Non-invasive ventilation and continuous positive pressure ventilation in emergency departments: where are we now?

Bolton, R P; Bleetman, Anthony

doi:10.1136/emj.2007.049072

Cited by 18 publications

(10 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…• The increasing success and cost savings of NIV to treat COPD exacerbation in other hospital settings (eg, general ward or emergency department), 17,30 as observed also in this survey: 86% of the respondent RHDCUs reported the use of NIV in other environments.…”

Section: Interventions Diseases and Outcomessupporting

confidence: 52%

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Scala¹,

Corrado

Confalonieri

et al. 2011

Respir Care

View full text Add to dashboard Cite

.03), and the physician-to-patient mean ratio and the nurse-to-patient mean ratio per shift were lower (P ‫؍‬ .001 and P ‫؍‬ .002, respectively). Admissions for only monitoring decreased (P < .001), and admissions for active interventions increased: noninvasive ventilation (P ‫؍‬ .002), invasive ventilation (P < .001), weaning from invasive ventilation (P < .001), and tracheal decannulation (P < .001). The complexity of RHDCU patients' conditions increased: there was a reduction in the percentage of COPD patients (P < .001) and an increase in the percentage of patients with neuromyopathies (P < .001) and de novo hypoxemia (P ‫؍‬ .006). CONCLUSIONS: Between 1997 and 2007 there was an increase in the number and expertise of Italian RHDCUs, with a shift toward less expensive care, and greater complexity of interventions and patient dysfunctions. These findings support the crucial role of RHDCUs in the management of respiratory critical patients.

show abstract

Section: Interventions Diseases and Outcomessupporting

confidence: 52%

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Scala¹,

Corrado

Confalonieri

et al. 2011

Respir Care

View full text Add to dashboard Cite

show abstract

“…Indications of NIV commencement include: COPD exacerbation, moreover PH < 7.32 and PaCO 2 > 45 mmHg or PaO 2 < 60mmHg despite receiving oxygen with Max FIO 2 of 60% (12). Very few studies has been carried out to eliminate invasive interventions for determining NIV indication including Crawford’s study in which different parameters have been studied for determining the index of NIV requirement such as: RSBI, PH, Lactate, MV, Carbon Dioxide production (VCO 2 ), End-Tidal CO 2 (ETCO2), Air way dead space and APACHE II criterion.…”

Section: Discussionmentioning

confidence: 99%

“…However, the process of intubation and ventilation support in these patients is associated with an increased rate of complications and it would be difficult to wean these patients from ventilator (9, 10). Considering the complications associated with mechanical ventilation in patients with acute respiratory failure or COPD, researches have shown that Non-Invasive ventilation (NIV) could aid ventilation by reducing respiratory work; therefore reducing intubation, morbidity and mortality rates in these patients (11, 12). To determine indications of requiring NIV in patients suffering respiratory failure, available guidelines are based on ABG findings in these patients which eventually would expose them to an invasive procedure; therefore, providing a non-invasive predictive factor necessitating NIV could be of great importance.…”

Section: Introductionmentioning

confidence: 99%

Rapid Shallow Breathing Index Survey, a Predictor of non-Invasive Ventilation Necessity in Patients With Chronic Obstructive Pulmonary Disease Exacerbation: An Analytical Descriptive Prospective Study

Soleimanpour¹,

Taghizadieh²,

Salimi³

et al. 2014

Iran Red Crescent Med J

View full text Add to dashboard Cite

Background:Patients with Chronic Obstructive Pulmonary Disease (COPD) are susceptible to respiratory failure which would ultimately lead to their hospitalization. Need to Non-Invasive Ventilation (NIV) is considered as the choice respiratory support in acute respiratory failure and is associated with a beneficial role in patients with COPD exacerbation. Hence, determining patients that would benefit NIV could be of great assistance.Objectives:We aimed at evaluating the use of Rapid Shallow Breathing Index (a ratio determined by the frequency (f) divided by the tidal volume (VT)) in NIV requirement in COPD patients.Patients and Methods:In a prospective descriptive study, ninety eight patients over 40 years old with documented COPD exacerbation who were referred to emergency department of Imam Reza hospital, Tabriz, Iran were studied. Rapid Shallow Breathing Index (RSBI), ABG parameters and APACHE II scoring were measured in each patient. Quantitative data were analyzed by Student's t-test and One-way ANOVA and qualitative data were analyzed using chi square (X2). Findings were analyzed with SPSS software version 16.Results:Patients requiring NIV included 43.9 % of all studied patients. RSBI and APACHE II score with sensitivity of 94.8 %, (cut off point = 110) and 72 % (cut off point = 14) respectively, had high diagnostic sensitivity and also the ability to predict patients requiring NIV. None of ABG parameters solely played a significant role in determining patients requiring NIV.Conclusions:RSBI and APACHE II score in patients with COPD exacerbation are of the ability to predict NIV requirement, as a predicting factor of Non-Invasive Ventilation requirement.

