Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure

Chevrolet, Jean-Claude; Jolliet, Philippe; Abajo, Bianca; Toussi, Azita; Louis, Martine A.

doi:10.1378/chest.100.3.775

Cited by 150 publications

(71 citation statements)

References 15 publications

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“…These results contradict the findings of a previous study concluding that noninvasive ventilation was "a very time-consuming procedure for nurses" [8]. There was no difference in the duration of NIPSV sessions or in the overall assistance time per session between the two groups of patients.…”

Section: Discussioncontrasting

confidence: 98%

“…NIPSV can avoid the need for endotracheal intubation and its increasingly documented complications [7]. Nevertheless, this method of ventilation requires the presence of nurses familiar with the technique, and this may be time-consuming [3,8]. Moreover, according to certain reports [2,4,9,10], some patients do not tolerate noninvasive ventilatory support, and side-effects of these techniques occur quite frequently [3,11].…”

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confidence: 99%

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Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

et al. 2000

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Methods of noninvasive pressure support ventilation (NIPSV) are not always easy to apply in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD).The assistance time spent by nurses in relation to ventilatory time was prospectively studied, when NIPSV was used, in a sequential mode, in COPD patients with either acute exacerbations (58 patients, group I) or postextubation hypercapnic respiratory insufficiency (42 patients, group II) in a medical intensive care unit.During the first 24 h after enrolment, NIPSV was used for 6.7 3.2 h (mean SD) in group I and 5.6 3.1 h in group II; the duration of NIPSV sessions and the nurse time consumption per session were respectively 47 12 and 11 7 min in group I, and 46 12 and 11 6 min in group II. After the first 24 h of the study, the duration of NIPSV was 4.7 3.2 h . day -1 in group I and 4.9 3.5 h . day -1 in group II, and the nurse time consumption dropped significantly: the duration of NIPSV sessions and the nurse time consumption per session were respectively 44 10 and 7 4 min in group I, and 47 14 and 7 3 min in group II. Between the first 24 h and the subsequent period of 24 h, the nursing time dropped significantly (98 versus 59 min in group I (p<0.05), and 85 versus 52 min in group II (p<0.05)). There was no difference in the duration of NIPSV sessions, or in the overall assistance time per session, between the two groups of patients.In conclusion, the study seems to favour a quite low assistance time spent by nurses in relation to ventilatory time when noninvasive pressure support ventilation is used in chronic obstructive pulmonary disease patients with either acute exacerbations or postextubation hypercapnic respiratory insufficiency. Methods of noninvasive pressure support ventilation (NIPSV) are being proposed more and more for patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure [1±6]. NIPSV can avoid the need for endotracheal intubation and its increasingly documented complications [7]. Nevertheless, this method of ventilation requires the presence of nurses familiar with the technique, and this may be time-consuming [3,8]. Moreover, according to certain reports [2, 4, 9, 10], some patients do not tolerate noninvasive ventilatory support, and side-effects of these techniques occur quite frequently [3,11].Three articles have demonstrated that the institution of noninvasive mechanical ventilation is not significantly more time-consuming for personnel than traditional medical therapy [4,12] or invasive mechanical ventilation [13]. However, two of these studies [12,13] were performed in respiratory intensive care units (ICUs) with a specialized activity, and where patient/staff ratios are generally lower than in general ICUs [13]. The authors consider that the problem lies not in comparing the workload linked to utilization of NIPSV with that linked to standard treatment or invasive mechanical ventilation, since it is advisable to use NIPSV to avoid intubation. It is more a question of know...

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Section: Discussioncontrasting

confidence: 98%

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confidence: 99%

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

et al. 2000

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“…The duration of invasive mechanical ventilation was 13±6 days (range, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] in the 4 patients in the treatment group who required reintubation and who had favourable outcomes. In the surviving patients, the total time of ventilatory assistance for the treatment of the postextubation distress (duration of NIPSV in all patients in the treatment group, and duration of invasive mechanical ventilation performed after reintubation in patients in both groups who required reintubation) was 6±4 days (range, 2-21) in the treatment group compared with 11±8 days (range, 5-25) in the control group (p<0.01).…”

Section: Clinical Studymentioning

confidence: 99%

“…According to the literature, secondary effects of the NIPSV techniques occur frequently, most frequently involving cutaneous lesions, leaks and gastric insufflation. Moreover, noninvasive ventilation requires the presence of nurses familiar with the technique, and this may be time-consuming [3,12]. In a recent publication it was demonstrated that NIPSV performed with a sequential mode may be used in the management of patients with acute exacerbations of COPD [13].…”

mentioning

confidence: 99%

Noninvasive pressure support ventilation in COPD patients with postextubation hypercapnic respiratory insufficiency

