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Non invasive ventilation guidelines

B Schönhofer
Invasive ventilation via endotracheal tube as access to the airways often is treatment of choice of acute respiratory failure. Multifactor-related increases the number of patients who are dependent on the ventilator for a longer period. The prolonged weaning (or "liberation") from mechanical ventilation therefore has an increasing importance.In Germany since the 90s of the last century, weaning units have been established in lung clinics. With the aim of achieving the highest possible quality of treatment in these weaning centers, the network "WeanNet" was founded in 2007 within the German Society of Pneumology and Respiratory Medicine (DGP)...
February 2019: Pneumologie
Aoife Gleeson, Faye Johnson
OBJECTIVES: An increasing number of patients with motor neuron disease (MND) in the UK and Ireland use assisted ventilation, and a small proportion of these use long-term tracheostomy ventilation (TV).1 2 NICE guidelines recommend that patients with MND should routinely receive specialist palliative care input.3 The aim was to establish the extent to which hospices and specialist palliative care units (SPCUs) in the UK and Ireland currently manage patients with MND using assisted ventilation especially TV and to identify any associated barriers...
February 2, 2019: BMJ Supportive & Palliative Care
Yonathan Freund, Judith Gorlicki, Marine Cachanado, Sarah Salhi, Vanessa Lemaître, Tabassome Simon, Alexandre Mebazaa
BACKGROUND: Acute heart failure (AHF) is one of the most common diagnoses for elderly patients in the emergency department (ED), with an admission rate above 80% and 1-month mortality around 10%. The European guidelines for the management of AHF are based on moderate levels of evidence, due to the lack of randomized controlled trials and the scarce evidence of any clinical added value of a specific treatment to improve outcomes. Recent reports suggest that the very early administration of full recommended therapy may decrease mortality...
January 31, 2019: Trials
Robab Breyer-Kohansal, Sylvia Hartl, Marie-Kathrin Breyer, Andrea Schrott, Michael Studnicka, Daniel Neunhäuserer, Gerhard Fülöp, Otto Chris Burghuber
OBJECTIVE: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are the major reason for COPD hospitalization and increased risk for readmissions. The organizational structure of Austrian hospitals provides the opportunity to investigate the impact of specialized respiratory care compared to general care on adherence to guidelines and readmission in AECOPD. METHODS: The data from the European COPD audit, a prospective observational non-interventional cohort trial were analyzed...
January 28, 2019: Wiener Klinische Wochenschrift
Abigail Bishopp, Amy Oakes, Pearlene Antoine-Pitterson, Biman Chakraborty, David Comer, Rahul Mukherjee
Background: Non-invasive ventilation (NIV) is a valuable treatment in the management of acute hypercapnic respiratory failure. NIV is not without risks. One such adverse effect is the development of pressure ulcers over the nasal bridge which have an incidence of up to 20% of patients requiring NIV in this setting. The role of medical devices in the development of hospital acquired pressure ulcers has been increasingly recognised with 10-35% of all hospital acquired ulcers attributed to medical devices...
January 2019: Ulster Medical Journal
Giuseppe F Sferrazza Papa, Giulia M Pellegrino, Hameeda Shaikh, Agata Lax, Luca Lorini, Massimo Corbo
In amyotrophic lateral sclerosis (ALS), respiratory muscle weakness leads to respiratory failure and death. Non-invasive positive pressure ventilation (NIPPV) appears to reduce lung function decline, thus improving survival and quality-of-life of patients affected by the disease. Unfortunately, clinical features and timing to start NIPPV are not well defined. Starting from recent findings, we examine established and novel tests of respiratory muscle function that could help clinicians decide whether and when to start NIPPV in ALS...
December 2018: Minerva Medica
Stephen C Bourke, Thomas Piraino, Lara Pisani, Laurent Brochard, Mark W Elliott
Non-invasive ventilation is standard therapy in the management of both hypoxaemic and hypercapnic respiratory failure of various causes. The evidence base for its use and when and how it should be used has been reviewed in two recent guidelines. In this Series paper, we look beyond the guidelines to what is happening in everyday clinical practice in the real world, how patient selection can be refined to maximise the chances of a successful outcome, and emerging alternative therapies. Real-world application of non-invasive ventilation diverges from guideline recommendations, particularly with regard to patient selection and timing of initiation...
