scholarly journals Noninvasive positive pressure ventilation therapy can improve cardiac structure and function in patients with coronary artery disease combined with severe obstructive sleep apnea/hypopnea syndrome

2013 ◽  
Author(s):  
Xinbing Liu ◽  
Liuliu Feng ◽  
Guoliang Cao ◽  
Hongman Huang ◽  
Jianhua Yu ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Structure And Function ◽  
Positive Pressure ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Cardiac Structure And Function ◽  
Artery Disease ◽  
And Function ◽  
Hypopnea Syndrome

Stress Echocardiography

2018 ◽  
pp. 326-334
Author(s):  
L. Samuel Wann
Keyword(s):  
Cardiac Disease ◽  
Stress Echocardiography ◽  
Comprehensive Evaluation ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Ultrasound Assessment ◽  
Cardiac Structure And Function ◽  
Artery Disease ◽  
Sensitivity Specificity ◽  
And Function

The Stress Echocardiography chapter reviews the opportunities to increase sensitivity and specificity of stress testing for the diagnosis of ischemic heart disease with adjunctive echocardiography with exercise or dobutamine-atropine stress. Baseline imaging prior to stress should include a comprehensive evaluation of cardiac structure and function, including the assessment of valvular disease with Doppler echocardiography. The chapter discusses stress echocardiography protocols; image analysis and reporting; sensitivity, specificity, and accuracy for detection of coronary artery disease; and evaluation of noncoronary cardiac disease. New and developing echocardiographic technology, including ultrasound assessment of myocardial perfusion, real-time 3D echocardiographic, and strain imaging are also discussed.

scholarly journals The Effect of Noninvasive Positive Pressure Ventilation on Pneumonia Hospitalizations in Children With Neurological Disease

2017 ◽  
Vol 4 ◽  
pp. 2329048X1668902
Author(s):  
Abeyat Zaman-Haque ◽  
Craig Campbell ◽  
Dhenuka Radhakrishnan
Keyword(s):  
Neurological Disease ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Respiratory Compromise ◽  
Obstructive Sleep ◽  
Before And After ◽  
Change In The Mean ◽  
The Mean ◽  
Neurological Conditions

The aim of this retrospective single-institution observational study was to identify whether the frequency of hospitalizations for pneumonia would change before and after the initiation of noninvasive positive pressure ventilation in children with neurological conditions. Included patients were 1 to 18 years old with an underlying neurological disease and had been prescribed nocturnal noninvasive positive pressure ventilation. The authors excluded patients with a tracheostomy or those who used noninvasive positive pressure ventilation solely for obstructive sleep apnea. A total of 14 patients were included in the study, among whom there was no significant change in the mean number of pneumonias 2 years before versus after the initiation of noninvasive positive pressure ventilation (mean difference = −0.714, standard deviation = 2.4, P = .312). These findings suggest that while noninvasive positive pressure ventilation may not reduce absolute pneumonia frequency, it may have the beneficial value of preventing an increase in the frequency of pneumonias over time, especially in children with progressive respiratory compromise.

scholarly journals Obstructive sleep apnea increases the risk of cardiovascular damage: a systematic review and meta-analysis of imaging studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mi Lu ◽  
Zhenjia Wang ◽  
Xiaojun Zhan ◽  
Yongxiang Wei
Keyword(s):  
Systematic Review ◽  
Coronary Atherosclerosis ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Structure And Function ◽  
Cardiac Structure ◽  
Cardiovascular Damage ◽  
Obstructive Sleep ◽  
Cardiac Structure And Function ◽  
And Function

Abstract Background We aimed to perform a systematic review and meta-analysis of the association between obstructive sleep apnea (OSA) and cardiac as well as coronary impairment evaluated using imaging modalities. Finding of this study will provide more robust evidence regarding OSA-induced cardiovascular damage. Methods We systematically searched through PubMed, EMBASE, and Cochrane library databases for relevant literatures on the association between OSA and cardiovascular damage evaluated using imaging modalities, and manually searched the references of selected articles for additional relevant articles. For each clinical parameter relevant to the meta-analysis, we first evaluated the methodological heterogeneity of the relevant studies and thereafter pooled the data together using fixed effect or random effect model. The difference in the relevant indices of cardiovascular damage between OSA patients and controls was evaluated using the standardized mean difference. Results Of the 82 articles included in the final systematic analysis, 20 studies explored the association between OSA and coronary atherosclerosis. OSA patients had higher rate of coronary atherosclerosis assessed by coronary artery calcification score and plaque volume. Moreover, the severity of OSA and coronary atherosclerosis displayed a positive correlation. The rest of the studies (n = 62) evaluated cardiac alterations in OSA patients. According to the inclusion and exclusion criteria, 46 studies yielding 3082 OSA patients and 1774 controls were pooled for the meta-analysis. For left cardiac structure and function, OSA patients exhibited significantly wider left atrial diameter; higher left atrium volume index; wider left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and left ventricular mass; higher left ventricular mass index; wider interventricular septum diameter and posterior wall diameter; and higher left ventricular myocardial performance index (all p < 0.05). In addition, compared with controls, left ventricular ejection fraction was significantly decreased in OSA patients (p = 0.001). For right cardiac structure and function, OSA patients displayed a significant increase in right ventricular diameter and right ventricular myocardial performance index (both p < 0.001). Finally, compared with controls, OSA patients displayed significant decrease in tricuspid annular plane systolic excursion and RV fractional area change (p = 0.001). Conclusion Overall, this systematic review and meta-analysis provides imaging evidence in support that OSA patients are at a higher risk of developing coronary atherosclerosis and display cardiac remodeling and dysfunction.

Flexible Bronchoscopy Assisted by Noninvasive Positive Pressure Ventilation

2011 ◽  
Vol 31 (3) ◽  
pp. 70-76 ◽  
Author(s):  
Septimiu D. Murgu ◽  
Jocelyn Pecson ◽  
Henri G. Colt
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Flexible Bronchoscopy ◽  
Positive Pressure ◽  
Airway Collapse ◽  
Obstructive Sleep ◽  
Refractory Hypoxemia ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Noninvasive positive pressure ventilation is an alternative to intubation in critically ill patients with respiratory insufficiency or poor gas exchange who may require flexible bronchoscopy for diagnostic or therapeutic purposes. This ventilatory technique might help decrease the risk of bronchoscopy-related complications in patients with refractory hypoxemia, postoperative respiratory distress, severe emphysema, obstructive sleep apnea, and obesity hypoventilation syndrome and allows bronchoscopic assessment of patients with severe dyspnea from expiratory central airway collapse. In this review, the physiological rationale, indications, contraindications, techniques, and monitoring requirements for flexible bronchoscopy assisted by noninvasive positive pressure ventilation are described, with an emphasis on the role of critical care nurses in this procedure.

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