Noninvasive Ventilation for Post-Pneumonectomy Severe Hypoxemia

Abstract

ARDS remains a lethal complication after major lung resections. The reported mortality ranges from 50% to 100%, with increased incidence and mortality rates in pneumonectomy patients. The pathogenesis of early ARDS is still not fully understood, and the majority of patients will require mechanical ventilation. A review of the literature reveals that the role of noninvasive ventilation (NIV) in ARDS after lung resection is unclear, in contrast to its well established benefits in other types of respiratory failure. NIV is a technique of augmenting alveolar ventilation delivered by face mask, without introducing an endotracheal tube. NIV may reduce the need for endotracheal mechanical ventilation and improve clinical outcome in patients with acute respiratory failure after lung resection, avoiding complications related to intubation. We present a case of early ARDS following left-sided pneumonectomy, where bi-level positive airway pressure ventilation prompted a successful outcome.

High-Flow Nasal Cannula Therapy in a Patient with Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty

“…In cases with worsening hypoxemia, noninvasive ventilation has been a first-line intervention to avoid endotracheal intubation [7]. Noninvasive ventilation is a technique to augment alveolar ventilation delivered by face mask, without endotracheal intubation.…”

The effectiveness of long-term respiratory support in a patient after pneumonectomy

“…В исследовании C.P. Koutsogiannidis et al представлен случай раннего ОРДС после левосторонней пульмонэктомии по поводу рака легкого, где двухуровневая вентиляция с положительным давлением в дыхательных путях привела к успешному результату [13]. В исследовании С. Lorut et al профилактическая послеоперационная НВЛ не снижала частоту развития острой ДН у пациентов с ХОБЛ, перенесших операцию по резекции легкого, и не влияла на частоту других послеоперационных осложнений, уровень смертности, длительность госпитализации [14].…”

Tailoring Noninvasive Ventilation Management in Non-ICU Settings and the Cardiac Surgery Context

“…1 The use of NIV has also increased in other acute respiratory failure etiologies, such as acute lung injury and ARDS, severe communityacquired pneumonia, chest trauma, and in immunocompromised patients. 3 During the past decade, therapeutic applications of NIV have been reported in postoperative respiratory failure 4,5 and in acute respiratory distress after extubation, as a first-line intervention, though with controversial effectiveness. 6 Indisputably, the effectiveness of NIV commencement depends on the establishment of a successful institutional NIV program.…”