scholarly journals Quadriceps Endurance Increases Following Cycling Exercise With Non-Invasive Ventilation In Moderate-To-Severe COPD Patients. A Non-Randomized Controlled Study

2019 ◽  
Vol Volume 14 ◽  
pp. 2461-2468
Author(s):  
Pierre Labeix ◽  
Mathieu Berger ◽  
Isabelle Court Fortune ◽  
Leonard Feasson ◽  
Samuel Verges ◽  
...  
Keyword(s):  
Randomized Controlled Study ◽  
Controlled Study ◽  
Invasive Ventilation ◽  
Cycling Exercise ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Copd Patients ◽  
Non Invasive Ventilation ◽  
Severe Copd

scholarly journals Respiratory support in COPD patients after acute exacerbation with monitoring the quality of support (Rescue2-monitor): an open-label, prospective randomized, controlled, superiority clinical trial comparing hospital- versus home-based acute non-invasive ventilation for patients with hypercapnic chronic obstructive pulmonary disease

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Keyword(s):  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Open Label ◽  
Obstructive Pulmonary Disease ◽  
Free Survival ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Copd Patients ◽  
Non Invasive Ventilation

AbstractChronic obstructive pulmonary disease (COPD) is expected to be the 3rd leading cause of death worldwide by 2020. Despite improvements in survival by using acute non-invasive ventilation (NIV) to treat patients with exacerbations of COPD complicated by acute hypercapnic respiratory failure (AHRF), these patients are at high risk of readmission and further life-threatening events, including death. Recent studies suggested that NIV at home can reduce readmissions, but in a small proportion of patients, and with a high level of expertise. Other studies, however, do not show any benefit of home NIV. This could be related to the fact that respiratory failure in patients with stable COPD and their response to mechanical ventilation are influenced by several pathophysiological factors which frequently coexist in the same patient to varying degrees. These pathophysiological factors might influence the success of home NIV in stable COPD, thus long-term NIV specifically adapted to a patient’s “phenotype” is likely to improve prognosis, reduce readmission to hospital, and prevent death. In view of this conundrum, Rescue2-monitor (R2M), an open-label, prospective randomized, controlled study performed in patients with hypercapnic COPD post-AHRF, will investigate the impact of the quality of nocturnal NIV on the readmission-free survival. The primary objective is to show that any of 3 home NIV strategies (“rescue,” “non-targeted,” and “targeted”) will improve readmission-free survival in comparison to no-home NIV. The “targeted” group of patients will receive a treatment with personalized (targeted) ventilation settings and extensive monitoring. Furthermore, the influence of comorbidities typical for COPD patients, such as cardiac insufficiency, OSA, or associated asthma, on ventilation outcomes will be taken into consideration and reasons for non-inclusion of patients will be recorded in order to evaluate the percentage of ventilated COPD patients that are screening failures. ClinicalTrials.gov NCT03890224. Registered on March 26, 2019.

Sequential Non-Invasive Following Short-Term Invasive Mechanical Ventilation in the Treatment of Tuberculosis with Respiratory Failure: A Randomized Controlled Study

2021 ◽  
Author(s):  
Nai-Min Kang ◽  
Nan Zhang ◽  
Bao-Jian Luo ◽  
En-Dong Wu ◽  
Jian-Quan Shi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Randomized Controlled Study ◽  
Arterial Oxygen ◽  
Controlled Study ◽  
Invasive Ventilation ◽  
Ventilation Time ◽  
Non Invasive ◽  
Randomized Controlled

Abstract Background: Invasive and non-invasive mechanical ventilation (MV) have been combined as sequential MV (SMV) in the treatment of respiratory failure. However, the effectiveness remains unclear. Here, we performed a randomized controlled study to assess the efficacy and safety of SMV in the treatment of tuberculosis with respiratory failure.Methods. Forty-four tuberculosis patients diagnosed with respiratory failure were randomly divided into SMV group (n=24) and conventional MV (CMV) group (n=20). Initially, the patients in both groups received invasive positive pressure ventilation (IPPV). When the patients' conditions were relieved, the ventilation modality in SMV group was switched to oronasal face continuous positive airway pressure (CPAP) until weaning. Results. After treatment, the patients in SMV group had similar respiratory rate, heart rate, oxygenation index, alveolo-arterial oxygen partial pressure difference (A-aDO2), blood pH, PaCO2 to those in CMV group (all P value>0.05). There was no significant difference in ventilation time and ICU stay between the two groups (P>0.05), but SMV group significantly reduced the time of invasive ventilation (mean difference (MD):-36.2 hrs,95% confidence interval (CI):-53.6,-18.8 hrs,P<0.001). SMV group also reduced the incidence of ventilator-associated pneumonia (VAP;relative risk (RR):0.44,95% CI:0.24,0.83,P=0.006) and atelectasis (RR:0.49,95% CI:0.24,1.00,P=0.040). Conclusions. SMV was effective in treating tuberculosis with respiratory failure. It showed advantages in reducing invasive ventilation time and ventilator-associated adverse events.

