Search results for " Respiratory failure"

showing 10 items of 43 documents

Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: Study protocol for a pilot randomized controlled trial, the PROT…

2018

Background Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). Methods PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and under…

procedurePressure supportTime Factorsgenetic structuresbreathingmedicine.medical_treatmentMedicine (miscellaneous)Pilot Projects[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tractintensive care unitlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawtime factorClinical endpointpatient safetyMulticenter Studies as TopicPharmacology (medical)030212 general & internal medicinerandomized controlled trial (topic)Intervention study; Mechanical ventilation; Positive-pressure ventilation; Pressure support; Recruitment; Sigh; Ventilator-induced lung injury; Weaning; Feasibility Studies; Humans; Hypoxia; Intubation Intratracheal; Lung; Multicenter Studies as Topic; Pilot Projects; Positive-Pressure Respiration; Recovery of Function; Respiratory Insufficiency; Time Factors; Treatment Outcome; Randomized Controlled Trials as Topic; Medicine (miscellaneous); Pharmacology (medical)HypoxiaLungpathophysiologyendotracheal intubationRandomized Controlled Trials as TopicVentilator-induced lung injurylcsh:R5-920Intervention studyadultpilot studyfeasibility studytreatment outcome Feasibility Studie3. Good healthTreatment OutcomeAnesthesiapositive end expiratory pressureBreathingmulticenter study (topic)oxygenationRecruitmentlcsh:Medicine (General)Respiratory Insufficiencyrespiratory tract intubationcirculatory and respiratory physiologyHumanextubationPressure support ventilationWeaningLung injuryArticleSpontaneous breathing trialNO03 medical and health sciencesIntensive care[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]medicineIntubation IntratrachealHumanscontrolled studyPilot ProjectSightreatment failureMechanical ventilationhypoxemiapressure support ventilationtreatment durationbusiness.industrylung inflationrespiratory failureconvalescenceRecovery of Functionmajor clinical studymortalitywater acute respiratory failurehospital dischargeIntratracheal030228 respiratory systemrandomized controlled trialFeasibility StudiesbusinessPositive-pressure ventilationIntubationclinical protocol
researchProduct

High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis.

2019

Abstract Purpose The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results We included four studies in the primary analysis: one RCT…

medicine.medical_specialtyCritical CareAcute respiratory failure High flow nasal cannula High flow nasal therapy Immunocompromised patients Mechanical ventilation Noninvasive ventilation Oxygen therapy Cannula Humans Immunocompromised Host Intubation Intratracheal Noninvasive Ventilation Oxygen Inhalation Therapy Randomized Controlled Trials as Topic Respiratory Distress Syndrome Adult Critical Caremedicine.medical_treatmentAcute respiratory failureCritical Care and Intensive Care Medicinelaw.inventionImmunocompromised Host03 medical and health sciencesMechanical ventilation0302 clinical medicineRandomized controlled triallawInternal medicineOxygen therapyIntubation IntratrachealImmunocompromised patientmedicineCannulaHumansIntubationHigh flow nasal therapyRandomized Controlled Trials as TopicRespiratory Distress Syndromebusiness.industryMortality rateOxygen Inhalation Therapy030208 emergency & critical care medicineRetrospective cohort studyOdds ratioOxygen therapyIntensive care unitHigh flow nasal cannula030228 respiratory systemMeta-analysisbusinessNoninvasive ventilation
researchProduct

Usefulness of telemedicine for home ventilator-dependent children.

2018

Introduction Medical care for ventilator-dependent children must avoid hospital confinement, which is detrimental to the patient, their family and Paediatric Intensive Care Unit. Our objective was to assess the role of telemedicine in facilitating early and permanent discharge of such patients to home care. Methods This was a prospective clinical study (2007–2017) in tracheotomised ventilator-dependent children. We used a Big Data Telemedicine home system (Medlinecare 2.1) from the Paediatric Intensive Care Unit. Specialised home-nursing services were available. Clinical events were analysed using the Chi-square test (significance p < 0.05). Families subsequently completed a satisfaction…

Malemedicine.medical_specialtyTelemedicinemedicine.medical_treatmentHealth Informatics03 medical and health sciencesPaediatric intensive care unit0302 clinical medicine030225 pediatricsmedicineHumans030212 general & internal medicineProspective StudiesIntensive care medicineChildMechanical ventilationVentilators Mechanicalbusiness.industryVentilator dependentInfantHome Care ServicesRespiration ArtificialPatient DischargeTelemedicineChild PreschoolQuality of LifeFemaleEmergenciesbusinessChronic respiratory failureJournal of telemedicine and telecare
researchProduct

