ARDS Secondary to Descending Necrotizing Mediastinitis Treated By Long-Term Extracorporeal Respiratory Support

PURPOSE: Congenital myotonic dystrophy (CDM) results in hypotonia and acute respiratory distress at birth. Previous studies show that prolonged periods of intubation (>4 weeks) correlate with increased mortality rates. The objective is to describe the use and duration of respiratory support in newborns with CDM and how these relate to mortality. METHODS: A retrospective chart review was performed at a tertiary pediatric hospital among children with confirmed diagnosis of CDM. The main outcome measures were: mortality, duration of invasive mechanical ventilation (IMV) and non-invasive partial pressure ventilation (NIPPV), along with long-term use of respiratory support and equipment. RESULTS: A total of 18 subjects met inclusion criteria, 83%.f which had documented respiratory distress at birth, 39%.equired NIPPV, and 50%.equired intubation in the neonatal period. The earliest NIPPV was initiated at day one of life, and the latest extubation to NIPPV was at 17 days of life. CONCLUSION: This cohort required IMV for shorter periods with earlier transitions to NIPPV which suggests a possible change in practice and earlier transition to NIPPV recently. Further data are needed to determine if there is a possible correlation between the need for NIPPV/IMV and mortality rates.

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Early complications of long-term respiratory support

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)40846-5 ◽

1972 ◽

Vol 64 (5) ◽

pp. 729-738 ◽

Cited By ~ 27

Author(s):

William H. Fleming ◽

John C. Bowen ◽

Charles R. Hatcher

Keyword(s):

Respiratory Support ◽

Early Complications

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Changing consumption of resources for respiratory support and short-term outcomes in four consecutive geographical cohorts of infants born extremely preterm over 25 years since the early 1990s

BMJ Open ◽

10.1136/bmjopen-2020-037507 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037507

Author(s):

Jeanie L Y Cheong ◽

Joy E Olsen ◽

Li Huang ◽

Kim M Dalziel ◽

Rosemarie A Boland ◽

...

Keyword(s):

Retinopathy Of Prematurity ◽

Periventricular Leukomalacia ◽

Respiratory Support ◽

Non Invasive ◽

Discharge Home ◽

Nasal Cannulae ◽

Extremely Preterm ◽

Additional Costs ◽

Prospective Longitudinal

ObjectivesIt is unclear how newer methods of respiratory support for infants born extremely preterm (EP; 22–27 weeks gestation) have affected in-hospital sequelae. We aimed to determine changes in respiratory support, survival and morbidity in EP infants since the early 1990s.DesignProspective longitudinal cohort study.SettingThe State of Victoria, Australia.ParticipantsAll EP births offered intensive care in four discrete eras (1991–1992 (24 months): n=332, 1997 (12 months): n=190, 2005 (12 months): n=229, and April 2016–March 2017 (12 months): n=250).Outcome measuresConsumption of respiratory support, survival and morbidity to discharge home. Cost-effectiveness ratios describing the average additional days of respiratory support associated per additional survivor were calculated.ResultsMedian duration of any respiratory support increased from 22 days (1991–1992) to 66 days (2016–2017). The increase occurred in non-invasive respiratory support (2 days (1991–1992) to 51 days (2016–2017)), with high-flow nasal cannulae, unavailable in earlier cohorts, comprising almost one-half of the duration in 2016–2017. Survival to discharge home increased (68% (1991–1992) to 87% (2016–2017)). Cystic periventricular leukomalacia decreased (6.3% (1991–1992) to 1.2% (2016–2017)), whereas retinopathy of prematurity requiring treatment increased (4.0% (1991–1992) to 10.0% (2016–2017)). The average additional costs associated with one additional infant surviving in 2016–2017 were 200 (95% CI 150 to 297) days, 326 (183 to 1127) days and 130 (70 to 267) days compared with 1991–1992, 1997 and 2005, respectively.ConclusionsConsumption of resources for respiratory support has escalated with improved survival over time. Cystic periventricular leukomalacia reduced in incidence but retinopathy of prematurity requiring treatment increased. How these changes translate into long-term respiratory or neurological function remains to be determined.