December 2018: Lancet Respiratory Medicine
Andrea Wolfler, Gianfranco Raimondi, Cecilia Pagan de Paganis, Elena Zoia
Bronchiolitis is one of the most frequent reasons for Pediatric Intensive Care Unit (PICU) admission in children less than 1 year of age. It causes a wide spectrum of clinical scenarios from mild to severe respiratory failure and supportive therapy range from high flow nasal cannula (HFNC) to nonconventional ventilation and extra corporeal membrane oxygenation (ECMO) in the most severe forms. Aim of this article is to review the available ventilation mode in children with bronchiolitis and the scientific evidence...
December 2018: Minerva Pediatrica
Gina Ancora, Paola Lago, Elisabetta Garetti, Daniele Merazzi, Patrizia Savant Levet, Carlo Valerio Bellieni, Luisa Pieragostini, Anna Pirelli
AIM: This review informed pain control guidelines for clinicians performing mechanical ventilation, nasal continuous positive airway pressure and endotracheal intubation on term and preterm newborn infants. METHODS: We reviewed literature published between 1986 and June 2017 on analgesia and sedation during assisted ventilation and before endotracheal intubation in newborn infants admitted to neonatal intensive care units. The subsequent guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation approach...
October 5, 2018: Acta Paediatrica
John Titus George, Ajay Kumar Mishra, Ramya Iyadurai
Introduction: Diabetic ketoacidosis (DKA) is a serious acute metabolic complication of diabetes mellitus (DM). It is classified into mild, moderate, and severe based on severity as per the American Diabetes Association (ADA) guidelines. There are limited data on the correlation between the severity of DKA and its outcomes using this classification system. The aim is to study the correlation between the outcomes and severity of DKA in a tertiary care center in India. Methodology: In this retrospective pilot study, 1527 patients with DM were identified over a span of 3 years, of which 63 had a discharge diagnosis of DKA and 37 fulfilled the ADA criteria for DKA...
July 2018: Journal of Family Medicine and Primary Care
Jean-Damien Ricard, Fadia Dib, Marina Esposito-Farese, Jonathan Messika, Christophe Girault
INTRODUCTION: This study protocol describes a trial designed to investigate whether high-flow heated and humidified nasal oxygen (HFHO) therapy in patients with hypercapnic acute respiratory failure (ARF) reduces the need of non-invasive ventilation (NIV). METHODS AND ANALYSIS: This is an open-label, superiority, international, parallel-group, multicentre randomised controlled two-arm trial, with an internal feasibility pilot phase. 242 patients with hypercapnic ARF requiring NIV admitted to an intensive care unit, an intermediate care or a respiratory care unit will be randomised in a 1:1 ratio to receive HFHO or standard oxygen in between NIV sessions...
September 19, 2018: BMJ Open
Inger Oey, David Waller
Despite a positive result in favour of lung volume reduction surgery (LVRS), from one of the largest randomized controlled trial in thoracic surgery, the identification of poor outcome in certain high-risk groups has resulted in a worldwide decrease in its utilization. Patient selection is the key to successful lung volume reduction which, with the advent of a range of less invasive techniques, has become more complex. The greater variety of potential therapeutic options will inevitably lead to debate amongst treating clinicians...
August 2018: Journal of Thoracic Disease
Arnaud W Thille, Grégoire Muller, Arnaud Gacouin, Rémi Coudroy, Alexandre Demoule, Romain Sonneville, François Beloncle, Christophe Girault, Laurence Dangers, Alexandre Lautrette, Séverin Cabasson, Anahita Rouzé, Emmanuel Vivier, Anthony Le Meur, Jean-Damien Ricard, Keyvan Razazi, Guillaume Barberet, Christine Lebert, Stephan Ehrmann, Walter Picard, Jeremy Bourenne, Gael Pradel, Pierre Bailly, Nicolas Terzi, Matthieu Buscot, Guillaume Lacave, Pierre-Eric Danin, Hodanou Nanadoumgar, Aude Gibelin, Lassane Zanre, Nicolas Deye, Stéphanie Ragot, Jean-Pierre Frat
INTRODUCTION: Recent practice guidelines suggest applying non-invasive ventilation (NIV) to prevent postextubation respiratory failure in patients at high risk of extubation failure in intensive care unit (ICU). However, such prophylactic NIV has been only a conditional recommendation given the low certainty of evidence. Likewise, high-flow nasal cannula (HFNC) oxygen therapy has been shown to reduce reintubation rates as compared with standard oxygen and to be as efficient as NIV in patients at high risk...
