Search results for " Noninvasive ventilation"

showing 10 items of 16 documents

Noninvasive respiratory support in acute hypoxemic respiratory failure associated with COVID-19 and other viral infections

2020

ABSTRACTIntroductionNoninvasive respiratory support (NRS) such as noninvasive ventilation (NIV) and high flow nasal therapy (HFNT) have been used in the treatment of acute hypoxemic respiratory failure (AHRF) related to the coronavirus disease (COVID-19) and other viral infections. However, there is a lack of consensus in favor of or against NRS use due to the risks of worsening hypoxemia, intubation delay, and aerosols environmental contamination associated with the use of these tools. We aimed to summarize the evidence on the use of NRS in adult patients with COVID-19 and other viral pneumonia (i.e. H1N1, SARS, MERS) and AHRF. We also searched for studies evaluating the risk of aerosoliza…

Adultmedicine.medical_specialtyContext (language use)Diseasemedicine.disease_causeHIGH FLOW NASAL THERAPYAirborne transmissionHFNCHypoxemialaw.invention03 medical and health sciences0302 clinical medicineInfluenza A Virus H1N1 SubtypeRandomized controlled trial030202 anesthesiologylawmedicineHumansCOVID-19; Noninvasive ventilation Pneumonia viral Adult Humans Pandemics SARS-CoV-2 COVID-19 Coronavirus. Influenza A Virus H1N1 Subtype Noninvasive Ventilation Respiratory InsufficiencyH1N1 SubtypeIntensive care medicinePandemicsAerosolizationCoronavirusNoninvasive VentilationPneumonia viralSARS-CoV-2business.industryCOVID-19030208 emergency & critical care medicinemedicine.diseaseCoronavirusAnesthesiology and Pain MedicineCoronavirus. Influenza A VirusViral pneumoniamedicine.symptomRespiratory InsufficiencybusinessHFNT
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High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol f…

2019

Background Noninvasive ventilation (NIV) is indicated to treat respiratory acidosis due to exacerbation of chronic obstructive pulmonary disease (COPD). Recent nonrandomized studies also demonstrated some physiological effects of high-flow nasal therapy (HFNT) in COPD patients. We designed a prospective, unblinded, multicenter, randomized controlled trial to assess the noninferiority of HFNT compared to NIV with respect to the reduction of arterial partial pressure of carbon dioxide (PaCO2) in patients with hypercapnic acute respiratory failure with mild-to-moderate respiratory acidosis. Methods We will enroll adult patients with acute hypercapnic respiratory failure, as defined by arterial…

Chronic ObstructiveTime FactorsExacerbationRespiratory ratemedicine.medical_treatmentMedicine (miscellaneous)Equivalence Trials as TopicAcute respiratory failurelaw.inventionPulmonary DiseaseHypercapnia03 medical and health sciencesPulmonary Disease Chronic ObstructiveStudy Protocol0302 clinical medicineAcute respiratory failure; Carbon dioxide; Chronic obstructive pulmonary disease; Emergency department; High-flow oxygen therapy through nasal cannula; Intensive care unit; Noninvasive ventilation; Acute Disease; Equivalence Trials as Topic; Humans; Hypercapnia; Italy; Lung; Multicenter Studies as Topic; Oxygen Inhalation Therapy; Prospective Studies; Pulmonary Disease Chronic Obstructive; Respiratory Insufficiency; Time Factors; Treatment Outcome; Noninvasive VentilationRandomized controlled triallawHigh-flow oxygen therapy through nasal cannulamedicineHumansMulticenter Studies as TopicPharmacology (medical)Intensive care unit030212 general & internal medicineProspective StudiesLungTidal volumeMechanical ventilationCOPDlcsh:R5-920business.industryEmergency departmentChronic obstructive pulmonary diseaseOxygen Inhalation Therapymedicine.diseaseIntensive care unitRespiratory acidosisTreatment OutcomeItalyCarbon dioxideAnesthesiaAcute DiseasebusinessRespiratory Insufficiencylcsh:Medicine (General)Acute respiratory failure; Carbon dioxide; Chronic obstructive pulmonary disease; Emergency department; High-flow oxygen therapy through nasal cannula; Intensive care unit; Noninvasive ventilationNoninvasive ventilation030217 neurology & neurosurgeryTrials
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Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analy…