show abstract

“…La pratique de la VNI en dehors des structures de réani-mation et notamment dans les services d'urgences a été évaluée plus récemment [3][4][5][6][7][8][9][10][11]. La VNI n'est plus une technique réservée aux unités de soins intensifs, et la mise en route précoce de ce support respiratoire, que ce soit dès la période préhospitalière ou dans un service d'accueil des urgences (SAU), se doit de bénéficier à un grand nombre de patients présentant une détresse respiratoire sévère.…”

Section: Mots Clés Ventilation · Ventilation Non Invasive · Préhospitunclassified

Non-invasive positive pressure ventilation in emergency medicine

Combes

Jabre

Vivien

et al. 2011

Ann. Fr. Med. Urgence

View full text Add to dashboard Cite

La ventilation non invasive (VNI) est une technique qui après avoir été largement validée en réanimation est utilisée de manière quotidienne dans les structures d'urgences pré-et intrahospitalières. Les deux pathologies pour lesquelles la VNI a démontré un bénéfice certain sont la décom-pensation de bronchopneumopathie chronique obstructive (BPCO) et l'oedème aigu pulmonaire (OAP) cardiogénique sévère. Les deux modes ventilatoires les plus souvent utilisés sont la ventilation spontanée avec aide inspiratoire et pression positive de fin d'expiration (VS AI-PEP), et la pression positive continue (VS PPC ou CPAP). La VS AI-PEP est le mode électif lors de la réalisation d'une VNI chez un patient BPCO en décompensation alors que VS AI-PEP et VS PPC peuvent être utilisées indifféremment en cas d'OAP. Le mode VS AI-PEP a été proposé dans d'autres indications que sont la préoxygénation avant intubation et l'insuffisance respiratoire aiguë hypocapnique. La VS AI-PEP peut être aussi utilisée dans le cadre d'une limitation thérapeutique chez des patients en détresse respiratoire. En médecine d'urgence, ces techniques de VNI doivent être mises en route le plus précocement possible soit en préhospitalier ou dès l'arrivée du patient au service d'accueil des urgences (SAU). Bien que l'expérience clinique soit moins grande que pour le milieu intrahospitalier, les nouveaux ventilateurs, compacts, performants et autonomes sur le plan énergie permettent de débuter la VNI dès la prise en charge préhospi-talière par les équipes de Smur. Pour citer cette revue : Ann. Fr. Med. Urgence 1 (2011). Mots clés Ventilation · Ventilation non invasive · Préhospitalier · UrgencesAbstract Non-invasive positive pressure ventilation (NIPPV) is a respiratory technique validated for several years in intensive care units, which has became a standard of care in emergency units in recent years. The best indications for NIPPV are patients with chronic obstructive pulmonary disease (COPD) exacerbation and those with acute congestive heart failure (CHF). The two ventilatory modes usually used are spontaneous modes: the bi-level positive airway pressure (BiPAP) and the continuous positive airway pressure (CPAP). BiPAP is the only mode indicated for COPD decompensation, whereas CPAP or BiPAP can be used in CHF. BiPAP has been proposed in case of other indications such as preoxygenation technique before tracheal intubation, in case of acute respiratory failure and in patients with "do not intubate" status. In emergency medicine, NIPPV should be started as earlier as possible either in the prehospital setting or at the patient's arrival in the emergency department. New ventilators are small with high performance capacities and are equipped with batteries which allow NIPPV to be started in the prehospital setting by the mobile medical units.

show abstract

Non-invasive ventilation and continuous positive pressure ventilation in emergency departments: where are we now?

Cited by 18 publications

References 40 publications

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Rapid Shallow Breathing Index Survey, a Predictor of non-Invasive Ventilation Necessity in Patients With Chronic Obstructive Pulmonary Disease Exacerbation: An Analytical Descriptive Prospective Study

Non-invasive positive pressure ventilation in emergency medicine

Contact Info

Product

Resources

About