scholarly journals Non-invasive ventilation alternating with high-flow nasal oxygen versus high-flow nasal oxygen alone after extubation in COPD patients: a post hoc analysis of a randomized controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arnaud W. Thille ◽  
◽  
Rémi Coudroy ◽  
Mai-Anh Nay ◽  
Arnaud Gacouin ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
High Flow ◽  
Trial Registration ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Copd Patients ◽  
Non Invasive Ventilation ◽  
Post Hoc

Abstract Background Several randomized clinical trials have shown that non-invasive ventilation (NIV) applied immediately after extubation may prevent reintubation in patients at high-risk of extubation failure. However, most of studies included patients with chronic respiratory disorders as well as patients without underlying respiratory disease. To date, no study has shown decreased risk of reintubation with prophylactic NIV after extubation among patients with chronic obstructive pulmonary disease (COPD). We hypothesized that prophylactic NIV after extubation may decrease the risk of reintubation in COPD patients as compared with high-flow nasal oxygen. We performed a post hoc subgroup analysis of COPD patients included in a multicenter, randomized, controlled trial comparing prophylactic use of NIV alternating with high-flow nasal oxygen versus high-flow nasal oxygen alone immediately after extubation. Results Among the 651 patients included in the original study, 150 (23%) had underlying COPD including 86 patients treated with NIV alternating with high-flow nasal oxygen and 64 patients treated with high-flow nasal oxygen alone. The reintubation rate was 13% (11 out of 86 patients) with NIV and 27% (17 out of 64 patients) with high-flow nasal oxygen alone [difference, − 14% (95% CI − 27% to − 1%); p = 0.03]. Whereas reintubation rates were significantly lower with NIV than with high-flow nasal oxygen alone at 72 h and until ICU discharge, mortality in ICU did not differ between groups: 6% (5/86) with NIV vs. 9% (6/64) with high-flow nasal oxygen alone [difference − 4% (95% CI − 14% to 5%); p = 0.40]. Conclusions In COPD patients, prophylactic NIV alternating with high-flow nasal oxygen significantly decreased the risk of reintubation compared with high-flow nasal oxygen alone. Trial registration The study was registered at http://www.clinicaltrials.gov with the trial registration number NCT03121482 (20 April 2017)

scholarly journals Sequential non-invasive following short-term invasive mechanical ventilation in the treatment of tuberculosis with respiratory failure: a randomized controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nai-Min Kang ◽  
Nan Zhang ◽  
Bao-Jian Luo ◽  
En-Dong Wu ◽  
Jian-Quan Shi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Invasive Ventilation ◽  
Ventilation Time ◽  
Non Invasive ◽  
Randomized Controlled

Abstract Background Invasive and non-invasive mechanical ventilation (MV) have been combined as sequential MV in the treatment of respiratory failure. However, the effectiveness remains unclear. Here, we performed a randomized controlled study to assess the efficacy and safety of sequential MV in the treatment of tuberculosis with respiratory failure. Methods Forty-four tuberculosis patients diagnosed with respiratory failure were randomly divided into sequential MV group (n = 24) and conventional MV group (n = 20). Initially, the patients in both groups received invasive positive pressure ventilation. When the patients' conditions were relieved, the ventilation modality in sequential MV group was switched to oronasal face mask continuous positive airway pressure until weaning. Results After treatment, the patients in sequential MV group had similar respiratory rate, heart rate, oxygenation index, alveolo-arterial oxygen partial pressure difference (A-aDO2), blood pH, PaCO2 to those in conventional MV group (all P value > 0.05). There was no significant difference in ventilation time and ICU stay between the two groups (P > 0.05), but sequential MV group significantly reduced the time of invasive ventilation (mean difference (MD): − 36.2 h, 95% confidence interval (CI) − 53.6, − 18.8 h, P < 0.001). Sequential MV group also reduced the incidence of ventilator-associated pneumonia (VAP; relative risk (RR): 0.44, 95% CI 0.24, 0.83, P = 0.006) and atelectasis (RR:0.49, 95% CI 0.24,1.00, P = 0.040). Conclusions Sequential MV was effective in treating tuberculosis with respiratory failure. It showed advantages in reducing invasive ventilation time and ventilator-associated adverse events. Registration number for clinical trial Chinese Clinical Trial Registry ChiCTR2000032311, April 21st, 2020

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