2017

Abstract Purpose To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. Methods We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. Results Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in …

Critical CareDatabases Factualmedicine.medical_treatmentAirway management; Apneic oxygenation; Endotracheal intubation; Noninvasive ventilation; Oxygen inhalation therapy; PreoxygenationCritical IllnessSettore MED/41 - AnestesiologiaEndotracheal intubationAirway managementCochrane LibraryCritical Care and Intensive Care Medicinemedicine.disease_causelaw.invention03 medical and health sciences0302 clinical medicineApneic oxygenationRandomized controlled triallawPreoxygenationmedicineIntubation IntratrachealIntubationCannulaHumansMED/41 - ANESTESIOLOGIAHypoxiabusiness.industryOxygen inhalation therapy030208 emergency & critical care medicineEndotracheal intubationRespiration ArtificialIntubation procedure030228 respiratory systemMeta-analysisAnesthesiaCritical IllneAirway managementbusinessRespiratory InsufficiencyNasal cannulaNoninvasive ventilationHuman
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Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

2019

<b><i>Background:</i></b> Noninvasive mechanical ventilation (NIV) is an effective treatment in patients with neuromuscular diseases (NMD) to improve symptoms, quality of life, and survival. <b><i>Summary:</i></b> NIV should be used early in the course of respiratory muscle involvement in NMD patients and its requirements may increase over time. Therefore, training on technical equipment at home and advice on problem solving are warranted. Remote monitoring of ventilator parameters using built-in ventilator software is recommended. Telemedicine may be helpful in reducing hospital admissions. Anticipatory planning and palliative care should be …

Duchenne muscular dystrophyPulmonary and Respiratory MedicineRespiratory Therapymedicine.medical_specialtyTelemedicineTime FactorsPalliative caremedicine.medical_treatmentNeuromuscular disorderHome care03 medical and health sciencesTracheostomy0302 clinical medicineQuality of life (healthcare)Health caremedicineRespiratory muscleHumansIn patient030212 general & internal medicineIntensive care medicineAmyotrophic lateral sclerosiAmyotrophic lateral sclerosis; Duchenne muscular dystrophy; Home care; Neuromuscular disorders; Noninvasive ventilation; TracheostomyMechanical ventilationbusiness.industryNeuromuscular DiseasesAmyotrophic lateral sclerosisRespiration Artificial030228 respiratory systemQuality of LifeRespiratory InsufficiencybusinessNoninvasive ventilationNeuromuscular disordersFollow-Up StudiesLong term ventilationRespiration
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Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

2018

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiog…

MaleARDSmodelos logísticosDatabases Factualmedicine.medical_treatment[SDV]Life Sciences [q-bio]humanoslnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]Kaplan-Meier EstimateCritical Care and Intensive Care MedicineAcute respiratory failureSeverity of Illness IndexCohort Studiesrandomized-trial0302 clinical medicineMechanical ventilationRisk Factorsestudios prospectivosEpidemiology80 and overicuMedicineProspective StudiesProspective cohort studyestudios de cohortesImmunodeficiencymediana edadestadísticasAged 80 and overRespiratory Distress Syndromeancianocritically-ill patientsRespirationresultado del tratamientorespiraciónStatisticslcsh:Medical emergencies. Critical care. Intensive care. First aidadultoMiddle Aged3. Good healthfailureIntensive Care UnitsTreatment OutcomeArtificialCohortprospective multicenterImmunocompromised patientsAcute respiratory failure; ARDS; Immunocompromised patients; Mechanical ventilation; Noninvasive ventilation; Critical Care and Intensive Care MedicineFemaleNoninvasive ventilationHumanestimación de Kaplan-MeierAdultmedicine.medical_specialtyLogistic ModelIntensive Care UnitSocio-culturaleunidades de cuidados intensivossurvivalStatistics NonparametricSepsisDatabases03 medical and health sciencesImmunocompromised HostInternal medicineImmunocompromised patientcancerfactores de riesgoHumansNonparametricíndice de gravedad de la enfermedadintensive-care-unitFactualAgedMechanical ventilationbusiness.industryResearchRisk FactorRespiratory Distress Syndrome Adult030208 emergency & critical care medicinelcsh:RC86-88.9medicine.diseaseRespiration ArtificialPneumoniaProspective StudieLogistic Models030228 respiratory systemmalignanciesARDShuésped inmunodeprimidoCohort StudiebusinessAcute respiratory failure; ARDS; Immunocompromised patients; Mechanical ventilation; Noninvasive ventilation; Adult; Aged; Aged 80 and over; Cohort Studies; Databases Factual; Female; Humans; Intensive Care Units; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Prospective Studies; Respiration Artificial; Respiratory Distress Syndrome Adult; Risk Factors; Severity of Illness Index; Statistics Nonparametric; Treatment Outcome; Immunocompromised Host
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Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome: Insights from the LUNG SAFE Study