Hilbert¹,

Gruson²,

Portel³

et al. 1998

Eur Respir J

199

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Patients with chronic obstructive pulmonary disease (COPD) who have been intubated and mechanically ventilated may prove difficult to wean. Noninvasive ventilation may be used in an attempt to avoid new endotracheal intubation. The efficacy of administration of noninvasive pressure support ventilation was evaluated in 30 COPD patients with postextubation hypercapnic respiratory insufficiency, compared with 30 historically matched control patients who were treated conventionally. Patients were included in the study if, within 72 h postextubation, they presented with respiratory distress, defined as the combination of a respiratory frequency >25 breaths x min(-1), an increase in the arterial carbon dioxide tension (Pa,CO2) of at least 20% compared with the value measured after extubation, and a pH <7.35. Noninvasive pressure support ventilation was effective in correcting gas exchange abnormalities. The use of noninvasive ventilation significantly reduced the need for endotracheal intubation: 20 of the 30 patients (67%) in the control group required endotracheal intubation, compared with only six of the 30 patients (20%) in the noninvasive-ventilation group (p<0.001). In-hospital mortality was not significantly different between the two groups, but the mean duration of ventilatory assistance for the treatment of the postextubation distress, and the length of intensive care unit stay related to this event, were both significantly shortened by noninvasive ventilation (p<0.01). In conclusion, noninvasive ventilation may be used in the management of patients with chronic obstructive pulmonary disease and postextubation hypercapnic respiratory insufficiency.

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“…36 Bir diğer çalışmada ise NIMV kullanılan hastalarda daha fazla bakım zamanına gerek duyulduğu belirtilmiş ve bu da NIMV'nin başarısızlığı olarak yorumlanmıştır. 37 Maske kullanımı hem konforsuzdur hem de akut dispneik hastalar için klostrofobiktir. Ayrıca fasiyal deri nekrozuna yol açabilir.…”

Section: Bulgularunclassified

Comparison of Noninvasive Mechanical Ventilation Volume Assured Pressure Support Mode With Manual Pressure Support in Acute Respiratory Failure of Chronic Obstructive Pulmonary Disease

Rollas¹,

Berktas²,

Berkoğlu³

2012

Solunum

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ÖZETAmaç: Kronik obstrüktif akciğer hastalığına (KOAH) bağlı akut hiperkapnik solunum yetmezliğinin düzeltilmesinde, volüm garantili basınç desteği (average volume assured pressure support: AVAPS) stratejisinin manuel basınç desteği ile, etkinlik ve tolerabilite açısından karşılaştırılmasıdır. ABSTRACTAim: The aim of this study was to compare the efficacy and tolerability of average volume assured pressure support (AVAPS) strategy with the support of manual pressure in chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure. Materials and Methods:Thirty-five patients treated for acute hypercapnic respiratory failure due to COPD were included in the study. Ventilation was applied with the same bilevel device respectively, 45 minutes with manual pressure support ventilation, 45 minutes with AVAPS and again 45 minutes with manual pressure support ventilation modes. Between each sequence 60 minutes without noninvasive mechanical ventilation (NIMV) was provided. Thirteen patients with pressure support and 11 patients with AVAPS mode continued the application of NIMV for approximately 24 hours overenight. At the beginning and at the end of each period of NIMV; arterial blood gases, respiratory rates, dyspnea scores (BORG visual analogue scale, 0 = no dyspnea, 10 = severe dyspnea), heart rate, arterial blood pressure, ventilatory parameters (volume, pressure) and mask leaks were recorded.Results: Twenty three of 35 patients included in the study were male and 12 were female. The mean value of body mass index was 27.2±5.6 kg/m 2 . With respect to the initial values of pH and PaCO 2 improvements was observed in each NIMV period (for both values p<0.001), but no difference was found between AVAPS and manuel pressure support (p>0.05). After 24 hour follow-up, in two patients continuing with AVAPS group

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Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure

Cited by 150 publications

References 15 publications

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

Noninvasive pressure support ventilation in COPD patients with postextubation hypercapnic respiratory insufficiency

Comparison of Noninvasive Mechanical Ventilation Volume Assured Pressure Support Mode With Manual Pressure Support in Acute Respiratory Failure of Chronic Obstructive Pulmonary Disease

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