The patient needing prolonged mechanical ventilation: a narrative review

Ambrosino, Nicolino; Vitacca, Michele

doi:10.1186/s40248-018-0118-7

Cited by 68 publications

(50 citation statements)

References 104 publications

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“…With the increasing life expectancy worldwide, it causes a high rate of chronic diseases. Up to 20 million people worldwide are admitted to ICUs and require MV [5]. Only 30.000 patients undergo mechanical ventilation in the United Kingdom and 500.000 in the United States annually.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in mechanically ventilated patients

Calik¹

2020

Ann Clin Anal Med

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Aim: In this study, we aimed to investigate the prognostic values of respiratory parameters recorded within the first 48 hours in patients connected to mechanical ventilation in the intensive care unit (ICU), in terms of 30-day mortality. Material and Method: This prospective study included patients who received mechanical ventilation due to acute respiratory failure between 2011 and 2013. The demographic characteristics of the patients, Glasgow Coma Score (GCS) scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) values, vital signs, the results of complete blood count, biochemistry parameters and blood gas analyses were recorded. Patients were divided into two groups as survivors and non-survivors, and the differences in the parameters between the groups were analysed. Results: The study included 99 mechanically ventilated patients with the mean age 71.73 (18-105) years. Of the patients, 56 (56.6%) were male and 43 (43.4%) were female. Comparison of the survivors (n=37) with the non-survivors (n=62) indicated that the non-survivors had no statistical differences in terms of age, gender, or concomitant diseases. The values of GCS, APACHE II, and SOFA were significantly different between survivors and non-survivors (for all, p<0.001). Significant differences were also noted in FiO2 (p<0.001), pH (p=0.001), PO2 (p=0.044), PCO2 (p=0.046), A-a Gradient (p<0.001) and the expected increase of O2 gradient (p=0.026) between two groups. Discussion: Our findings indicate that, during the follow-up of the mechanically ventilated patients, respiratory parameters measured within the first 48 hours are cheap and easy-to-use parameters to predict the prognosis.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors in mechanically ventilated patients

Calik¹

2020

Ann Clin Anal Med

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“…With the increasing life expectancy worldwide, it causes a high rate of chronic diseases. Up to 20 million people worldwide are admitted to ICUs and require MV [7]. Only 30.000 patients undergo mechanical ventilation in the United Kingdom and 500.000 in the United States annually.…”

Section: Discussionmentioning

confidence: 99%

“…[8,9]. In the USA, the total cost of ICU beds is four-fold compared to the cost of total hospital beds [7]. The incidence may even differ between countries and even between regions in the same country.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of natriuretic peptides in intensive care units

Calik¹

2019

Eu Clin Anal Med

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Aim: In this study, we aimed to investigate the relationship between the values of atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) measured in the first 24 hours and the disease severity and prognostic value of the patients who underwent mechanical ventilation in the intensive care unit.Material and Method: Ninety-nine non-pregnant patients aged 18 years and older who underwent mechanical ventilation in the intensive care unit between 2011 and 2013 due to acute respiratory failure were included in this prospective study. Results: The study included 99 mechanically ventilated patients whose mean ages were 71.73 (18-105) years. Of the patients, 56 (56.6%) were male and 43 (43.4%) were female. Assessment of patients was carried out with the worst data recorded in the first 24 hours. There was no statistically significant difference between the groups in age, gender, and additional diseases (p=0.311, p=0.456, and p=0.820 respectively). When the survivors (n=75) and the non-survivors (n=24) were compared, the values of GCS, APACHE II and SOFA were significantly different (p=0.031, p<0.001, and p<0.001 respectively). The median ANP values were 303 (46-51536) -230 (173-7370) (p = 0.148), and the median CNP values were 88 (0-4795) -86 (4-203) (p = 0.419), respectively in survivors and non-survivors. Discussion: In our study, although a slight decrease was determined between the values of ANP and CNP measured, it wasn't statistically significant. ANP and CNP can potentially determine the risk of death. It is still open to debate. Further researches are required for ANP and CNP in a longer time and in larger patient populations.

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“…Long-term home mechanical ventilation is increasingly used by patients with chronic ventilatory failure (CVF) due to advanced diseases such as chronic obstructive pulmonary disease (COPD), restrictive thoracic disease and neuromuscular diseases [2]. The last reported (and underestimated) prevalence of European patients requiring long-term assisted ventilation is 6.6 per 100,000 population [3].…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Ventilation as an Adjunct to Exercise Training in Chronic Ventilatory Failure: A Narrative Review

Vitacca

Ambrosino

2018

Respiration

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Background: Chronic ventilatory failure (CVF) may be associated with reduced exercise capacity. Long-term non-invasive ventilation (NIV) may reduce patients’ symptoms, improve health-related quality of life and reduce mortality and hospitalisations. There is an increasing use of NIV during exercise training with the purpose to train patients at intensity levels higher than allowed by their pathophysiological conditions. Objective: This narrative review describes the possibility to train patients with CVF and NIV use as a tool to increase the benefits of exercise training. Methods: We searched papers published between 1985 and 2018 in (or with the summary in) English language in PubMed and Scopus databases using the keywords “chronic respiratory failure AND exercise,” “non invasive ventilation AND exercise,” “pulmonary rehabilitation” and “exercise training.” Results: Exercise training is feasible and effective also in patients with CVF. Assisted ventilation can improve exercise tolerance in different clinical conditions. In patients under long-term home ventilatory support, NIV administered also during walking results in improved oxygenation, decreased dyspnoea and increased walking distance. Continuous positive airway pressure and different modalities of assisted ventilation have been delivered through different interfaces during exercise training programmes. Patients with CVF on long-term NIV may benefit from exercising with the same ventilators, interfaces and settings as used at home. Conclusion: We need more randomised clinical trials to investigate the effects of NIV on exercise training in patients with CVF and define organisation and setting.

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The patient needing prolonged mechanical ventilation: a narrative review

Cited by 68 publications

References 104 publications

Prognostic factors in mechanically ventilated patients

Prognostic factors in mechanically ventilated patients

Prognostic value of natriuretic peptides in intensive care units

Non-Invasive Ventilation as an Adjunct to Exercise Training in Chronic Ventilatory Failure: A Narrative Review

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