2016

Rationale: Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse.Objectives: To determine whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful.Methods: The LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study described the management of patients with ARDS. This substudy examines the current practice of NIV use in ARDS, the utility of the PaO2/FiO2 ratio in classifying patients receiving NIV, and the impact of NIV on outcome.Measurements and Main…

MaleARDSprocedureblood oxygen tensionCritical Care and Intensive Care MedicineSeverity of Illness Indexlaw.invention0302 clinical medicinelawHospital MortalityRespiratory Distress SyndromeAcute respiratory distress syndromeadult respiratory distress syndromeMiddle AgedIntensive care unitIntensive Care Unitsmedicine.anatomical_structureTreatment Outcomepriority journalpositive end expiratory pressureNoninvasive ventilationdisease severityFemaletreatment outcome AgedNoninvasive ventilationprospective studyHumanAdultPulmonary and Respiratory Medicinemedicine.medical_specialtycohort analysiIntensive Care Unitdisease classificationAcute respiratory distressArticleNO03 medical and health sciencesacute respiratory distress syndrome; noninvasive ventilationlength of staySeverity of illnessSettore MED/41 - ANESTESIOLOGIAmedicineSequential Organ Failure Assessment ScoreHumansIn patientAcute respiratory distress syndrome; Noninvasive ventilation; Aged; Female; Hospital Mortality; Humans; Intensive Care Units; Male; Middle Aged; Respiratory Distress Syndrome Adult; Severity of Illness Index; Treatment Outcome; Noninvasive Ventilation; Pulmonary and Respiratory Medicine; Critical Care and Intensive Care MedicineIntensive care medicineoutcome assessmentAgedLungbusiness.industryRespiratory Distress Syndrome Adult030208 emergency & critical care medicinemedicine.diseasemajor clinical studymortalityrespiratory tract diseasesbreathing ratemulticenter study030228 respiratory systemincidenceObservational studyobservational studybusinessAcute respiratory distress syndrome; Noninvasive ventilation;
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High flow nasal therapy versus noninvasive ventilation as initial ventilatory strategy in COPD exacerbation: a multicenter non-inferiority randomized…

2020

Abstract Background The efficacy and safety of high flow nasal therapy (HFNT) in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease (AECOPD) are unclear. Our aim was to evaluate the short-term effect of HFNT versus NIV in patients with mild-to-moderate AECOPD, with the hypothesis that HFNT is non-inferior to NIV on CO2 clearance after 2 h of treatment. Methods We performed a multicenter, non-inferiority randomized trial comparing HFNT and noninvasive ventilation (NIV) in nine centers in Italy. Patients were eligible if presented with mild-to-moderate AECOPD (arterial pH 7.25–7.35, PaCO2 ≥ 55 mmHg before ventilator support). Primary endpoint was the mean di…

