine (MorphineD10), buprenorphine (BuprenorphineD10), methadone (Methadone D10), and 10% dextrose (D10) in conscious horses. Six adult horses were studied. Treatments were administered into the lombo-sacral subarachnoid space through an epidural catheter, MorphineD10 at 0.01mg kg-1, BuprenorphineD10 at 0.001mg kg-1, MethadoneD10 at 0.01mg kg-1, and 10% dextrose as a control group. The results showed that there are minimum changes in heart and respiratory rate, blood gases, blood pressure, and body temperature after subarachnoid administration of hyperbaric opioids in horses. No sedation and nor motor impairment or behavioral changes occur.

scholarly journals High flow nasal cannula in asthmatic children with suspected COVID-19

2021 ◽  
Vol 34 ◽  
Author(s):  
Valéria Cabral Neves ◽  
Joyce de Oliveira de Souza ◽  
Adriana Koliski ◽  
Bruno Silva Miranda ◽  
Debora Carla Chong e Silva
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Rate ◽  
Clinical Data ◽  
Invasive Mechanical Ventilation ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Gradual Improvement ◽  
Arterial Blood

Abstract Introduction: The use of a high-flow nasal cannula as an alternative treatment for acute respiratory failure can reduce the need for invasive mechanical ventilation and the duration of hospital stays. Objective: The present study aimed to describe the use of a high-flow nasal cannula in pediatric asthmatic patients with acute respiratory failure and suspected COVID-19. Methods: To carry out this research, data were collected from medical records, including three patients with asthma diagnoses. The variables studied were: personal data (name, age in months, sex, weight, and color), clinical data (physical examination, PRAM score, respiratory rate, heart rate, and peripheral oxygen saturation), diagnosis, history of the current disease, chest, and laboratory radiography (arterial blood gases and reverse-transcriptase polymerase chain reaction). Clinical data were compared before and after using a high-flow nasal cannula. Results: After the application of the therapy, a gradual improvement in heart, respiratory rate, PaO2/FiO2 ratio, and the Pediatric Respiratory Assessment Measure score was observed. Conclusion: The simple and quick use of a high-flow nasal cannula in pediatric patients with asthma can be safe and efficient in improving their respiratory condition and reducing the need for intubation.

Approach to the Patient with Acute Respiratory Failure

2016 ◽  
Author(s):  
Eddy Fan ◽  
Alice Vendramin
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Life Support ◽  
Ventilatory Support ◽  
Lung Protective Ventilation ◽  
Positive Pressure ◽  
Hypoxemic Respiratory Failure ◽  
Arterial Blood ◽  
Common Causes

Acute respiratory failure (ARF) is a common reason for admission to the intensive care unit (ICU), and is associated with significant morbidity and mortality. Failure of one or more components of the respiratory system can lead to hypoxemia, hypercabia, or both. Initial evaluation of patients with ARF should include physical examination, chest imaging, and arterial blood gases (ABG) sampling. As ARF is often a life-threatening emergency, a patient’s oxygenation and ventilation will need to be supported at the same time that diagnostic and therapeutic interventions are planned. The priorities for early treatment are essentially those of basic life support: airway and breathing. The first step is to assess a patient’s airway and ascertain that it is patent. This is followed by efforts to support both oxygenation and ventilation. This can include non-invasive or invasive mechanical ventilatory support. As with all interventions, there are risks inherent in the use of mechanical ventilation, which may be minimized by the use of lung protective ventilation (i.e., with low tidal volumes and airway pressures). Finally, due to the potential complications associated with mechanical ventilation, it is important to regularly assess whether a patient continues to require the assistance of the ventilator, and to liberate patients from mechanical ventilation at the earliest opportunity when clinically safe and feasible to do so. Figures depict pressure-time curve. Tables list the clinical causes of hypoxemic respiratory failure, oxygen delivery devices, indications for noninvasive positive pressure support, common causes of abnormal respiratory mechanics, and common causes of acute respiratory distress syndrome (ARDS). This review contains 2 highly rendered figures, 5 tables, and 86 references.

SEVERITY OF RESPIRATORY FAILURE ARTERIAL BLOOD-GASES IN UNTREATED PATIENTS

The Lancet ◽  
1965 ◽  
Vol 285 (7381) ◽  
pp. 336-338 ◽  
Author(s):  
M.W. McNicol ◽  
E.J.M. Campbell
Keyword(s):  
Respiratory Failure ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood
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