James Leatherman
Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma...
June 2015: Chest
A Hemming, I MacKenzie, S Finfer
The case is reported of a 28 year old woman with status asthmaticus unresponsive to three days of maximal medical treatment. Resolution of bronchospasm was achieved with an infusion of the intravenous anaesthetic agent ketamine.
January 1994: Thorax
Nicholas S Ward, Kevin M Dushay
OBJECTIVE: To summarize the current literature on mechanical ventilation of patients with chronic obstructive pulmonary disease (COPD) using published data to augment commonly accepted principles of clinical practice. DATA SOURCE: A MEDLINE/PubMed search from 1966 to November 2006 using the search terms mechanical ventilation, respiratory failure, noninvasive positive pressure ventilation (NIPPV), and COPD, and weaning. Subsequent searches were done on more specific issues such as heliox...
May 2008: Critical Care Medicine
Jhaymie L Cappiello, Michael B Hocker
Noninvasive ventilation (NIV) in severe acute asthma is controversial but may benefit this population by preventing intubation. We report on a 35-year-old male asthma patient who presented to our emergency department via emergency medical services. The patient was responsive, diaphoretic, and breathing at 35 breaths/min on 100% oxygen with bag-mask assistance, with S(pO2) 88%, heart rate 110-120 beats/min, blood pressure 220/110 mm Hg, and temperature 35.8 °C. NIV at 12/5 cm H2O and FIO2 0.40 was applied, and albuterol at 40 mg/h was initiated...
October 2014: Respiratory Care
M J Tobin, R F Lodato
No abstract text is available yet for this article.
September 1989: Chest
Maria Paula Caramez, Joao B Borges, Mauro R Tucci, Valdelis N Okamoto, Carlos R R Carvalho, Robert M Kacmarek, Atul Malhotra, Irineu Tadeu Velasco, Marcelo B P Amato
OBJECTIVE: To reevaluate the clinical impact of external positive end-expiratory pressure (external-PEEP) application in patients with severe airway obstruction during controlled mechanical ventilation. The controversial occurrence of a paradoxic lung deflation promoted by PEEP was scrutinized. DESIGN: External-PEEP was applied stepwise (2 cm H(2)O, 5-min steps) from zero-PEEP to 150% of intrinsic-PEEP in patients already submitted to ventilatory settings minimizing overinflation...
July 2005: Critical Care Medicine
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