scholarly journals Observational case-control study of non-invasive ventilation in patients with ARDS

2016 ◽  
Vol 69 (1) ◽  
Author(s):  
G. Domenighetti ◽  
A. Moccia ◽  
R. Gayer
Keyword(s):  
Mortality Rate ◽  
Control Group ◽  
Invasive Ventilation ◽  
Suitable Alternative ◽  
Real Effects ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Organ Failures ◽  
Distant Organ ◽  
Control Study

Background. The application of non-invasive pressure support ventilation (NIPSV) in patients with acute lung injury or ARDS remains controversial despite recent promising results. Data in rather homogeneous ARDS groups is lacking. Objective. To compare the outcome of NIPSV-treated patients satisfying the diagnostic criteria for primary (pulmonary) ARDS (ARDSp) and presenting without distant organ failures at admission, with those of a matched control group treated in the same ICU with endotracheal mechanical ventilation (ETMV). Methods. We applied NIPSV in 12 immunocompetent and collaborative patients who met the above cited criteria. NIPSV failure rate, short-term oxygenation, length of stay, mortality rate and complications were analyzed and compared with a control group of 12 intubated ARDSp-patients matched for age, SAPS II, PaO2/FiO2 and pH at admission. Results. NIPSV failed in 4 patients developing distant organ failures. Compared to the ETMV control group, NIPSV success patients had reduced cumulative time on ventilation (p = 0.001) and length of ICU stay (p = 0.004). After the first 60’ of ventilation, oxygenation improved more in the NIPSV than in the ETMV group (146 ± 52 mmHg vs 109 ± 34 mmHg; p = 0.05). The overall ICU mortality rate did not differ significantly between the groups but tended to be higher in the NIPSV group. Conclusions. In ARDSp patients without distant organ failures at admission and during the disease course, NIPSV might be a suitable alternative to invasive ventilation; however, the real effects on outcome of NIPSV applied to stable homogeneous subgroups of ARDS patients merit further investigations in randomised studies.

Effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration in preterm infants using non-invasive ventilation

MedPharmRes ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 46-51
Author(s):  
Chau Vu Bao Nguyen ◽  
Tinh Thu Nguyen ◽  
Tam Thi Thanh Pham ◽  
Sen Thi Hong Lam ◽  
Le An Pham ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Nasal Cannula ◽  
The Other ◽  
Control Group ◽  
Invasive Ventilation ◽  
Nasal Bridge ◽  
Non Invasive ◽  
Hydrocolloid Dressing ◽  
Non Invasive Ventilation

Background: The use of non-invasive ventilation (NIV) in preterm infants is becoming increasingly common. The use of cannula in NIV can cause ulceration of the nasal bridge with the current practices using the thin foam patches. This study aims to evaluate the effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration comparing to that of the thin foam patches. Methods: A prospective cohort study using hydrocolloid dressing pads (1 November to 30 April 2020) was compared to that of a historical control group using thin foam dressing (1 April to 15 October 2019) to evaluate the effectiveness of hydrocolloid dressing pads. All participants were preterm infants (less than 37 weeks of gestational age) and used nasal cannula NIV at the Department of Neonatal Intensive Care (NICU), Children's Hospital 1. Results: 71 infants used hydrocolloid dressing pads, and 42 used ordinary thin foam nasal dressings. In the hydrocolloid dressings group, two infants (2.8%) had nasal ulcers; among them, one was mild, and the other was moderate. In comparison, ten infants (23.8%) using thin foam dressings developed ulcers, of which seven were mild, two were moderate, and one was severe. Using hydrocolloid nasal dressings significantly reduced nasal ulceration compared to thin foam dressings (OR = 0.09, 95%CI = 0.02 – 0.45). Conclusion: Using hydrocolloid nasal dressings for preterm infants on nasal cannula NIV significantly reduced nasal ulceration compared to ordinary thin foam dressings.

scholarly journals Predictive factors for prognosis after gastrostomy placement in routine non-invasive ventilation users ALS patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Adèle Hesters ◽  
Maria del Mar Amador ◽  
Rabab Debs ◽  
Nadine Le Forestier ◽  
Timothée Lenglet ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Proportional Hazards Model ◽  
Age At Onset ◽  
Cox Proportional Hazards Model ◽  
Tube Placement ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Ventilator Dependence ◽  
Als Patients

