Non-invasive ventilation for critically ill patients with pandemic H1N1 2009 influenza A virus infection

Ñamendys‐Silva, Silvio A.; Hernández-Garay, Marisol; Rivero-Sigarroa, Eduardo

doi:10.1186/cc8883

Cited by 28 publications

(18 citation statements)

References 5 publications

(11 reference statements)

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“…These factors create a need for an alternative interface for NIPPV. A past report indicated that NIPPV was not well suited for supporting patients with H1N1 viral pneumonia [19]. Questionable efficacy and the risk of aerosolization have curtailed the use of NIPPV early in the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Helmet CPAP revisited in COVID-19 pneumonia: A case series

et al. 2020

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Introduction: Noninvasive positive pressure ventilation (NIPPV) plays an important role in the management of respiratory failure. However, since the emergence of the COVID-19 pandemic, utilization of traditional face mask NIPPV has been curtailed in part due to risk of aerosolization of respiratory particles and subsequent health care worker exposure. A randomized clinical trial in 2016 reported that an alternative interface, helmet NIPPV, may be more effective than traditional NIPPV at preventing intubation and improving mortality. The helmet NIPPV interface provides positive airway pressure, while also theoretically minimizing aerosolization, making it a feasible modality in management of respiratory failure in COVID-19 patients. Case and outcomes: This report describes a single-center experience of a series of three COVID-19 patients with hypoxemic respiratory failure managed with helmet NIPPV. One patient was able to avoid intubation while a second patient was successfully extubated to NIPPV. Ultimately, the third patient was unable to avoid intubation with helmet NIPPV, although the application of the device was late in the progression of the disease. Discussion: NIPPV is an important modality in the management of respiratory failure and has been shown to reduce the need for immediate endotracheal intubation in select populations. For patients unable to tolerate facemask NIPPV, the helmet provides an alternate interface. In COVID-19 patients, the helmet interface may reduce the risk of virus exposure to health care workers from aerosolization. Based on this experience, we recommend that helmet NIPPV can be considered as a feasible option for the management of patients with COVID-19, whether the goal is to prevent immediate intubation or avoid post-extubation respiratory failure. Randomized studies are needed to definitively validate the use of helmet NIPPV in this population. Conclusion: Helmet NIPPV is a feasible therapy to manage COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Helmet CPAP revisited in COVID-19 pneumonia: A case series

et al. 2020

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“…The emerging COVID-19 pandemic has led to a widespread shortage of intensive care unit (ICU) beds, ventilators, and trained operators, resulting in an effort to provide respiratory support and ventilation to patients by a number of alternative means. To ration ventilators, hospitals have increased usage of nontraditional methods of ventilating patients, including repurposing noninvasive positive pressure ventilators (NIPPV) [21]. and using multiplex ventilation to ventilate multiple patients with a single ventilator.…”

Section: Discussionmentioning

confidence: 99%

Design and performance testing of a novel emergency ventilator for in-hospital use

et al. 2020

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Background: The rapidly evolving COVID-19 pandemic has led to increased use of critical care resources, particularly mechanical ventilators. Amidst growing concerns that the health care system could face a shortage of ventilators in the future, there is a need for an affordable, simple, easy to use, emergency stockpile ventilator. Methods: Our team of engineers and clinicians designed and tested an emergency ventilator that uses a single limb portable ventilator circuit. The circuit is controlled by a pneumatic signal with electronic microcontroller input, using air and oxygen sources found in standard patient rooms. Ventilator performance was assessed using an IngMar ASL 5000 breathing simulator, and it was compared with a commercially available mechanical ventilator. Results: The emergency ventilator provides volume control mode, intermittent mandatory ventilation and continuous positive airway pressure. It can generate tidal volumes between 300 and 800 mL with <10% error, with pressure, volume, and waveforms substantially equivalent to existing commercial ventilators. Conclusions: We describe a cost effective, safe, and easy to use ventilator that can be rapidly manufactured to address ventilator shortages in a pandemic setting. It meets basic clinical needs and can be provided for emergency use in cases requiring mechanical ventilation because of complications due to respiratory failure from infectious diseases.

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“…NIV is recommended for patients with H1N1 virus infection complicated by pneumonia, acute lung injury, and ARDS because it improves oxygenation and reduces the work of breathing in these patients, but treatment should also be based upon published, evidence-based guidelines for sepsis-associated ARDS. In fact, standard lung-protective ventilation strategies are appropriate initially [22,23].…”

Section: Discussionmentioning

confidence: 99%

Clinical Findings in Albanian Patients with 2009 Influenza AH1N1 Admitted at the Intensive Care Unit

Ndreu

Kraja

Bino

et al. 2013

ISRN Emergency Medicine

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Due to the ease of cross-continent spread of infectious diseases, the 2009 influenza AH1N1 (H1N1) affected many countries. This observational prospective study looked at Albanian patients admitted with 2009 H1N1 at the ICU of the Department of Infectious Diseases at the University Hospital Center of Tirana, from November 2009 to March 2010. Demographic data, symptoms, comorbidities, and clinical outcomes were collected from each patient. The number of days spent in the ICU was recorded for each patient along with their radiological and laboratory findings, and outcome at discharge. Critical illness occurred in 31 patients admitted with confirmed 2009 H1N1. The median age of patients was 35 years. Five (16.1%) patients required endotracheal intubation; noninvasive oxygen therapy (NIV) was used in 15 (48.4%) patients via nasal tube; and continuous positive airway pressure (CPAP) and pressure support ventilation (PSV) oxygen masks were used in 11 (35.5%) patients. All patients were treated with oseltamivir. Four patients admitted and treated did not survive. Critical illness in the setting of 2009 H1N1 admitted in the ICU predominantly affected young adults. NIV could play a role in treating 2009 influenza H1N1 infection-related hypoxemic respiratory failure that was associated with severe hypoxemia, pneumonia, requirement for prolonged mechanical ventilation, and the frequent use of antiviral therapy.

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Non-invasive ventilation for critically ill patients with pandemic H1N1 2009 influenza A virus infection

Cited by 28 publications

References 5 publications

Helmet CPAP revisited in COVID-19 pneumonia: A case series

Helmet CPAP revisited in COVID-19 pneumonia: A case series

Design and performance testing of a novel emergency ventilator for in-hospital use

Clinical Findings in Albanian Patients with 2009 Influenza AH1N1 Admitted at the Intensive Care Unit

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