Effect of high-flow nasal therapy on dyspnea, comfort, and respiratory rate

2019

Informazione non disponibile

medicine.medical_specialtyLetteracute respiratory failureRespiratory ratebusiness.industryMEDLINElcsh:Medical emergencies. Critical care. Intensive care. First aidOxygen Inhalation Therapylcsh:RC86-88.9high flow nasal therapyCritical Care and Intensive Care MedicineCannula Dyspnea Humans Oxygen Inhalation Therapy Patient Comfort Respiratory RateDyspneaRespiratory RateEmergency medicineNIVmedicineCannulaHumansAcute respiratory failurePatient ComfortCOTHigh flowbusiness
researchProduct

Tidal Volume Estimation during Helmet Noninvasive Ventilation: an Experimental Feasibility Study

2019

AbstractWe performed a bench (BS) and human (HS) study to test the hypothesis that estimation of tidal volume (VT) during noninvasive helmet pressure support ventilation (nHPSV) would be possible using a turbine driven ventilator (TDV) coupled with an intentional leak single-limb vented circuit. During the BS a mannequin was connected to a lung simulator (LS) and at different conditions of respiratory mechanics, positive end expiratory pressure (PEEP) levels and leaks (30, 50 and 80 L/min). All differences were within the 95% limits of agreement (LoA) in all conditions in the Bland-Altman plot. The overall bias (difference between VT measured by TDV and LS) was 35 ml (95% LoA 10 to 57 ml), …

AdultMaleLeakmedicine.medical_specialtylcsh:MedicineSettore MED/41 - AnestesiologiaPressure support ventilationTherapeuticsRespiratory physiologyManikinsArticlePositive-Pressure Respiration03 medical and health sciences0302 clinical medicineInternal medicineHealthy volunteersTidal VolumemedicineHumanslcsh:SciencePositive end-expiratory pressureTidal volumeMouthpieceVentilators Mechanicalacute respiratory failureMultidisciplinarybusiness.industrylcsh:RhelmetReproducibility of Resultsnoninvasive ventilation030208 emergency & critical care medicineEquipment DesignHealthy Volunteers030228 respiratory systemPreclinical researchRespiratory MechanicsCardiologyFeasibility Studieslcsh:QFemaleHead Protective DevicesNoninvasive ventilationbusinessScientific Reports
researchProduct

Noninvasive ventilation in chest trauma: systematic review and meta-analysis

2013

Purpose: Single studies of Noninvasive Ventilation (NIV) in the management of acute respiratory failure in chest trauma patients have produced controversial findings. The aim of this study is to critically review the literature to investigate whether NIV reduces mortality, intubation rate, length of stay and complications in patients with chest trauma, compared to standard therapy. Methods: We performed a systematic review and meta-analysis of randomized controlled trials, prospective and retrospective observational studies, by searching PubMed, EMBASE and bibliographies of articles retrieved. We screened for relevance studies that enrolled adults with chest trauma who developed mild to sev…

AdultRiskmedicine.medical_specialtyThoracic Injuriesmedicine.medical_treatmentMEDLINEChest traumaAcute respiratory failureCritical Care and Intensive Care MedicineAnesthesiologyIntubation IntratrachealmedicineHumansIntubationMeta-analysiIn patientAcute respiratory failureHospital MortalityIntensive care medicineOutcomeNoninvasive VentilationThoracic Injuriebusiness.industryLength of StayTreatment OutcomeMeta-analysisNoninvasive ventilationRespiratory InsufficiencybusinessStandard therapyHumanIntensive Care Medicine
researchProduct

High Flow Nasal Therapy Use in Patients with Acute Exacerbation of COPD and Bronchiectasis: A Feasibility Study

2020

The efficacy and feasibility of high flow nasal therapy (HFNT) use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and bronchiectasis is unknown. We performed a single-center, single-arm prospective observational study in patients with AECOPD, documented bronchiectasis, pH >= 7.35, respiratory rate (RR) >= 26 breaths/minute despite receiving maximal medical treatment and oxygen via face mask up to 10 L/m. Patients received HFNT (Airvo 2, Fisher & Paykel) at a gas flow of 50 L/min and FIO2 adjusted to maintain SpO(2) >= 92%. Dyspnea, rated by Borg scale, RR, arterial blood gases and mucus production (ranging from 1 to 3) were collected befor…