Abstract Due to the expanding use of non-invasive ventilation (NIV) in amyotrophic lateral sclerosis (ALS), the question of enteral nutrition is increasingly raised in NIV users ALS patients. Here, we aimed to determine the prognostic factors for survival after gastrostomy placement in routine NIV users, taking into consideration ventilator dependence. Ninety-two routine NIV users ALS patients, who underwent gastrostomy insertion for severe dysphagia and/or weight loss, were included. We used a Cox proportional hazards model to identify factors affecting survival and compared time from gastrostomy to death and 30-day mortality rate between dependent (daily use ≥ 16 h) and non-dependent NIV users. The hazard of death after gastrostomy was significantly affected by 3 factors: age at onset (HR 1.047, p = 0.006), body mass index < 20 kg/m2 at the time of gastrostomy placement (HR 2.012, p = 0.016) and recurrent accumulation of airway secretions (HR 2.614, p = 0.001). Mean time from gastrostomy to death was significantly shorter in the dependent than in the non-dependent NIV users group (133 vs. 250 days, p = 0.04). The 30-day mortality rate was significantly higher in dependent NIV users (21.4% vs. 2.8%, p = 0.03). Pre-operative ventilator dependence and airway secretion accumulation are associated with worse prognosis and should be key decision-making criteria when considering gastrostomy tube placement in NIV users ALS patients.

The Effect of Non-Invasive Mechanical Ventilation on Respiratory and Inflammatory Parameters in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Mohammad Hashemian ◽  
Atefeh Fakharian ◽  
Reyhaneh Zahiri ◽  
Esmaeil Mortaz ◽  
Mohammad Reza Masjedi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Invasive Mechanical Ventilation ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
The Third ◽  
Non Invasive Ventilation

Background: Chronic Obstructive Pulmonary Disease (COPD) is an airway obstructive disease that is often caused by smoking. The disease is currently the third leading cause of death worldwide. The current therapeutic approach is based on Non-Invasive Ventilation (NIV) therapy, which can reduce mortality, the need for hospitalization in the intensive care unit, and to some extent therapeutic complications. Therefore, this study was performed to determine the effect of non-invasive ventilation along with routine treatments on respiratory markers, inflammation, and clinical status of patients with COPD. Methods: A total of 30 patients with COPD referred to Masih Daneshvari Hospital were divided into control and intervention groups. In the intervention group, 15 patients underwent non-invasive ventilation in addition to the usual treatments, and in the control group, the patients underwent only the usual treatments. After completing the mMRC (Modified Medical Research Council) questionnaire and evaluating FEV1 (Forced Expiratory Value in one score), 5 ml of blood samples were taken from these patients at the beginning of the study, on the seventh to tenth day, and also in the third month, and the results of this evaluation were compared between the two groups. Results: Based on the results of this study, the mMRC score of the intervention group was significantly lower than the control group in the first week (p=0.043) and three months after treatment (p=0.049). However, indices such as FEV1, and IL-8(Interleukin-8) did not change significantly in both groups. Conclusion: The use of non-invasive mechanical ventilation along with standard treatments can play a relative role in improving patient outcomes.

scholarly journals Extracorporeal CO2 Removal in Acute Exacerbation of COPD Not Responding to Non-Invasive Ventilation: a Single Center Experience

2021 ◽  
Author(s):  
Mathilde Azzi ◽  
Jerome Aboab ◽  
Sophie Alviset ◽  
Daria Ushmorova ◽  
Luis Ferreira ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Control Group ◽  
Complication Rates ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Copd Patients ◽  
Non Invasive Ventilation ◽  
The Mean ◽  
And Control ◽  
Mean Time

