Hyperacute Hemodynamic Effects of BiPAP Noninvasive Ventilation in Patients With Acute Heart Failure and Left Ventricular Systolic Dysfunction in Emergency Department

Iurilli, Cinzia Moret; Brunetti, Natale Daniele; Corato, Paola Rita Di; Salvemini, Giuseppe; Ciccone, Marco Matteo; Procacci, Vito

doi:10.1177/0885066617740849

Cited by 17 publications

(11 citation statements)

References 22 publications

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“…We would thank Dr Briones Claudett for his kind attention to our work. 1 Some observations raised in his letter 2 can be easily shared, some other, unfortunately, much less. Of course, our population is very small and not intended as representative of the whole cohort of patients affected by acute heart failure, acute heart failure with systolic dysfunction, acute heart failure with systolic dysfunction and resistant to diuretics.…”

mentioning

confidence: 84%

Hyperacute Hemodynamic Effects of BiPAP Noninvasive Ventilation: To(o) Di(uretics) or Not To(o) Di(uretics)?

Iurilli

Brunetti

Corato

et al. 2018

J Intensive Care Med

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mentioning

confidence: 84%

Hyperacute Hemodynamic Effects of BiPAP Noninvasive Ventilation: To(o) Di(uretics) or Not To(o) Di(uretics)?

Iurilli

Brunetti

Corato

et al. 2018

J Intensive Care Med

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“…These effects could negate the potential benefits of avoiding intraoperative endotracheal intubation and mechanical ventilation [16]. Since NIV can (1) partially compensate for the affected respiratory function by unloading the respiratory muscles and reducing the work of breathing, (2) improve alveolar recruitment with preservation of lung volumes, resulting in better gas exchange, (3) reduce right ventricular preload and left ventricular afterload, and (4) avoid complications of invasive mechanical ventilation [35][36][37][38][39][40], the intraoperative use of NIV along with NA may be, at least in theory, justifiable in some patients with COPD or chest wall and NMDs (Figure 1).…”

Section: Non-invasive Ventilation To Support Lung Function During Neumentioning

confidence: 99%

Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review

Corcione

Karim

Mina

et al. 2019

ait

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Unlike general anaesthesia, neuraxial anaesthesia (NA) reduces the burden and risk of respiratory adverse events in the post-operative period. However, both patients affected by chronic obstructive pulmonary disease (COPD) and chest wall disorders and/or neuromuscular diseases may experience the development or the worsening of respiratory failure, even during surgery performed under NA; this latter negatively affects the function of accessory respiratory muscles, resulting in a blunted central response to hypercapnia and possibly in an exacerbation of cardiac dysfunction (NA-induced relative hypovolemia). According to European Respiratory Society (ERS) and American Thoracic Society (ATS) guidelines, non-invasive ventilation (NIV) is effective in the post-operative period for the treatment of both impaired pulmonary gas exchange and ventilation, while the intra-operative use of NIV in association with NA is just anecdotally reported in the literature. Whilst NIV does not assure a protected patent airway and requires the patient's cooperation, it is a handy tool during surgery under NA: NIV is reported to be successful for treatment of acute respiratory failure; it may be delivered through the patient's home ventilator, may reverse hypoventilation induced by sedatives or inadvertent spread of anaesthetic up to cervical dermatomes, and allow the avoidance of intubation in patients affected by chronic respiratory failure, prolonging the time of non-invasiveness of respiratory support (i.e., neuromuscular patients needing surgery). All these advantages could make NIV preferable to oxygen in carefully selected patients.

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“…Respiratory failure resulting from cardiogenic pulmonary edema or congestive heart failure (CHF) is a condition that can be treated effectively by using non-invasive ventilation (NIV) [17][18][19][20][21][22]. In CHF, pathophysiological changes include congestion in pulmonary vascular bed, interstitial edema and fluid accumulation in the alveoli.…”

Section: Radiological Assessment In Patients With Cardiogenic Pulmonamentioning

confidence: 99%

“…In CHF, pathophysiological changes include congestion in pulmonary vascular bed, interstitial edema and fluid accumulation in the alveoli. This initially causes hypoxemic respiratory failure; followed by hypercapneic respiratory failure [19,20].…”

Section: Radiological Assessment In Patients With Cardiogenic Pulmonamentioning

confidence: 99%

Radiology Findings and Non-Invasive Ventilation Response

Işıklar¹,

Serin

Esquinas

2018

Advances in Respiratory Medicine

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Although NIV is a simple and useful method, considerable variation in its use across countries, regions and hospitals may be noted. The patient should be evaluated according to subjective response (respiratory distress, consciousness, problems related to mask and airflow), physiological responses (respiration rate, respiratory effort, air leakage) and patient-ventilator compliance (gas exchange, pulse oximetry, arterial blood gases). Normalization in respiration rate within 1 or 2 hours after initiation of treatment is one of the most important markers for recovery. The goal is to maintain respiration rate between 20 and 30 breaths/ minute. Reduction in intercostal and supraclavicular retractions, paradoxical respiration and sympathetic activity indicate success of treatment. Arterial blood gases are measured within first 2 hours in order to assess pH and CO 2 ; and as needed thereafter. In general, NIV is assessed by arterial blood gases, hemodynamic parameters and several laboratory tests. There is limited number of studies in NIV. Here, we aimed to assess radiological implications of gas distribution within lung tissue during NIV therapy.

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Hyperacute Hemodynamic Effects of BiPAP Noninvasive Ventilation in Patients With Acute Heart Failure and Left Ventricular Systolic Dysfunction in Emergency Department

Abstract: The BiPAP NIV may rapidly ameliorate several hemodynamic, arterial blood gas, and microcirculation indexes in patients with AHF and left ventricular systolic dysfunction.

Cited by 17 publications

References 22 publications

Hyperacute Hemodynamic Effects of BiPAP Noninvasive Ventilation: To(o) Di(uretics) or Not To(o) Di(uretics)?

Hyperacute Hemodynamic Effects of BiPAP Noninvasive Ventilation: To(o) Di(uretics) or Not To(o) Di(uretics)?

Non-invasive ventilation during surgery under neuraxial anaesthesia: a pathophysiological perspective on application and benefits and a systematic literature review

Radiology Findings and Non-Invasive Ventilation Response

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