scholarly journals Efficacy of new intermittent abdominal pressure ventilator for post-ischemic cervical myelopathy ventilatory insufficiency

2019 ◽  
Vol 14 ◽  
Author(s):  
Paolo I. Banfi ◽  
Eleonora Volpato ◽  
John R. Bach
Keyword(s):  
Cervical Myelopathy ◽  
Ventilatory Support ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Abdominal Pressure ◽  
Arterial Blood Gas ◽  
Non Invasive ◽  
Arterial Blood ◽  
Non Invasive Ventilation ◽  
Ventilatory Insufficiency

Non-invasive ventilation (NIV) is the treatment of choice for patients symptomatic for respiratory muscle dysfunction. It can normalize gas exchange and provide up to continuous non-invasive ventilator support (CNVS) as an alternative to intubation and tracheotomy. It is usually provided via non-invasive facial interfaces or mouthpieces, but these can be uncomfortable and uncosmetic. The intermittent abdominal pressure ventilator (IAPV) has been used for diurnal ventilatory support since 1938 but has been off the market since about 1990. Now, however, with greater emphasis on non-invasive management, a new IAPV is available. A patient with chronic ventilatory insufficiency post-ischemic cervical myelopathy, dependent on sleep NVS since 2003, developed symptomatic daytime hypercapnia for which he also used diurnal NVS via nasal pillows. However, he preferred not having to use facial interfaces. When not using diurnal NVS he was becoming dyspnoeic. Diurnal use of an IAPV was introduced. Arterial blood gas analysis using the IAPV decreased his blood pH from 7.45 to 7.42, PaCO2 from 58 to 37mmHg, and improved PaO2 from 62 to 92mmHg. At discharge, the patient used the IAPV 8 h/day with improved mood and quality of life. Consequently, he returned to work as a painter.

Respiratory

2013 ◽  
Author(s):  
Victoria Stacey
Keyword(s):  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Blood Gas ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Non Invasive ◽  
Arterial Blood ◽  
Non Invasive Ventilation ◽  
Arterial Blood Gas Analysis

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

scholarly journals The Role of Extracorporeal Membrane Oxygenation in The Protective Lung Strategy after Cardiac Surgery in a Tertiary Intensive Care Unit

2020 ◽  
Vol 2 (2) ◽  
pp. 61-67
Author(s):  
Ibrahim Mungan ◽  
◽  
Sema Turan ◽  
Keyword(s):  
Cardiac Surgery ◽  
Ventilatory Support ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Mechanical Ventilatory Support ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Pulmonary Failure ◽  
Arterial Blood Gas Analysis

Background: In cases of respiratory failure, Lung-Protective Ventilation Strategy (LPVS) which limits ventilator-induced lung injury is recommended. However, CO2 retention is a major impediment for LPVS and Extracorporeal membrane oxygenation (ECMO) supplies enough time to the lungs for rest and recovery. We aimed to find out the connection between ECMO usage and the reduction of mechanical ventilatory values in patients who required ECMO therapy after cardiac surgery due to pulmonary failure. Methods: In this retrospective cohort study, we analyzed 21 consecutive patients receiving a venovenous ECMO for pulmonary failure after cardiac surgery and 19 patients non-ECMO group. Demographic variables including age, gender, predicted body weight, and heart rate and the arterial blood gas analysis data, mechanical ventilator parameters and clinical outcomes were derived from institutional database. Results: The mean age of the patients was 55.57 years and ECMO patients were younger than non-ECMO group patients (p=0.005). The other descriptive variables and clinical parameters did not differ between groups statistically. The mechanical ventilator parameters and arterial blood gas analysis were worse in the ECMO group before the procedure (p <0.001) whereas improvement in data was more significant in the ECMO group after the procedure (p<0.001 in Pplateau and PaO2) . The patients in the non-ECMO group stayed longer in hospital (35.68 days vs 16.9 days) and in ICU (31.11 days vs 13.33 days) than the patients in the ECMO group. The duration of the mechanical ventilatory support did not differ between groups. Conclusion: The intensivists had a big dilemma involving the balance between maintaining a sensible blood-gas exchange and protecting the lung from adverse effects of mechanical ventilatory support. The extracorporeal life support –ECMO- was advised until the pulmonary failure was resolved. We found that ECMO support was decreasing the high Plateau Pressure and respiratory rate more than the non-ECMO group.

Respiratory emergencies

2017 ◽  
Author(s):  
Ashis Banerjee ◽  
Clara Oliver
Keyword(s):  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
British Thoracic Society ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Non Invasive Ventilation ◽  
Short Answer Question ◽  
Respiratory Emergencies

Difficulty in breathing is both a common presenting complaint and a major acute presentation in the emergency department (ED). This chapter covers the common causes of breathlessness. It focuses on the management and diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in line with the British Thoracic Society guidelines, which may commonly appear as a short-answer question (SAQ). In addition, this chapter covers the pathophysiology of T2RF and its management, including the indications and contraindications for non-invasive ventilation. Another common topic examined in the SAQ paper is acid-base disturbances. This chapter includes a section on the indications and interpretation of arterial blood gas analysis.

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