Abstract Background: Acute exacerbation of chronic obstructive pulmonary disease (ae-COPD) has a gold standard treatment: non-invasive ventilation (NIV). However, this treatment sometime fails, and an invasive mechanical ventilation (IMV) is required. The extracorporeal CO₂ removal (ECCO₂R) device can be an alternative to intubation. The aim of the study is to evaluate ECCO₂R efficiency and safety and enlighten ECCO₂R benefit/risk compared to IMV.Methods: Consecutive ae-COPD patients for whom NIV failed were retrospectively analyzed during two periods: before and after the ECCO₂R device implementation in our ICU in 2015. We considered the before period as standard of care and patients were treated with IMV. The ECCO₂R device was a pump-driven veno-venous system (Xenios AG).Results: The two groups (ECCO₂R n = 26 and Control group n = 25) were comparable at baseline except for the BMI which was significantly higher in the ECCO₂R group (30kg/m² versus 25kg/m²). The pH and PaCO₂ improved significantly in both groups. The mean time on ECCO₂R was 5,4 days whereas IMV lasted 27 days in the control group. Four patients needed IMV in the ECCO₂R group (of which 3 occurred after ECCO₂R weaning). There were 7 major bleeding events with ECCO₂R and 3 led to premature termination of ECCO₂R. In the control group, there were 8 ventilator associated pneumonia, 25 haemodynamic instability and 6 self extubations. The mean time in ICU and hospital stay in the ECCO₂R and control groups were 18 vs 30 days, 29 vs 49 days, respectively and the 90-day mortality rates were 15% vs 28%.Conclusions: ECCO₂R brings significant improvement on pH and PaCO₂ in ae-COPD patients failing NIV therapy and permit to avoid intubation in 85% with low complication rates compared to IMV. These results have yet to be proven in a larger randomized study.Trial registration: ClinicalTrials.gov, NCT04882410. Date of registration May 12th 2021, Retrospectively registered.https://www.clinicaltrials.gov/ct2/show/NCT04882410

scholarly journals Effect of Pulmonary Rehabilitation on Patients’Outcome After Extubation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ying Zhao ◽  
Qingyun Yang ◽  
Ruochen Wen ◽  
Xingshuo Hu ◽  
Hongjun Gu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
High Flow ◽  
Control Group ◽  
Invasive Ventilation ◽  
Diaphragm Thickness ◽  
Non Invasive ◽  
Randomized Controlled ◽  
Non Invasive Ventilation

Abstract Background: To evaluate whether pulmonary rehabilitation can improve respiratory function and life quality of the patients who were removed from invasive mechanical ventilation in the ICU and sequentially treated with high-flow humidification therapy instrument. Methods: This study is a single-center clinical randomized controlled trial. Selected from April 2019 to April 2020, 53 patients who were sequentially treated with High-Flow Humidification Device after extubation in the ICU were randomly divided into two groups. The experimental group received pulmonary rehabilitation treatment, while the control group received only conventional treatment. All patients were then evaluated for rehabilitation and bedside diaphragm ultrasound measurement.Results: Compared with the control group, experimental group’s incidences of non-invasive ventilation use, re-intubation and complication were significantly reduced (P <0.05), yet there was no significant reduction of two groups’ mortality rate (P = 0.3). The experimental group's MRCsum (Medical Research Council sum) muscle strength score, 30-second sit-up test parameter, and modified Barthel index all presented significant difference (P <0.05). The degree of diaphragm movement, end-inspiratory diaphragm thickness and diaphragm thickness variation rate were significantly increased (P <0.05). Conclusions: Pulmonary rehabilitation is safe with certain efficacy. It is of great significance to the enhancement of patient's peripheral muscle strength and endurance, respiratory function, and daily life activities. It can reduce the incidences of non-invasive ventilation use and re-intubation and help patients return to their families and society better. Nevertheless, the current development of pulmonary rehabilitation is not perfect. Subsequent research of a multi-center randomized controlled trial should be conducted to further explore the efficacy of pulmonary rehabilitation, promote the spread of pulmonary rehabilitation technics, and provide home-based rehabilitation guidance and long-term follow-up for discharged ICU patients.Trial registration: Clinical trial registration number: NCT04368286; Ethics number: S2018-212-01.Subject: ①Number: 2018FC-WJFWZX-2-04. ②Chinese PLA Health Care Grant: 17BJZ35.

scholarly journals Efficacy of Prolonged-Release Melatonin 2 mg (PRM 2 mg) Prescribed for Insomnia in Hospitalized Patients for COVID-19: A Retrospective Observational Study