MaleExacerbationEquivalence Trials as TopicCritical Care and Intensive Care MedicineAcute respiratory failurelaw.invention03 medical and health sciencesPulmonary Disease Chronic Obstructive0302 clinical medicineRandomized controlled triallawClinical endpointmedicineHumansCannulaAcute respiratory failure; Chronic obstructive pulmonary disease; High flow nasal cannula; High flow nasal therapy; Noninvasive ventilation030212 general & internal medicineHigh flow nasal therapyAgedCOPDbusiness.industryResearchhigh flow oxygen therapy high flow nasal cannula noninvasive ventilation COPD carbon dioxide acute respiratory failureChronic obstructive pulmonary diseaselcsh:Medical emergencies. Critical care. Intensive care. First aidOxygen Inhalation Therapylcsh:RC86-88.9Middle Agedmedicine.diseaseSymptom Flare UpConfidence intervalHigh flow nasal cannula030228 respiratory systemItalyAnesthesiaBreathingNoninvasive ventilationFemaleHigh flowbusinessNoninvasive ventilationHuman
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Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day–17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered.

MalePediatricsEpidemiologyProtease InhibitorComorbiditymedicine.disease_causeClinical Laboratory TechniqueSevere Acute Respiratory SyndromeDisease OutbreaksFeces0302 clinical medicineSettore MED/38 - Pediatria Generale E SpecialisticaCOVID-19 TestingRetrospective StudiePandemic030212 general & internal medicineViralChildCoronavirusPediatricDisease OutbreakCoinfectionHospitals PediatricSettore MED/38HospitalsDiarrheaTreatment OutcomeSARS-CoV-2 infection; children; covid-19; hydroxychloroquine; pneumonia; Adolescent; Antiviral Agents; Betacoronavirus; COVID-19; COVID-19 Testing; Child; Child Preschool; Chronic Disease; Clinical Laboratory Techniques; Coinfection; Comorbidity; Coronavirus; Coronavirus Infections; Diarrhea; Disease Outbreaks; Feces; Female; Fever; Hospitals Pediatric; Humans; Immunocompromised Host; Infant; Infant Newborn; Italy; Male; Noninvasive Ventilation; Pandemics; Pneumonia Viral; Protease Inhibitors; Retrospective Studies; SARS-CoV-2; Severe Acute Respiratory Syndrome; Treatment OutcomeItalyChild PreschoolCoinfectionFemalemedicine.symptomCoronavirus InfectionsRapid CommunicationHumanDiarrheamedicine.medical_specialtyCOVID-19; ItalyhydroxychloroquineAdolescentFeverCoronaviruPneumonia ViralAntiviral Agents03 medical and health sciencesBetacoronavirusImmunocompromised Hostchildren030225 pediatricsVirologyIntensive caremedicineHumanspneumoniaProtease InhibitorsPreschoolPandemicsRetrospective StudiesAntiviral Agentchildren; covid-19; hydroxychloroquine; pneumonia; SARS-CoV-2 infection; Adolescent; Antiviral Agents; Betacoronavirus; Child; Child Preschool; Chronic Disease; Clinical Laboratory Techniques; Coinfection; Comorbidity; Coronavirus; Coronavirus Infections; Diarrhea; Disease Outbreaks; Feces; Female; Fever; Hospitals Pediatric; Humans; Immunocompromised Host; Infant; Infant Newborn; Italy; Male; Noninvasive Ventilation; Pandemics; Pneumonia Viral; Protease Inhibitors; Retrospective Studies; Severe Acute Respiratory Syndrome; Treatment OutcomeNoninvasive VentilationBetacoronaviruPandemicbusiness.industryClinical Laboratory TechniquesCoronavirus InfectionSARS-CoV-2pneumonia.SARS-CoV-2 infectionPublic Health Environmental and Occupational HealthInfant NewbornCOVID-19InfantRetrospective cohort studymedicine.diseaseNewbornComorbidityCoronavirusPneumoniaChronic DiseaseFecebusiness
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The MITOS system predicts long-term survival in amyotrophic lateral sclerosis

2015

ObjectiveThe choice of adequate proxy for long-term survival, the ultimate outcome in randomised clinical trials (RCT) assessing disease-modifying treatments for amyotrophic lateral sclerosis (ALS), is a key issue. The intrinsic limitations of the ALS Functional Rating Scale-Revised (ALSFRS-R), including non-linearity, multidimensionality and floor-effect, have emerged and its usefulness argued. The ALS Milano-Torino staging (ALS-MITOS) system was proposed as a novel tool to measure the progression of ALS and overcome these limitations. This study was performed to validate the ALS-MITOS as a 6-month proxy of survival in 200 ALS patients followed up to 18 months.MethodsAnalyses were performe…

