Blood Product Utilization Within 48 Hours of Death in an Oncologic ICU

Moukhachen, Hala; Hale, Kaye; Pastores, Stephen M.; Miller, Quentin; Huynh, Khy; Neville, Timothy; Halpern, Neil A.

doi:10.1378/chest.1389772

Cited by 2 publications

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“…On average, dedicated NIV platforms perform better than ICU ventilators using the NIV algorithm [75]. In particular, the synchrony between the machine and the patient is better with dedicated NIV platforms [75]. …”

Section: Reviewmentioning

confidence: 99%

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

2014

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BackgroundIdentifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor.ResultsThe possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance.ConclusionsEvery clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation.

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Section: Reviewmentioning

confidence: 99%

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

2014

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“…A similar model of leakage, which is greater during inspiration than during expiration, were used by Carteaux et al, using a water column of variable height to study the frequency of asynchronies at different leak levels [12]. The impact of these models on monitoring reliability, however, has not been evaluated to date.…”

Section: Discussionmentioning

confidence: 99%

Effect of dynamic random leaks on the monitoring accuracy of home mechanical ventilators: a bench study

Sogo

Montanyà²,

Monsó

et al. 2013

BMC Pulm Med

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BackgroundSo far, the accuracy of tidal volume (VT) and leak measures provided by the built-in software of commercial home ventilators has only been tested using bench linear models with fixed calibrated and continuous leaks. The objective was to assess the reliability of the estimation of tidal volume (VT) and unintentional leaks in a single tubing bench model which introduces random dynamic leaks during inspiratory or expiratory phases.MethodsThe built-in software of four commercial home ventilators and a fifth ventilator-independent ad hoc designed external software tool were tested with two levels of leaks and two different models with excess leaks (inspiration or expiration). The external software analyzed separately the inspiratory and expiratory unintentional leaks.ResultsIn basal condition, all ventilators but one underestimated tidal volume with values ranging between -1.5 ± 3.3% to -8.7% ± 3.27%. In the model with excess of inspiratory leaks, VT was overestimated by all four commercial software tools, with values ranging from 18.27 ± 7.05% to 35.92 ± 17.7%, whereas the ventilator independent-software gave a smaller difference (3.03 ± 2.6%). Leaks were underestimated by two applications with values of -11.47 ± 6.32 and -5.9 ± 0.52 L/min. With expiratory leaks, VT was overestimated by the software of one ventilator and the ventilator-independent software and significantly underestimated by the other three, with deviations ranging from +10.94 ± 7.1 to -48 ± 23.08%. The four commercial tools tested overestimated unintentional leaks, with values between 2.19 ± 0.85 to 3.08 ± 0.43 L/min.ConclusionsIn a bench model, the presence of unintentional random leaks may be a source of error in the measurement of VT and leaks provided by the software of home ventilators. Analyzing leaks during inspiration and expiration separately may reduce this source of error.

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Blood Product Utilization Within 48 Hours of Death in an Oncologic ICU

Cited by 2 publications

References 0 publications

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

Effect of dynamic random leaks on the monitoring accuracy of home mechanical ventilators: a bench study

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