Noninvasive positive-pressure ventilation in acute respiratory failure

Peñuelas, Óscar; Frutos‐Vivar, Fernando; Esteban, Andrés

doi:10.1503/cmaj.060147

Cited by 46 publications

(35 citation statements)

References 47 publications

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Section: Resultsmentioning

confidence: 99%

“…Either a nasal or facial mask is used, which serves as an interface between the patient and the ventilator [45,46]. Such methods of ventilation serve to reduce respiratory function and improve respiratory gas exchange [45,46]. Positive effects were observed with the use of NIV, including improvements in BIPP [25,27], BIPP associated with PEP [30], CPAP [24][25][26] and BiPAP [24,26] in the first days after HS, when the breathing is characterized by low tidal volume, offset by increased respiratory rate [24].…”

Section: Resultsmentioning

confidence: 99%

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Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Renault¹,

Costa-Val²,

Rossetti

2008

Rev Bras Cir Cardiovasc

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The aim of this study is to make a literature review about the different techniques of respiratory physiotherapy used after cardiac surgery and their effectiveness in reverting pulmonary dysfunction. It has been used as reference publications in English and Portuguese using as keywords thoracic surgery, respiratory exercises, physiotherapy modalities, postoperative complications and coronary artery bypass grafting, contained in the following databases -BIREME, SciELO Brazil, LILACS, PUBMED, from 1997 to 2007. A secondary study through list of references of identified articles also was performed. It has been selected eleven randomized trials (997 patients). Among the articles included in this study, incentive spirometry was used in three; deep breathing exercises in six; deep breathing exercises associated with positive expiratory pressure in four and positive expiratory pressure associated with inspiratory resistance in two. Three studies used intermittent positive pressure breathing. Continuous positive airway pressure and bi-level positive airway pressure has been used in three and two studies respectively. The protocols used in the studies were varied and the co-interventions were present in most of them. The different analyzed variables and the time of postoperatory follow-up make a comparative analysis difficult. Pulmonary dysfunction is evident in the postoperatory period of cardiac surgery. The use of non-invasive ventilation has been associated with good results in the first postoperatory days. Despite the known importance of postoperatory respiratory physiotherapy, until now, there is no consensus in the literature about the superiority of one technique over the others. 563RENAULT, JA ET AL -Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery Bras Cir Cardiovasc 2008; 23(4): 562-569 Rev METHODS Search StrategyUsing a primary and secondary search strategy, we performed a literature review of the different techniques of respiratory physiotherapy used in the PO of heart surgery and their effectiveness in the reversion of pulmonary dysfunction, using as publications in English and Portuguese as references. The descriptors used were thoracic surgery, respiratory exercises, physiotherapy modalities, postoperative complications and CABG, and were searched for in the following data sources: BIREME, SciELO Brazil, LILACS and PUBMED from 1997 until 2007. We avoided an excess of similar studies. A secondary search through the considered articles' list of references was also performed. Criteria for the selection of studiesRandomized clinical studies were selected for analysis if they had more than 20 patients and adults who had undergone HS, and if they compared different techniques of respiratory physiotherapy, or if they compared these techniques to procedures without respiratory physiotherapy in the PO. We also selected articles about HS and its pulmonary repercussions in order to introduce the subject and provide a stronger theoretical base. Variables analyzedThe analyzed v...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Renault¹,

Costa-Val²,

Rossetti

2008

Rev Bras Cir Cardiovasc

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“…45 The role of NIV in the respiratory management of acute SCI at the level of C4 and below warrants further investigation. These roles of NIV in the treatment of respiratory failure and weaning would appear plausible given the indications for NIV in other adult ICU populations.…”

Section: Discussionmentioning

confidence: 99%

“…These roles of NIV in the treatment of respiratory failure and weaning would appear plausible given the indications for NIV in other adult ICU populations. 45,46 However, the use of NIV as a substitute for conventional mechanical ventilation would be unlikely to receive widespread support in the ICU community and at best would be case dependent. Given the results of this review, future research using NIV should be examined in combination with other therapies such as an intensive respiratory care protocol and outcomes should include ICU and hospital length of stay and the use and duration of intubation, tracheostomy, and mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