September 5, 2018: BMJ Open
Mikhail Kazachkov, Jose-Alberto Palma, Lucy Norcliffe-Kaufmann, Bat-El Bar-Aluma, Christy L Spalink, Erin P Barnes, Nancy E Amoroso, Stamatela M Balou, Shay Bess, Arun Chopra, Rany Condos, Ori Efrati, Kathryn Fitzgerald, David Fridman, Ronald M Goldenberg, Ayelet Goldhaber, David A Kaufman, Sanjeev V Kothare, Jeremiah Levine, Joseph Levy, Anthony S Lubinsky, Channa Maayan, Libia C Moy, Pedro J Rivera, Alcibiades J Rodriguez, Gil Sokol, Mark F Sloane, Tina Tan, Horacio Kaufmann
BACKGROUND: Familial dysautonomia (Riley-Day syndrome, hereditary sensory autonomic neuropathy type-III) is a rare genetic disease caused by impaired development of sensory and afferent autonomic nerves. As a consequence, patients develop neurogenic dysphagia with frequent aspiration, chronic lung disease, and chemoreflex failure leading to severe sleep disordered breathing. The purpose of these guidelines is to provide recommendations for the diagnosis and treatment of respiratory disorders in familial dysautonomia...
August 2018: Respiratory Medicine
Tessa Martherus, André Oberthuer, Janneke Dekker, Stuart B Hooper, Erin V McGillick, Angela Kribs, Arjan B Te Pas
Most very preterm infants have difficulty aerating their lungs and require respiratory support at birth. Currently in clinical practice, non-invasive ventilation in the form of continuous positive airway pressure (CPAP) and positive pressure ventilation (PPV) is applied via facemask. As most very preterm infants breathe weakly and unnoticed at birth, PPV is often administered. PPV is, however, frequently ineffective due to pressure settings, mask leak and airway obstruction. Meanwhile, high positive inspiratory pressures and spontaneous breathing coinciding with inflations can generate high tidal volumes...
January 2019: Archives of Disease in Childhood. Fetal and Neonatal Edition
Robyn McDannold, Bentley J Bobrow, Vatsal Chikani, Annemarie Silver, Daniel W Spaite, Tyler Vadeboncoeur
BACKGROUND: Clinical investigations have shown improved outcomes with primary compression cardiopulmonary resuscitation strategies. It is unclear whether this is a result of passive ventilation via chest compressions, a low requirement for any ventilation during the early aspect of resuscitation or avoidance of inadvertent over-ventilation. OBJECTIVES: To quantify whether chest compressions with guideline-compliant depth (>2 in) produce measurable and substantial ventilation volumes during emergency department resuscitation of out-of-hospital cardiac arrest...
September 2018: American Journal of Emergency Medicine
Eshwara Vandana Kalwaje, Jordi Rello
Optimizing management of ventilator-associated pneumonia (VAP) should focus on the accurate identification of true lung infection, determination of the etiological agent, and early institution of adequate empirical therapy and de-escalation. Local adaptation of the standard guidelines leads to favorable outcome in the management of VAP Areas covered: In this review, we present the concepts of early adequate therapy and the key considerations such as patient characters, clinical and etiological diagnosis, and assessment of patients for de-escalation that favor optimization of therapy...
August 2018: Expert Review of Anti-infective Therapy
Mabelle Gomes de Oliveira Cavalcanti, Lívia Barboza Andrade, Patrícia Clara Pereira Dos Santos, Leandro Ricardo Rodrigues Lucena
BACKGROUND: Obesity is characterized by excessive accumulation of body fat, which causes damage to the health of individuals, such as breathing difficulties. AIM: To verify the results of non-invasive ventilation as a preventive strategy on the decline of respiratory function and postoperative complications in patients undergoing Roux-en-Y gastric bypass. METHODS: This is a randomized trial, according to CONSORT standards, with obese adults aged 18-40 years...
June 21, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Wolfram Windisch, Jens Geiseler, Karsten Simon, Stephan Walterspacher, Michael Dreher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010, the German Respiratory Society (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure." However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines. For this reason, the updated guidelines are now published...
2018: Respiration; International Review of Thoracic Diseases
Wolfram Windisch, Jens Geiseler, Karsten Simon, Stephan Walterspacher, Michael Dreher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010, the German Respiratory Society (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, DGP) has leadingly published the Guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure." However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the Guidelines...
2018: Respiration; International Review of Thoracic Diseases
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