Pulmonary and Respiratory MedicineMaleAcute exacerbation of chronic obstructive pulmonary diseasemedicine.medical_specialtyExacerbationbronchiectasishumidification03 medical and health sciencesPulmonary Disease Chronic Obstructivebronchiectasi0302 clinical medicineacute respiratory failure bronchiectasis COPD High flow nasal cannula humidification mucus plug sputumRespiratory RateInternal medicineMedicineCannulaHumansCOPDIn patientAcute respiratory failure030212 general & internal medicineProspective StudiesAgedCOPDBronchiectasisacute respiratory failurebusiness.industryOxygen Inhalation TherapysputumCarbon Dioxidemedicine.diseaseSymptom Flare UpHigh flow nasal cannulaMucusDyspnea030228 respiratory systemmucus plugSputumFeasibility StudiesFemalemedicine.symptomBlood Gas AnalysisbusinessHigh flow
researchProduct

Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure.

2022

Abstract Background Excessive inspiratory effort could translate into self-inflicted lung injury, thus worsening clinical outcomes of spontaneously breathing patients with acute respiratory failure (ARF). Although esophageal manometry is a reliable method to estimate the magnitude of inspiratory effort, procedural issues significantly limit its use in daily clinical practice. The aim of this study is to describe the correlation between esophageal pressure swings (ΔPes) and nasal (ΔPnos) as a potential measure of inspiratory effort in spontaneously breathing patients with de novo ARF. Methods From January 1, 2021, to September 1, 2021, 61 consecutive patients with ARF (83.6% related to COVID…

Self-inflicted lung injuryCritical Care and Intensive Care MedicineAcute respiratory failureself-inflicted lung injuryNon-invasive Mechanical ventilationesophageal pressure swingsacute respiratory failure non-invasive mechanical ventilation esophageal pressure swings nasal pressure swings endotracheal intubation COVID-19 respiratory monitoring inspiratory effort self-inflicted lung injuryHumansInspiratory effortendotracheal intubationEsophageal pressure swingsAcute respiratory failure Non-invasive Mechanical ventilation Esophageal pressure swings Nasal pressure swings Endotracheal intubation COVID-19 Respiratory monitoring Inspiratory effort Self-inflicted lung injuryRespiratory Distress Syndromeacute respiratory failurenon-invasive mechanical ventilationNoninvasive VentilationRespiratory monitoringCOVID-19Endotracheal intubationRespiration ArtificialAcute respiratory failure; COVID-19; Endotracheal intubation; Esophageal pressure swings; Inspiratory effort; Nasal pressure swings; Non-invasive Mechanical ventilation; Respiratory monitoring; Self-inflicted lung injuryNasal pressure swingsnasal pressure swingsrespiratory monitoringRespiratory Insufficiencyinspiratory effortCritical care (London, England)
researchProduct

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
researchProduct

Effectiveness and safety of a new helmet CPAP configuration allowing tidal volume monitoring in patients with COVID-19.

2021

Abstract Background High generated tidal volumes (Vt) have been correlated with higher risk of self-induced lung injury and worse clinical outcome. This study aimed to evaluate the effectiveness and safety of a new helmet continuous positive airway pressure delivered (h-CPAP) configuration allowing Vt monitoring in patients affected by COVID-19. Methods This prospective observational study was performed in the respiratory intermediate care unit of University Hospital in Turin, Italy, between March 24th, and June 15th, 2020. Included patients were treated with CPAP via a single-limb intentional leak configuration by a turbine-driven ventilator, provided with a dedicated patch. Effectiveness …

Pulmonary and Respiratory MedicineLeakTidal volume monitoringmedicine.medical_specialtyCoronavirus disease 2019 (COVID-19)List of abbreviations: ARF Acute respiratory failuremedicine.medical_treatmentLung injuryTidal volumeVt Tidal volumeCPAPMedicineIn patientContinuous positive airway pressureTidal volumeHelmetCPAP Continuous positive airway pressureRICU Respiratory intermediate care unitbusiness.industryCOVID-19ICU Intensive care unitEmergency medicineHFNT High flow nasal therapyObservational studyOriginal ArticleTDVs turbine-driven ventilatorsbusinessPulmonology
researchProduct