scholarly journals Use and performance of non-invasive ventilation in Internal Medicine ward: a real-life study

2015 ◽  
Author(s):  
Francesco Ventrella ◽  
Armando Giancola ◽  
Sergio Cappello ◽  
Maria Pipino ◽  
Graziano Minafra ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Real Life ◽  
Invasive Ventilation ◽  
Internal Medicine Ward ◽  
Life Study ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Real Life Study ◽  
And Performance

scholarly journals Defining successful non‐invasive ventilation initiation: Data from a real‐life cohort

Respirology ◽  
2021 ◽  
Author(s):  
Grégoire Jolly ◽  
Léa Razakamanantsoa ◽  
Emeline Fresnel ◽  
Zouhaier Gharsallaoui ◽  
Antoine Cuvelier ◽  
...  
Keyword(s):  
Real Life ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Non invasive ventilation use for acute respiratory failure in general medical wards: a regional Italian survey

2020 ◽  
Author(s):  
Federico Lari ◽  
Fabio Gilioli ◽  
Maurizio Ongari ◽  
Giorgio Ballardini
Keyword(s):  
Internal Medicine ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Patient Monitoring ◽  
Invasive Ventilation ◽  
Regional Survey ◽  
Non Invasive ◽  
Italian Survey ◽  
Non Invasive Ventilation ◽  
Medical Wards

Non-invasive ventilation (NIV) is a rapidly spreading method in the last years even outside of intensive care units for the treatment of patients with acute respiratory failure (ARF). Its use in general medical wards in Italy and Europe is still largely incomplete and there are clear gaps in terms of organization, training, selection and patient monitoring. If these gaps are filled, NIV has also proven to be effective in general medical wards, especially if they have a critical care area. This publication reports the data collected by an Italian regional survey on the use of NIV in internal medicine, highlighting positive and negative aspects.

scholarly journals Remdesivir in Severe COVID-19 and Non-Invasive Ventilation: A Real-Life Experience

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1108
Author(s):  
Francesca Simioli ◽  
Carmine Nicoletta ◽  
Maria Rosaria Valentino ◽  
Maria Martino ◽  
Anna Annunziata ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Real Life ◽  
Lung Damage ◽  
Lung Involvement ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Markers Of Inflammation ◽  
Non Invasive Ventilation

Background: Antiviral treatment is a hot topic regarding therapy for COVID-19. Several antiviral drugs have been tested in the months since the pandemic began. Yet only Remdesivir obtained approval after first trials. The best time to administer Remdesivir is still a matter for discussion and this could also depend upon the severity of lung damage and the staging of the infection. Methods: We performed a real-life study of patients hospitalized forCOVID-19 and receiving non-invasive ventilation (NIV). In this single-center study, a 5 day course of Remdesivir was administered as compassionate use. Further therapeutic supports included antibiotics, low molecular weight heparin and steroids. Data collection included clinical signs and symptoms, gas exchange, laboratory markers of inflammation, and radiological findings. Major outcomes were de-escalation of oxygen-support requirements, clinical improvement defined by weaning from ventilation to oxygen therapy or discharge, and mortality. Adverse drug reactions were also recorded. All data were collected during hospitalization and during a 20-day follow up after treatment. Results: 51 patients were enrolled. A global clinical improvement was recorded in 22 patients (43%) at 12 days, and 36 (71%) at 20 days; in particular, at 12 days, 27 patients (53%) also had a de-escalation of oxygen-support class from a therapeutic point of view. Remdesivir use was associated with a lower hazard ratio for clinical improvement in the elderly (older than 70 years) and in subjects with more extensive lung involvement (total severity score at HRCT of more than 14). The 20-day mortality was 13%. Conclusions: Results demonstrated that Remdesivir is associated with an improvement in clinical, laboratory and radiological parameters in patients with severe COVID-19 and showed an overall mortality of 13%. We conclude that, in this cohort, Remdesivir was a beneficial add-on therapy for severe COVID-19, especially in adults with moderate lung involvement at HRCT.

scholarly journals Clinical characterization of respiratory droplet production during common airway procedures using high-speed imaging

2020 ◽  
Author(s):  
SK Mueller ◽  
R Veltrup ◽  
B Jakubaß ◽  
JS Kempfle ◽  
S Kniesburges ◽  
...  
Keyword(s):  
Airway Management ◽  
High Speed ◽  
Clinical Care ◽  
Real Life ◽  
Invasive Ventilation ◽  
High Speed Imaging ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Management Procedures

AbstractBackgroundDuring the COVID-19 pandemic, a significant number of healthcare workers have been infected with SARS-CoV-2. However, there remains little knowledge regarding droplet dissemination during airway management procedures in real life settings.Methods12 different airway management procedures were investigated during routine clinical care. A high-speed video camera (1000 frames/second) was for imaging. Quantitative droplet characteristics as size, distance traveled, and velocity were computed.ResultsDroplets were detected in 8/12 procedures. The droplet trajectories could be divided into two distinctive patterns (type 1/2). Type 1 represented a ballistic trajectory with higher speed droplets whereas type 2 represented a random trajectory of slower particles that persisted longer in air. Speaking and coughing lead to a larger amount of droplets than non-invasive ventilation therapy. The use of tracheal cannula filters reduced the amount of droplets.ConclusionsRespiratory droplet patterns generated during airway management procedures follow two distinctive trajectories based on the influence of aerodynamic forces. Speaking and coughing produce more droplets than non-invasive ventilation therapy confirming these behaviors as exposure risks. Even large droplets may exhibit patterns resembling the fluid dynamics smaller airborne aerosols that follow the airflow convectively and may place the healthcare provider at risk.