MalePredictive Value of TestWalkingLogistic regressionALS; MOTOR NEURON DISEASE; NEUROMUSCULAR; RANDOMISED TRIALS; Adult; Aged; Amyotrophic Lateral Sclerosis; Communication; Deglutition; Disability Evaluation; Disease Progression; Double-Blind Method; Female; Humans; Male; Middle Aged; Noninvasive Ventilation; Predictive Value of Tests; ROC Curve; Respiration; Self Care; Survival Analysis; Walking; Neurology (clinical); Psychiatry and Mental Health; Surgery; Arts and Humanities (miscellaneous); Medicine (all)law.inventionALS long-term survival ALSFRS-RDisability EvaluationRandomized controlled triallawNEUROMUSCULARAmyotrophic lateral sclerosisMOTOR NEURON DISEASEALS; MOTOR NEURON DISEASE; NEUROMUSCULAR; RANDOMISED TRIALS; Neurology (clinical); Psychiatry and Mental Health; Surgery; Arts and Humanities (miscellaneous)CommunicationRespirationMedicine (all)Area under the curveMiddle Agedals motor neuron disease neuromuscular randomised trialsPsychiatry and Mental HealthPredictive value of testsDisease ProgressionSettore MED/26 - NeurologiaFemaleSurvival AnalysiHumanAdultmedicine.medical_specialtyNOSwallowingDouble-Blind MethodArts and Humanities (miscellaneous)Predictive Value of TestsInternal medicinemedicineRANDOMISED TRIALSHumansSurvival analysisAgedNoninvasive VentilationReceiver operating characteristicbusiness.industryAmyotrophic Lateral Sclerosisals; motor neuron disease; neuromuscular; randomised trials; adult; aged; amyotrophic lateral sclerosis; communication; deglutition; disability evaluation; disease progression; double-blind method; female; humans; male; middle aged; noninvasive ventilation; predictive value of tests; roc curve; respiration; self care; survival analysis; walking; neurology clinical; psychiatry and mental health; surgery; arts and humanities ; medicinemedicine.diseaseSurvival AnalysisSurgeryDeglutitionSelf CareALS; MOTOR NEURON DISEASE; NEUROMUSCULAR; RANDOMISED TRIALS; Adult; Aged; Amyotrophic Lateral Sclerosis; Communication; Deglutition; Disability Evaluation; Disease Progression; Double-Blind Method; Female; Humans; Male; Middle Aged; Noninvasive Ventilation; Predictive Value of Tests; ROC Curve; Respiration; Self Care; Survival Analysis; Walking; Surgery; Arts and Humanities (miscellaneous); Neurology (clinical); Psychiatry and Mental HealthROC CurveSurgeryNeurology (clinical)ALSbusinessAmyotrophic Lateral Sclerosi
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Perioperative Adverse Events in Obstructive Sleep Apnea and Use of Noninvasive Mechanical Ventilation: Key Topics and Clinical Implications

2016

Obstructive sleep apnea (OSA) is a common public health care problem and, yet, the perioperative management of OSA remains inadequate. Patients affected by this condition are prone to early postoperative complications, in part due to the negative effects of sedative, analgesic, and anesthetic agents on pharyngeal tone and arousal responses to hypoxia, hypercapnia, and obstruction. The use of opioids may also contribute to late adverse events, mainly by suppressing the rapid eye movement phase of sleep. As a result, preoperative screening of patients at high risk of OSA, as well as the implementation of a perioperative strategy to reduce the risk of complications, should lead to early periop…

Mechanical ventilationmedicine.medical_specialtymedicine.drug_classbusiness.industrymedicine.medical_treatmentPerioperativeHypoxia (medical)medicine.diseaserespiratory tract diseasesObstructive sleep apneaSedativeObstructive sleep apnea Perioperative complications Noninvasive ventilation Noninvasive positive pressure ventilation Continuous positive airway pressuremedicineContinuous positive airway pressuremedicine.symptomIntensive care medicineAdverse effectbusinessHypercapnia
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