scholarly journals Non-invasive Ventilation for Acute Respiratory Failure

2014 ◽  
Vol 5 (2) ◽  
pp. 81-103
Author(s):  
Rodolfo Ferrari ◽  
Fabrizio Giostra ◽  
Daniela Agostinelli ◽  
Mario Cavazza
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Close Monitoring ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Key Points ◽  
Essential Questions ◽  
The Right

Giant steps are what Non-Invasive Mechanical Ventilation (NIMV) has taken in the last decades for the treatment of Acute Respiratory Failure. NIMV is safe and effective when applied early to carefully selected patients not meeting criteria for invasive ventilation. A well-fitting interface, close monitoring, coaching and clear information provided to patients, and a trained and skilled team available throughout the 24-h period are crucial factors to get to the best outcome, to reduce morbility and mortality associated to endotracheal intubation. Moving from the essential questions, in this review we focused on the key points to know and understand NIMV in some lights and shadows. What is NIMV and what do we mean speaking about NIMV? Which kind of NIMV is it suitable? Why NIMV works? Who is the right patient, and who is the right doctor, for NIMV? When to start NIMV? Where to perform NIMV? How to carry out NIMV? How long to go on with NIMV?

scholarly journals Role of Non-Invasive Mechanical Ventilation for Acute Respiratory Failure in Cancer Patients

2020 ◽  
Vol 3 (1) ◽  
pp. 298-301
Author(s):  
Madindra Bahadur Basnet ◽  
Krishna Prasad Acharya ◽  
Deepak Adhikari
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Cancer Patients ◽  
Invasive Mechanical Ventilation ◽  
Invasive Ventilation ◽  
Timely Initiation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Introduction: Acute respiratory failure is a common cause of Intensive care Unit admission for cancer patients. Non-invasive ventilation comes in between the two extreme situations: either provide only oxygen or ventilate invasively. This study was done to find the usefulness and efficacy of non-invasive ventilation in a cancer patient. Materials and Methods: A cross-sectional study was done at Nepal Cancer Hospital. Data analysis of patients requiring non-invasive ventilation at the Intensive care Unit from April 14, 2018, to April 13, 2019, were included. Results: Among 68 studied patients, the primary reason for the initiation of non-invasive ventilation sepsis (16.32%), pneumonia (10.88%), and lung cancer (10.2%). Postoperative atelectasis, pulmonary edema, and morphine overdose were associated with good respiratory improvement and Intensive care Unit survival (100%, 75% and 66.67% respectively). Respiratory failure with carcinoma lung, lung fibrosis, acute respiratory distress syndrome, terminally ill patients, and patients with low Glasgow Coma Scale had high failure rates (Survival: 13.33%, 14.29%, 16.67%, 0%, and 20% respectively). Conclusions: Non-invasive ventilation seems to be an effective way of ventilation for cancer patients. The selection of patients and timely initiation of non-invasive ventilation is of utmost importance for a better outcome.  

scholarly journals Clinical scoring for the failure of non-invasive ventilation in acute respiratory failure patients in the Emergency Department.

2020 ◽  
Author(s):  
Wijittra liengswangwong ◽  
Chaiyaporn Mahidol Yuksen ◽  
Tipanun Thepkong ◽  
Pornita Nakasint ◽  
Chetsadakon Jenpanitpong
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Serum Lactate ◽  
Multivariable Logistic Regression Analysis ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Scoring

Abstract Background Non-invasive mechanical ventilation (NIV) has become an alternative to an invasive artificial airway for the management of acute respiratory failure (ARF). NIV failure causes delayed intubation, which eventually has been associated with increased morbidity and mortality. This study aimed to develop the clinical scoring system of NIV failure in ARF patients. Methods This study was a diagnostic, retrospectively cross-sectional, and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between February 2017 and December 2017. We included all of the acute respiratory failure patients aged >18 years and received non-invasive ventilation (NIV). Clinical factors associated with NIV failure were recorded. The predictive model and prediction score for NIV failure were developed by multivariable logistic regression analysis. Result A total of 329 acute respiratory failure patients have received NIV success (N = 237) and failure (N = 92). This study showed that NIV failure was associated with heart rate > 110 bpm, systolic BP < 110 mmHg, SpO2 < 90%, arterial pH < 7.30 and serum lactate. The clinical scores were classified into three groups: low, moderate, and high. Conclusion We suggested that the novel clinical scoring of the NIV failure in this study may use as a good predictor for NIV failure in the emergency room.

scholarly journals Early detection of non-invasive ventilation failure among acute respiratory failure patients in the emergency department

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
W. Liengswangwong ◽  
C. Yuksen ◽  
T. Thepkong ◽  
P. Nakasint ◽  
C. Jenpanitpong
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Serum Lactate ◽  
Multivariable Logistic Regression Analysis ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Scoring

