Noninvasive positive-pressure ventilation as a weaning strategy for intubated adults with respiratory failure

Abstract

Summary estimates from 16 trials of moderate to good quality that included predominantly participants with COPD suggest that a weaning strategy that includes NPPV may reduce rates of mortality and ventilator-associated pneumonia without increasing the risk of weaning failure or reintubation.

Prospective Observational Study of Predictors of Re-Intubation Following Extubation in the Surgical ICU

“…Nowadays, NIV is increasingly used to facilitate early extubation as well as to prevent and manage failed extubation. 51,52 In our study, the rate of NIV used after extubation was 12%, and of these, 29% required re-intubation. Our study demonstrated that subjects who required reintubation following a failed NIV attempt had a higher rate of morbidity and mortality than those who did not require re-intubation.…”

Prospective Observational Study of Predictors of Re-Intubation Following Extubation in the Surgical ICU

“…Nowadays, NIV is increasingly used to facilitate early extubation as well as to prevent and manage failed extubation. 51,52 In our study, the rate of NIV used after extubation was 12%, and of these, 29% required re-intubation. Our study demonstrated that subjects who required reintubation following a failed NIV attempt had a higher rate of morbidity and mortality than those who did not require re-intubation.…”

Prolonged Invasive Mechanical Ventilation in a Tertiary Respiratory ICU: Outcomes, Challenges, and Future Directions

“…Across the cohort, the principal weaning modalities employed were structured SBT protocols using PSV and T-piece trials, progressive transition to BiPAP via a leak valve through the tracheostomy, and early physiotherapy-driven ambulation. In patients with COPD and chronic type II respiratory failure, such as index case 2, early NIV bridging through the tracheostomy was associated with progressive ventilator independence by resting the respiratory muscles while allowing stepwise weaning of invasive support [ 16 , 17 ].…”

“…A key feature that distinguished our approach was the early transition to BiPAP support via the tracheostomy using a leak valve, which allowed progressive nocturnal ventilatory rest with daytime weaning trials. This technique is particularly valuable in patients with chronic hypercapnic respiratory failure, including COPD, BCOS, and OSA overlap, where respiratory muscle fatigue must be carefully managed and home BiPAP is ultimately the planned long-term support strategy [ 16 , 17 , 34 ].…”

Evidências do uso de ventilação não invasiva com pressão positiva pós-extubação: uma revisão de literatura

“…A revisão de Cochrane faz algumas considerações sobre o sucesso no desmame ser considerado quando há ausência de reintubação dentro de três dias, ou se reintubação ou ventilação não invasiva não foi necessária dentro de 72 horas após a suspensão da ventilação mecânica. Sendo assim, a utilização de VNI após a extubação torna-se uma ferramenta aliada no desmame ventilatório e no reestabelecimento da função pulmonar (Burns, et al, 2018).…”

Prospective Observational Study of Predictors of Re-Intubation Following Extubation in the Surgical ICU

“…Nowadays, NIV is increasingly used to facilitate early extubation as well as to prevent and manage failed extubation. 51,52 In our study, the rate of NIV used after extubation was 12%, and of these, 29% required re-intubation. Our study demonstrated that subjects who required reintubation following a failed NIV attempt had a higher rate of morbidity and mortality than those who did not require re-intubation.…”

Prolonged Invasive Mechanical Ventilation in a Tertiary Respiratory ICU: Outcomes, Challenges, and Future Directions

“…Across the cohort, the principal weaning modalities employed were structured SBT protocols using PSV and T-piece trials, progressive transition to BiPAP via a leak valve through the tracheostomy, and early physiotherapy-driven ambulation. In patients with COPD and chronic type II respiratory failure, such as index case 2, early NIV bridging through the tracheostomy was associated with progressive ventilator independence by resting the respiratory muscles while allowing stepwise weaning of invasive support [ 16 , 17 ].…”

“…A key feature that distinguished our approach was the early transition to BiPAP support via the tracheostomy using a leak valve, which allowed progressive nocturnal ventilatory rest with daytime weaning trials. This technique is particularly valuable in patients with chronic hypercapnic respiratory failure, including COPD, BCOS, and OSA overlap, where respiratory muscle fatigue must be carefully managed and home BiPAP is ultimately the planned long-term support strategy [ 16 , 17 , 34 ].…”

Evidências do uso de ventilação não invasiva com pressão positiva pós-extubação: uma revisão de literatura

“…A revisão de Cochrane faz algumas considerações sobre o sucesso no desmame ser considerado quando há ausência de reintubação dentro de três dias, ou se reintubação ou ventilação não invasiva não foi necessária dentro de 72 horas após a suspensão da ventilação mecânica. Sendo assim, a utilização de VNI após a extubação torna-se uma ferramenta aliada no desmame ventilatório e no reestabelecimento da função pulmonar (Burns, et al, 2018).…”

Prospective Observational Study of Predictors of Re-Intubation Following Extubation in the Surgical ICU

“…Nowadays, NIV is increasingly used to facilitate early extubation as well as to prevent and manage failed extubation. 51,52 In our study, the rate of NIV used after extubation was 12%, and of these, 29% required re-intubation. Our study demonstrated that subjects who required reintubation following a failed NIV attempt had a higher rate of morbidity and mortality than those who did not require re-intubation.…”

Prolonged Invasive Mechanical Ventilation in a Tertiary Respiratory ICU: Outcomes, Challenges, and Future Directions

“…Across the cohort, the principal weaning modalities employed were structured SBT protocols using PSV and T-piece trials, progressive transition to BiPAP via a leak valve through the tracheostomy, and early physiotherapy-driven ambulation. In patients with COPD and chronic type II respiratory failure, such as index case 2, early NIV bridging through the tracheostomy was associated with progressive ventilator independence by resting the respiratory muscles while allowing stepwise weaning of invasive support [ 16 , 17 ].…”

“…A key feature that distinguished our approach was the early transition to BiPAP support via the tracheostomy using a leak valve, which allowed progressive nocturnal ventilatory rest with daytime weaning trials. This technique is particularly valuable in patients with chronic hypercapnic respiratory failure, including COPD, BCOS, and OSA overlap, where respiratory muscle fatigue must be carefully managed and home BiPAP is ultimately the planned long-term support strategy [ 16 , 17 , 34 ].…”

Evidências do uso de ventilação não invasiva com pressão positiva pós-extubação: uma revisão de literatura

“…A revisão de Cochrane faz algumas considerações sobre o sucesso no desmame ser considerado quando há ausência de reintubação dentro de três dias, ou se reintubação ou ventilação não invasiva não foi necessária dentro de 72 horas após a suspensão da ventilação mecânica. Sendo assim, a utilização de VNI após a extubação torna-se uma ferramenta aliada no desmame ventilatório e no reestabelecimento da função pulmonar (Burns, et al, 2018).…”