scholarly journals Comparative bench study evaluation of a modified snorkeling mask used during COVID-19 pandemia and standard interfaces for Non-Invasive Ventilation

2020 ◽  
Author(s):  
Giuliano Ferrone ◽  
Giorgia Spinazzola ◽  
Roberta Costa ◽  
Edoardo Piervincezi ◽  
Antonio Gullì ◽  
...  
Keyword(s):  
Pressure Support ◽  
Peak Inspiratory Pressure ◽  
Face Mask ◽  
Invasive Ventilation ◽  
Emergency Situations ◽  
Non Invasive ◽  
Bench Study ◽  
Non Invasive Ventilation ◽  
And Performance ◽  
Full Face

Abstract Background COVID-19 infection has put enormous pressure on the healthcare systems worldwide and especially on Intensive Care Units (ICUs). In this particular situation, a modified snorkeling mask into a mask for non-invasive continuous positive airway pressure (nCPAP) and non-invasive ventilation (NIV), with the help of 3D printers, has been proposed for clinical use. We designed a bench study to compare a Helmet (H), a Full face mask (RFF) and a modified full face snorkeling mask (MFF) for delivering nCPAP and NIV in pressure support mode (PSV). Methods A mannequin was connected to an active lung simulator. The inspiratory and expiratory variations in airways pressure observed with a high simulated effort (Pmus), were determined relative to the preset CPAP level. NIV was applied in PSV at two simulated respiratory rates and two cycling-off flow thresholds. During the bench study we measured the variables defining patient-ventilator interaction and performance. Results During nCPAP, the MFF presented significantly lower values of ΔPawi and ∆Pawe compared to the other interfaces tested (H and RFF). During NIV, the MFF demonstrated a better patient-ventilator interaction compared to RFF, as shown by significantly shorter Timepress and Delaytrexp (p < 0.01), but no significant differences were found in terms of Delaytrinsp and Timesync between the interfaces tested. At RR 20sim, the MFF presented the shorter ΔPtrigger (p < 0.01), moreover during all the conditions tested the MFF showed the longer PTP 200, 300 and 500 compared to RFF (p < 0.01). A major limitation of MFF is that during NIV with this interface it is possible to reach at maximum 18 cmH2O of peak inspiratory pressure. Over this pressure value, the presence of air leaks determined important asynchrony phenomena. For this reason, our test was limited to one pressure support and PEEP set (PS 10 cmH2O and PEEP 8 cmH2O). Conclusions The modified full face snorkeling mask can be used as an acceptable alternative to other interfaces for both nCPAP and NIV in emergency situations.

scholarly journals Acid–base balance, serum electrolytes and need for non-invasive ventilation in patients with hypercapnic acute exacerbation of chronic obstructive pulmonary disease admitted to an internal medicine ward

2016 ◽  
Vol 11 ◽  
Author(s):  
Alfonso Schiavo ◽  
Maurizio Renis ◽  
Mario Polverino ◽  
Arcangelo Iannuzzi ◽  
Francesca Polverino
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Acidosis ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Internal Medicine Ward ◽  
Acid Base ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Non Invasive Ventilation

Background: Hypoventilation produces or worsens respiratory acidosis in patients with hypercapnia due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these patients acid–base and hydroelectrolite balance are closely related. Aim of the present study was to evaluate acid–base and hydroelectrolite alterations in these subjects and the effect of non-invasive ventilation and pharmacological treatment. Methods: We retrospectively analysed 110 patients consecutively admitted to the Internal Medicine ward of Cava de’ Tirreni Hospital for acute exacerbation of hypercapnic chronic obstructive pulmonary disease. On admission all patients received oxygen with a Venturi mask to maintain arterial oxygen saturation at least >90 %, and received appropriate pharmacological treatment. Non-Invasive Ventilation (NIV) was started when, despite optimal therapy, patients had severe dyspnea, increased work of breathing and respiratory acidosis. Based on Arterial Blood Gas (ABG) data, we divided the 110 patients in 3 groups: A = 51 patients with compensated respiratory acidosis; B = 36 patients with respiratory acidosis + metabolic alkalosis; and C = 23 patients with respiratory acidosis + metabolic acidosis. 55 patients received only conventional therapy and 55 had conventional therapy plus NIV. Results: The use of NIV support was lower in the patients belonging to group B than in those belonging to group A and C (25 %, vs 47 % and 96 % respectively; p < 0.01). A statistically significant association was found between pCO2 values and serum chloride concentrations both in the entire cohort and in the three separate groups. Conclusions: Our study shows that in hypercapnic respiratory acidosis due to AECOPD, differently from previous studies, the metabolic alkalosis is not a negative prognostic factor neither determines greater NIV support need, whereas the metabolic acidosis in addition to respiratory acidosis is an unfavourable element, since it determines an increased need of NIV and invasive mechanical ventilation support.

Sign in / Sign up

Export Citation Format

Share Document