Prone position ventilation, recruitment maneuver and intravenous zanamivir in severe refractory hypoxemia caused by influenza A (H1N1)

Biatto, Jair; Costa, Eduardo L. V.; Pastore, Laerte; Kallás, Esper G.; Deheinzelin, Daniel; Schettino, Guilherme de Paula Pinto

doi:10.1590/s1807-59322010001100026

Cited by 10 publications

(5 citation statements)

References 11 publications

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“…139 During the influenza A/H1N1 pandemic, many cases and series were published involving this technique, with good results. 140 At present, the use of high-frequency ventilation requires further information in order to improve the existing level of evidence with a view to drawing reliable conclusions. Although a recent metaanalysis published by Sud et al, 141 involving 6 studies and including approximately 190 patients per management arm, has described a significant reduction in mortality after 30 days (RR = 0.77; 95%CI 0.61---0.98), more evidence is needed, since this metaanalysis was based on studies in reference centers, not blinded studies, and with a small number of patients.…”

Section: Use Of Non-conventional Strategies For the Management Of Refmentioning

confidence: 99%

Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit

Rodríguez

Álvarez–Rocha

Sirvent

et al. 2012

Medicina Intensiva (English Edition)

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Section: Use Of Non-conventional Strategies For the Management Of Refmentioning

confidence: 99%

Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit

Rodríguez

Álvarez–Rocha

Sirvent

et al. 2012

Medicina Intensiva (English Edition)

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“…The amount of time a patient spends weaning from mechanical ventilation has been estimated to be as long as 42% of the total duration of MV 5,6. Nevertheless, weaning practices have been revisited due to a recent increase in the use of noninvasive positive-pressure ventilation (NPPV) to avoid intubation or during weaning in patients with acute respiratory failure 7,8. …”

Section: Introductionmentioning

confidence: 99%

Shortening ventilatory support with a protocol based on daily extubation screening and noninvasive ventilation in selected patients

Nery

Pastore

Carvalho³

et al. 2011

Clinics

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BACKGROUND:Prolonged invasive mechanical ventilation and reintubation are associated with adverse outcomes and increased mortality. Daily screening to identify patients able to breathe without support is recommended to reduce the length of mechanical ventilation. Noninvasive positive-pressure ventilation has been proposed as a technique to shorten the time that patients remain on invasive ventilation.METHODS:We conducted a before-and-after study to evaluate the efficacy of an intervention that combined daily screening with the use of noninvasive ventilation immediately after extubation in selected patients. The population consisted of patients who had been intubated for at least 2 days.RESULTS:The baseline characteristics were similar between the groups. The intervention group had a lower length of invasive ventilation (6 [4;9] vs. 7 [4;11.5] days, p = 0.04) and total (invasive plus noninvasive) ventilator support (7 [4;11] vs. 9 [6;8], p = 0.01). Similar reintubation rates within 72 hours were observed for both groups. In addition, a lower ICU mortality was found in the intervention group (10.8% vs. 24.3%, p = 0.03), with a higher cumulative survival probability at 60 days (p = 0.05). Multivariate analysis showed that the intervention was an independent factor associated with survival (RR: 2.77; CI 1.14-6.65; p = 0.03), whereas the opposite was found for reintubation at 72 hours (RR: 0.27; CI 0.11-0.65; p = 0.01).CONCLUSION:The intervention reduced the length of invasive ventilation and total ventilatory support without increasing the risk of reintubation and was identified as an independent factor associated with survival.

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“…A MRA faz parte da estratégia protetora, sendo utilizada com aumento das pressões inspiratórias por curtos períodos de tempo para abrir os alvéolos colapsados e permitir a distribuição mais homogênea da ventilação [9,10]. Como a SDRA é uma doença que cursa de uma fase exsudativa a uma fase com fibrose alveolar e intersticial persistente, o diagnóstico precoce é fundamental, para que as MRA e a manutenção da abertura alveolar com PEEP suficiente sejam eficazes.…”

Section: Discussionunclassified

“…Um terço dos pacientes progridem para hipoxemia refratária pós-dano alveolar difuso associado com bronquiolite necrotizante e extensa hemorragia, e necessitam de técnicas de ventilação mecânica de resgate [8,9]. Estas técnicas incluem manobras de recrutamento alveolar, ventilação por posição prona, ventilação por alta frequência, oxigenação por membrana extracorpórea, dentre outros.…”

Section: Introductionunclassified

Estratégia protetora de ventilação mecânica na síndrome respiratória aguda grave por influenza: revisão sistemática

Pimenta¹,

Teixeira²

2022

Fisioter Bras

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Objetivo: Avaliar se a estratégia protetora de ventilação mecânica na síndrome do desconforto respiratório agudo (SDRA) por Influenza é capaz de reduzir o tempo de ventilação mecânica e aumentar a sobrevida. Métodos: A busca foi realizada nas bases de dados Pubmed, Embase, Cochrane, Lilacs, Medline, Scopus, Web of Science, Science Direct, Cinahl e SAGE, entre 2009 e 2019. Buscou-se por ensaios clínicos controlados e randomizados, estudos analíticos com grupo controle: coorte prospectiva ou controle histórico. A população estudada foi de indivíduos adultos com diagnóstico de síndrome respiratória aguda grave por Influenza, que receberam estratégia protetora de ventilação com baixos volumes correntes e/ou manobra de recrutamento alveolar comparada com qualquer outra estratégia. Resultados: A busca resultou em 445 referências; apenas 1 artigo preencheu os critérios de elegibilidade. O estudo incluído trouxe que o uso de baixos volumes traz benefícios para os pacientes com SDRA de etiologias virais, como menor tempo de ventilação mecânica, de internação em UTI e hospitalar. Conclusão: A escassez de artigos sobre a estratégia de ventilação protetora em SDRA secundário à infecção por Influenza não permite concluir se essa estratégia é capaz de reduzir o tempo de ventilação e/ou melhorar a sobrevida nessa população. A literatura carece de mais estudos que permitam conclusões robustas.

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Prone position ventilation, recruitment maneuver and intravenous zanamivir in severe refractory hypoxemia caused by influenza A (H1N1)

Cited by 10 publications

References 11 publications

Shortening ventilatory support with a protocol based on daily extubation screening and noninvasive ventilation in selected patients

Estratégia protetora de ventilação mecânica na síndrome respiratória aguda grave por influenza: revisão sistemática

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