The acute respiratory management of cervical spinal cord injury in the first 6 weeks after injury: a systematic review

et al. 2010

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Study design: Systematic review. Objectives: Identify, evaluate, and synthesize evidence regarding the effectiveness of various treatment strategies for the respiratory management of acute tetraplegia. Setting: Melbourne, Australia. Methods: A search of multiple electronic databases (Medline, Cinahl, EMBASE, Cochrane Library, Web of Science, http://www.guideline.gov and http://www.icord.org/scire) was undertaken accompanied by the reference lists of all relevant articles identified. Methodological quality was assessed using the Newcastle-Ottawa Scale and the PEDro Scale. Descriptive analysis was performed. Results: Twenty-one studies including 1263 patients were identified. The majority of the studies were case series (n ¼ 13). A variety of interventions were used for the management of respiratory complications. Mortality (ARR ¼ 0.4, 95% confidence interval (CI) 0.18, 0.61), the incidence of respiratory complications (ARR ¼ 0.36, 95% CI (0.08, 0.58)), and requirement for a tracheostomy (ARR ¼ 0.18, 95% CI (À0.05, 0.4)) were significantly reduced by using a respiratory protocol. A clinical pathway reduced duration of mechanical ventilation by 6 days 95% CI (À0.56, 12.56), intensive care unit length of stay by 6.8 days 95% CI (0.17-13.77) and costs. Intubation, mechanical ventilation, and tracheostomy are the mainstay of respiratory management for complete injuries above the level of C5. Conclusion: This review showed a clinical pathway with a structured respiratory protocol that includes a combination of treatment techniques provided regularly is effective in reducing respiratory complications and cost. The overall study quality was moderate and further studies using specific interventions that target respiratory complications are associated with specific regions of the cervical spine using more methodologically rigorous designs are required.

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“…(6) NPBV, KOAH akut atağında maksimum medikal tedaviye yanıtsız ve ventilatör desteği gereken hastalarda uygulanmalı-dır. NPBV uygulanan bu grupta en çok başarı pH 7,25'in üzerinde olan hastalarda gözlenmiştir.…”

Section: Discussionunclassified

Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Mehtap¹,

Öztürk²,

Pehlivanoğlu³

et al. 2011

J Turk Anaesth Int Care

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ÖZETKOAH (Kronik Obstrüktif Akciğer Hastalığı) olan hastalarda akut atağa bağlı solunum yetmezliğinde standart tedaviye ilave noninvaziv pozitif basınçlı ventilasyon (NPBV) uygulaması; endotrakeal entübasyon ve mekanik ventilasyon gereksinimini ve ilişkili komplikasyonları azaltır. Helmet, şeffaf, yüze bası uygulamadığı için toleransı daha iyi olan ve NPBV uygulamasında kullanılan ventilatör-hasta bağlantı cihazıdır. Bu olgu sunumunda; KOAH akut atağına bağlı akut solunum yetmezliği tanısı ile yoğun bakım ünitesine alarak helmetle NPBV uyguladığımız üç olgu sunulmuştur. Olguların helmetle takipleri sırasında, oksijenizasyon ve kliniklerinde hızlı iyileşme gözlenirken, PCO 2 düzeylerinde daha yavaş seyreden düzelme gözlenmiştir. Bu olgular aracılığıyla, KOAH akut atağında NPBV uygulamasında; helmetle kan gazlarında düzelme sağlanarak başarılı sonuçlar alınabileceği gösterilmiş ve ideal ventilatör-hasta bağlantı seçimi irdelenmiştir.Anahtar kelimeler: Akut solunum yetmezliği, kronik obstrüktif akciğer hastalığı, noninvaziv pozitif basınçlı ventilasyon, helmet SUMMARY Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary DiseaseNoninvasive positive pressure ventilation (NPPV) in addition to the standard treatment in the respiratory failure due to acute exacerbation in the patients with chronic obstructive pulmonary disease (COPD) decreases the need for endotracheal intubation, mechanical ventilation and their related complications. Helmet is a transparent interface device which has better tolerance in that it does not exert pressure on the face and ensures the connection between the patient and the ventilator device in the NPPV application. Herein, we presented three cases whom we applied NPPV with helmet in the intensive care unit for acute respiratory failure because of acute exacerbation of COPD. During the follow-up of cases with Helmet, while the rapid improvement was observed in their oxygenation and clinical status, levels of PCO 2 improved relatively slowly. These cases have demonstrated that the successful results would be able to be obtained by normalizing blood gases via NPPV application with helmet in the acute exacerbation of COPD. Besides, the optimal interface selection is discussed in this study.

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Noninvasive positive-pressure ventilation in acute respiratory failure

Cited by 46 publications

References 47 publications

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

The acute respiratory management of cervical spinal cord injury in the first 6 weeks after injury: a systematic review

Noninvasive Positive Pressure Ventilation by The Helmet in Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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