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Faculty Opinions recommendation of Carbon dioxide monitoring during long-term noninvasive respiratory support in children.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1148034.605142 ◽

2009 ◽

Author(s):

Petr Pohunek

Keyword(s):

Carbon Dioxide ◽

Respiratory Support ◽

Carbon Dioxide Monitoring

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What is the Role of Transtracheal Ventilation in Emergency and Long-Term Respiratory Support?

Perspectives in High Frequency Ventilation - Developments in Critical Care Medicine and Anesthesiology ◽

10.1007/978-94-009-6711-3_38 ◽

1983 ◽

pp. 314-315 ◽

Cited By ~ 1

Author(s):

M. Klain ◽

H. Keszler

Keyword(s):

Respiratory Support ◽

Transtracheal Ventilation

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The deletion variant of the CCR5 gene (rs333) but not the ACE gene (rs4340) is associated with long-term respiratory support in patients with COVID-19 pneumonia

Ukrainian Medical Journal ◽

10.32471/umj.1680-3051.140.195935 ◽

2020 ◽

Vol 140 ◽

Keyword(s):

Respiratory Support ◽

Ccr5 Gene ◽

Deletion Variant ◽

Ace Gene

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The deletion variant of the CCR5 gene (rs333) but not the ACE gene (rs4340) is associated with long-term respiratory support in patients with COVID-19 pneumonia

Ukrainian Medical Journal ◽

10.32471/umj.1680-3051.134.195935 ◽

2020 ◽

Keyword(s):

Respiratory Support ◽

Ccr5 Gene ◽

Deletion Variant ◽

Ace Gene

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Clinical outcomes of patients receiving prolonged extracorporeal membrane oxygenation for respiratory support

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466619848941 ◽

2019 ◽

Vol 13 ◽

pp. 175346661984894 ◽

Cited By ~ 4

Author(s):

Soo Jin Na ◽

Jae-Seung Jung ◽

Sang-Bum Hong ◽

Woo Hyun Cho ◽

Sang-Min Lee ◽

...

Keyword(s):

Respiratory Failure ◽

Mortality Rate ◽

Extracorporeal Membrane Oxygenation ◽

Hospital Mortality ◽

Acute Respiratory Failure ◽

Ecmo Support ◽

Respiratory Support ◽

Short Term ◽

Membrane Oxygenation

Background: There are limited data regarding prolonged extracorporeal membrane oxygenation (ECMO) support, despite increase in ECMO use and duration in patients with respiratory failure. The objective of this study was to investigate the outcomes of severe acute respiratory failure patients supported with prolonged ECMO for more than 28 days. Methods: Between January 2012 and December 2015, all consecutive adult patients with severe acute respiratory failure who underwent ECMO for respiratory support at 16 tertiary or university-affiliated hospitals in South Korea were enrolled retrospectively. The patients were divided into two groups: short-term group defined as ECMO for ⩽28 days and long-term group defined as ECMO for more than 28 days. In-hospital and 6-month mortalities were compared between the two groups. Results: A total of 487 patients received ECMO support for acute respiratory failure during the study period, and the median support duration was 8 days (4–20 days). Of these patients, 411 (84.4%) received ECMO support for ⩽28 days (short-term group), and 76 (15.6%) received support for more than 28 days (long-term group). The proportion of acute exacerbation of interstitial lung disease as a cause of respiratory failure was higher in the long-term group than in the short-term group (22.4% versus 7.5%, p < 0.001), and the duration of mechanical ventilation before ECMO was longer (4 days versus 1 day, p < 0.001). The hospital mortality rate (60.8% versus 69.7%, p = 0.141) and the 6-month mortality rate (66.2% versus 74.0%, p = 0.196) were not different between the two groups. ECMO support longer than 28 days was not associated with hospital mortality in univariable and multivariable analyses. Conclusions: Short- and long-term survival rates among patients receiving ECMO support for more than 28 days for severe acute respiratory failure were not worse than those among patients receiving ECMO for 28 days or less.

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