2021 ◽  
Vol 10 (24) ◽  
pp. 5857
Author(s):  
Carolina Bologna ◽  
Pasquale Madonna ◽  
Eduardo Pone
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Control Group ◽  
Prolonged Release ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Duration Of Therapy ◽  
Non Invasive Ventilation ◽  
Duration Of Hospitalization ◽  
Insomnia Treatment

Background: we have observed the effect of insomnia treatment in clinical and prognostic differences of patients admitted for COVID-19 pneumonia in respiratory sub-intensive units that were administered a prolonged-release melatonin 2 mg (PRM 2 mg) therapy versus a group of patients out of therapy. Materials and Methods: We evaluated 40 patients on prolonged-release melatonin 2 mg (PRM 2 mg) therapy versus a control group of 40 patients out of therapy. Results: patients in the PRM 2 mg group had a shorter duration of therapy with non-invasive ventilation (5.2 ± 3.0 vs. 12.5 ± 4.2; p < 0.001), with a shorter stay in sub-intensive care (12.3 ± 3.2 vs. 20.1 ± 6.1; p < 0.001), and, therefore, a shorter overall duration of hospitalization (31.3 ± 6.8 vs. 34.3 ± 6.9 p = 0.03). In addition, a lower incidence of delirium was found (2.2 ± 1.1 vs. 3.3 ± 1.3; p < 0.001). Conclusions: A significant increase in sleep hours and a reduction in delirium episodes occurs in hospitalized insomniac patients treated with PRM 2 mg, compared to untreated patients. Based on these preliminary results, we can assume that there are benefits of prolonged-release melatonin 2 mg in COVID-19 therapy.

scholarly journals Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0256027
Author(s):  
Kate Curtis ◽  
Sarah Kourouche ◽  
Stephen Asha ◽  
Julie Considine ◽  
Margaret Fry ◽  
...  
Keyword(s):  
Health Service ◽  
Behaviour Change ◽  
Chest Injury ◽  
Trial Registration ◽  
Care Bundle ◽  
Control Group ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Post Period

Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury—respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel. Methods This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality. Results There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18–0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04–0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61–9.45), physiotherapy OR 2.17 (95% CI 1.52–3.11), ICU doctor OR 6.13 (95% CI 3.94–9.55), ICU liaison OR 55.75 (95% CI 17.48–177.75), pain team OR 8.15 (95% CI 5.52 –-12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64–3.94) and regional analgesia OR 8.8 (95% CI 3.39–22.79), incentive spirometry OR 8.3 (95% CI 4.49–15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43–39.2) in the intervention group compared to the control group in the post- period. Conclusion The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement. Trial registration ANZCTR: ACTRN12618001548224, approved 17/09/2018

scholarly journals Application Effect and Nursing of Non-Invasive Ventilation in Acute Exacerbation of Chronic Obstruction Pulmonary Disease Patients

2015 ◽  
Vol 4 (4) ◽  
pp. 8
Author(s):  
Zongying Li
Keyword(s):  
Acute Exacerbation ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Control Group ◽  
Blood Gas ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Significant Difference ◽  
Experimental Group

<p><strong>Objective:</strong> To study the application methods, summarize the nursing experience and discuss the clinical effect of non-invasive ventilation in acute exacerbation of chronic obstructive pulmonary disease (COPD). <strong>Methods:</strong> 152 cases of AECOPD patients, who received treatment in our hospital from January 2011 to December 2013, were selected and divided into the experimental group and control group randomly. Patients in control group received conventional treatment, whereas besides conventional treatment, experimental group received non-invasive positive pressure ventilation and relevant nursing management. The changes in arterial blood gas and clinical indicators before and after treatment for both groups were observed. <strong>Results:</strong> After 7 days treatment, all the results of blood gas analysis were significantly improved (<em>p</em> &lt; 0.05). For the respiratory status (based on Borg scale), two groups were significantly improved after treatment, however, experimental group shown better than control group (<em>p</em> &lt; 0.05). The two groups had statistically significant difference (<em>p</em> &lt; 0.05) in the aspects of prognosis, endotracheal intubation and hospitalization time. As for the death index, there was no significant difference between two groups. No special treatment was needed for adverse reactions, they would be relieved slowly. <strong>Conclusion:</strong> Non-invasive positive pressure ventilation able to improve the recovery rate and quality of life of patients with acute exacerbation of COPD.</p>

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