Abstract Background Non-invasive mechanical ventilation (NIV) has become an alternative to an invasive artificial airway for the management of acute respiratory failure (ARF). NIV failure causes delayed intubation, which eventually has been associated with increased morbidity and mortality. This study aimed to develop the clinical scoring system of NIV failure in ARF patients. Methods This study was a diagnostic, retrospectively cross-sectional, and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between February 2017 and December 2017. We included all of the acute respiratory failure patients aged > 18 years and received non-invasive ventilation (NIV). Clinical factors associated with NIV failure were recorded. The predictive model and prediction score for NIV failure were developed by multivariable logistic regression analysis. Result A total of 329 acute respiratory failure patients have received NIV success (N = 237) and failure (N = 92). This study showed that NIV failure was associated with heart rate >  110 bpm, systolic BP <  110 mmHg, SpO2 < 90%, arterial pH < 7.30 and serum lactate. The clinical scores were classified into three groups: low, moderate, and high. Conclusion We suggested that the novel clinical scoring of the NIV failure in this study may use as a good predictor for NIV failure in the emergency room.

scholarly journals Early detection of non-invasive ventilation failure among acute respiratory failure patients in the Emergency Department

2020 ◽  
Author(s):  
Wijittra liengswangwong ◽  
Chaiyaporn Mahidol Yuksen ◽  
Tipanun Thepkong ◽  
Pornita Nakasint ◽  
Chetsadakon Jenpanitpong
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Serum Lactate ◽  
Multivariable Logistic Regression Analysis ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Clinical Scoring

Abstract Background Non-invasive mechanical ventilation (NIV) has become an alternative to an invasive artificial airway for the management of acute respiratory failure (ARF). NIV failure causes delayed intubation, which eventually has been associated with increased morbidity and mortality. This study aimed to develop the clinical scoring system of NIV failure in ARF patients. Methods This study was a diagnostic, retrospectively cross-sectional, and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between February 2017 and December 2017. We included all of the acute respiratory failure patients aged >18 years and received non-invasive ventilation (NIV). Clinical factors associated with NIV failure were recorded. The predictive model and prediction score for NIV failure were developed by multivariable logistic regression analysis.Result A total of 329 acute respiratory failure patients have received NIV success (N = 237) and failure (N = 92). This study showed that NIV failure was associated with heart rate > 110 bpm, systolic BP < 110 mmHg, SpO2 < 90 %, arterial pH < 7.30 and serum lactate. The clinical scores were classified into three groups: low, moderate, and high.Conclusion We suggested that the novel clinical scoring of the NIV failure in this study may use as a good predictor for NIV failure in the emergency room.

scholarly journals Comparison of high-flow nasal oxygen therapy and non-invasive ventilation in ICU patients with acute respiratory failure and a do-not-intubate orders: a multicentre prospective study OXYPAL

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045659
Author(s):  
René Robert ◽  
Denis Frasca ◽  
Julie Badin ◽  
C Girault ◽  
Christophe Guitton ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Therapy ◽  
High Flow ◽  
Invasive Ventilation ◽  
Clinical Practices ◽  
Icu Patients ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Registration Number

IntroductionA palliative approach to intensive care unit (ICU) patients with acute respiratory failure and a do-not-intubate order corresponds to a poorly evaluated target for non-invasive oxygenation treatments. Survival alone should not be the only target; it also matters to avoid discomfort and to restore the patient’s quality of life. We aim to conduct a prospective multicentre observational study to analyse clinical practices and their impact on outcomes of palliative high-flow nasal oxygen therapy (HFOT) and non-invasive ventilation (NIV) in ICU patients with do-not-intubate orders.Methods and analysisThis is an investigator-initiated, multicentre prospective observational cohort study comparing the three following strategies of oxygenation: HFOT alone, NIV alternating with HFOT and NIV alternating with standard oxygen in patients admitted in the ICU for acute respiratory failure with a do-not-intubate order. The primary outcome is the hospital survival within 14 days after ICU admission in patients weaned from NIV and HFOT. The sample size was estimated at a minimum of 330 patients divided into three groups according to the oxygenation strategy applied. The analysis takes into account confounding factors by modelling a propensity score.Ethics and disseminationThe study has been approved by the ethics committee and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03673631

Barotrauma during non-invasive ventilation for acute respiratory distress syndrome caused by COVID-19: a balance between risks and benefits

2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Ventilatory support is vital for the management of severe forms of COVID-19. Non-invasive ventilation is often used in patients who do not meet criteria for intubation or when invasive ventilation is not available, especially in a pandemic when resources are limited. Despite non-invasive ventilation providing effective respiratory support for some forms of acute respiratory failure, data about its effectiveness in patients with viral-related pneumonia are inconclusive. Acute respiratory distress syndrome caused by severe acute respiratory syndrome-coronavirus 2 infection causes life-threatening respiratory failure, weakening the lung parenchyma and increasing the risk of barotrauma. Pulmonary barotrauma results from positive pressure ventilation leading to elevated transalveolar pressure, and in turn to alveolar rupture and leakage of air into the extra-alveolar tissue. This article reviews the literature regarding the use of non-invasive ventilation in patients with acute respiratory failure associated with COVID-19 and other epidemic or pandemic viral infections and the related risk of barotrauma.

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