scholarly journals Non‐invasive ventilation for obese patients with chronic respiratory failure: Are two pressures always better than one?

Respirology ◽  
2019 ◽  
Vol 24 (10) ◽  
pp. 952-961 ◽  
Author(s):  
Patrick B. Murphy ◽  
Eui‐Sik Suh ◽  
Nicholas Hart
Keyword(s):  
Respiratory Failure ◽  
Chronic Respiratory Failure ◽  
Obese Patients ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Better Than

scholarly journals Effectiveness of non-invasive ventilation in acute respiratory failure of obese patients: a brief narrative review

2018 ◽  
Vol 12 (1) ◽  
pp. 5
Author(s):  
Maurizio Alessandro Cavalleri ◽  
Elena Barbagelata ◽  
Marco Scudeletti ◽  
Antonello Nicolini
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Obese Patients ◽  
Invasive Ventilation ◽  
Acute Setting ◽  
Non Invasive ◽  
High Severity ◽  
Non Invasive Ventilation ◽  
Hypoventilation Syndrome ◽  
High Severity Score

Non-invasive ventilation (NIV) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades compared to prior decades; nevertheless, NIV can have failure rates ranging from 5% to 50%. However, there are particular groups of patients that are more likely to benefit from NIV. One of these groups is patients with hypoventilation syndrome (OHS). The aim of this review is to seek evaluation of the effectiveness of NIV in acute setting. Only a few studies have investigated NIV success or failure in OHS patients. More than 30% of them were diagnosed when hospitalized for ARF. NIV rarely failed in reversing ARF. OHS patients who exhibited early NIV failure had a high severity score and a low HCO3 level at admission; more than half of hypercapnic patients with decompensated OHS exhibited a delayed but successful response to NIV. Patients with decompensation of OHS have a better prognosis and response to NIV than other hypercapnic patients. They require more aggressive NIV settings, a longer time to reduce PaCO2 levels, and more frequently a delayed but successful response to NIV.

scholarly journals Use of Nasal Non-Invasive Ventilation with a RAM Cannula in the Outpatient Home Setting

2017 ◽  
Vol 11 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Wilfredo De Jesus Rojas ◽  
Cheryl L. Samuels ◽  
Traci R. Gonzales ◽  
Katrina E. McBeth ◽  
Aravind Yadav ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Lung Disease ◽  
Chest Wall ◽  
Chronic Respiratory Failure ◽  
Respiratory Support ◽  
Positive Pressure ◽  
Successful Implementation ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Background: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings. Objective: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure. Methods: We performed a retrospective case series of 18 children (4 months to 19 years old) using the Nasal NIV/RAM Cannula in the Pediatric Pulmonary Clinic at the McGovern Medical School, UTHealth (2014-16). Consideration for Nasal NIV/RAM Cannula utilization included: inability to wean-off in-patient respiratory support, comfort for dyspnea, intolerability of conventional mask interfaces and tracheostomy avoidance. Results: Average age was 7 years. 50% were Caucasian, 38% African-American and 11% Hispanics. Pulmonary disorders included: chest wall weakness (38%), central control abnormalities (33%), obstructive lung disease (16%) and restrictive lung disease (11%). Indications for Nasal NIV/RAM Cannula initiation included: CPAP/BPAP masks intolerability (11%), dyspnea secondary to chest wall weakness (38%) and tracheostomy avoidance (50%). Average length of use of Nasal NIV/RAM Cannula was 8.4 months. Successful implementation of Nasal NIV/Ram Cannula was 94%. One patient required a tracheostomy following the use of Nasal NIV/RAM Cannula. Significant decrease in arterial PaCO2 pre and post Nasal NIV/RAM cannula initiation was notable (p=0.001). Conclusion: Outpatient use of Nasal NIV/RAM Cannula may prove to be a feasible and save treatment alternative for children with chronic respiratory failure, chest wall weakness, dyspnea and traditional nasal/face mask intolerance to avoid tracheostomy.

scholarly journals German National Guideline for Treating Chronic Respiratory Failure with Invasive and Non-Invasive Ventilation – Revised Edition 2017: Part 2

Respiration ◽  
2018 ◽  
Vol 96 (2) ◽  
pp. 171-203 ◽  
Author(s):  
Wolfram Windisch ◽  
Jens Geiseler ◽  
Karsten Simon ◽  
Stephan Walterspacher ◽  
Michael Dreher ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Chronic Respiratory Failure ◽  
National Guideline ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Is there enough room for non-invasive ventilation in pulmonary rehabilitation?

2020 ◽  
Vol 1 (2) ◽  
pp. 01-06
Author(s):  
Laura Ciobanu
Keyword(s):  
Respiratory Failure ◽  
Exercise Training ◽  
Pulmonary Rehabilitation ◽  
Chronic Respiratory Failure ◽  
Pharmacological Intervention ◽  
Main Body ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Pulmonary rehabilitation (PR) is a non-pharmacological intervention addressed to chronic obstructive pulmonary disease (COPD) and non-COPD chronic respiratory patients, a key management strategy scientifically demonstrated to improve exercise capacity, dyspnoea, health status and psychological wellbeing. The main body of literature comes from COPD patients, as they provide the core evidence for PR programmes. PR is recommended even to severe patients having chronic respiratory failure; their significant psychological impairment and potential for greater instability during the PR programme will be carefully considered by the multidisciplinary team. Optimizing medical management (e g, inhaled bronchodilators, oxygen therapy, non- invasive ventilation) may enhance the results of exercise training. Patients who already receive long-term domiciliary non- invasive ventilation (NIV) for chronic respiratory failure might exercise with NIV during exercise training if acceptable and tolerable to the patient. It is not advisable to offer long-term domiciliary NIV with the only aim to improve outcomes during PR course. There are different attempts to use both negative and positive NIV in limited clinical studies. Long-term adherence to exercise is an important goal of PR programmes and teams, targeting to translate all-domain gains of PR into increased physical activity and participation to real life. Being a reliable alternative for the future, studies should focus on pressure regimens, type of devices, acceptability and portability for everyday activities.

Sign in / Sign up

Export Citation Format

Share Document