oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Core Topics in Mechanical Ventilation
Lluis Blanch
Critical Care , 2009, DOI: 10.1186/cc7951
Abstract: The contents of Core Topics in Mechanical Ventilation edited by Ian Mackenzie can be separated into two general parts. Several chapters cover general respiratory physiology, which is essential to understand how mechanical ventilation works and interacts with cardio-respiratory performance. It is worth mentioning the good contributions on the physiology of gas exchange, carbon dioxide balance and cardio-respiratory interactions. Some chapters are dedicated to adjuncts of mechanical ventilation, including both general and custom adjuncts used in mechanically ventilated patients. Of note are the chapters dedicated to the effects and administration of oxygen and heliox, and to sedation, analgesia, paralysis and nutrition.The second part is devoted to mechanical ventilation. The reader can find recommendations about how to set the ventilator in several clinical scenarios such as asthma, chronic obstructive pulmonary disease, and chest, burn and blast injuries. One specific chapter is devoted to adverse effects and complications of mechanical ventilation. This chapter deals in a very comprehensive manner with management of the difficult airway, unplanned extubation and how to minimize and manage ventilation-induced lung injury (barotrauma, volutrauma, and atelectrauma), among others. The management of acute lung injury and acute respiratory distress syndrome are not covered in dedicated chapters, but major principles are included as paragraphs in distinct parts of the book. The same is the case for non-invasive mechanical ventilation, which nowadays can be considered an independent discipline that extends beyond anesthesia and intensive care departments. Three chapters deserve mention for their particular relevance: Management of the artificial airway, Modes of mechanical ventilation, and Mechanical ventilation for transport. These chapters are extensive and comprehensive and include technical documentation as well as tables and figures that are self-explanatory. I am als
Non Invasive Mechanical Ventilation  [PDF]
Dr U. D. Sharma
Indian Anaesthetists' Forum , 2004,
Abstract: Negative pressure ventilators (Tank and Cuirass ventilators) were the only non-invasive methods of assisting ventilation for many years mainly for ventilating large number of victims of Polio during their acute illness. In 1980s it was recognized that delivery of continuous positive airway pressure by close fitting nasal masks for treatment of obstructive sleep apnoea could also be used to deliver an intermittent positive pressure. This was followed by improvements in the interface and establishment of role of NIMV in patients of COPD. The use of NIMV has increased in last decade in various conditions to avoid complications of intubation.
Non-invasive mechanical ventilation
BL Giles
Southern African Journal of Critical Care , 2005,
Abstract: Non-invasive ventilation (NIV) is a modality of providing airway and pulmonary support in both acute and chronic diseases of the lung. The method of mechanical ventilation without the use of an endotracheal tube was developed over a century ago, but its utility has only been explored recently with advances in technology. NIV is the method of choice when there is a desire to avoid the inherent complications that arise from using artificial airway supports such as endotracheal tubes and tracheostomies. NIV can be used in the intensive care unit and in the outpatient setting in appropriately selected patients. Adult and paediatric critical care and respiratory divisions have a wealth of experience in successful use of NIV. The history, use and experience will be discussed along with recommendations for initiating NIV. SAJCC Vol. 21 (1) 2005: pp. 10-15
Knowledge and experience of physiotherapists on non-invasive ventilation  [PDF]
Isabel Cristina de Mendon?a Santiago,Fabíola Maria Sabino Meireles,Cymara Pessoa Kuehner,Mirizana Alves-de-Almeida
Revista Brasileira em Promo??o da Saúde , 2011,
Abstract: Objective: To compare knowledge and experience in non-invasive ventilation (NIV) among physiotherapists of hospital wards and adult Intensive Care Units (ICU). Methods: A study conducted from August/2007 to August/ 2008, in four public hospitals in Fortaleza-CE, Brazil, with 116 physiotherapists (42/wards and 76/ICU) on their practical and theoretical knowledge on NIV, with open and closed questions. The data was analyzed using descriptive statistics through SPSS (Statistical Package for Social Sciences) version 17. Results: Regarding the use of NIV, 22 of 42 physiotherapists from the wards and one of 74 from the ICU never administered it (p<0.05); 19 (45%) of physiotherapists from the wards and 58 (78%) from the ICU answered correctly on NIV as first choice; 18 (43%) physiotherapists from the wards and 64 (86%) from the ICU answered properly on physiological effects (p<0.05); 21 (50%) physiotherapists from the wards and 68 (92%) from the ICU answered appropriately on indications of NIV (p <0.05); 19 (45%) physiotherapists from wards and 71 (96%) from ICU answered correctly on contraindications of NIV (p <0.05); 8 (19%) physiotherapists in the wards and 36 (49%) in the ICU considered infrastructure satisfactory. In the ICU, 68 (92%) physiotherapists believed they were able to monitor NIV, in wards 13 (31%) did it (p <0.05). Conclusions: Physiotherapists of the ICU showed more experience regarding the administration of NIV; they had the knowledge and believed they were more apt to use it than those of the wards. As the physiotherapist is directly involved in this therapeutics, the knowledge and practice of NIV can be better exploited in the ICU and wards.
Shrinking the room for invasive ventilation in hypercapnic respiratory failure  [cached]
Scarpazza P,Incorvaia C,Melacini C,Cattaneo R
International Journal of COPD , 2013,
Abstract: Paolo Scarpazza,1 Cristoforo Incorvaia,2 Chiara Melacini,1 Roberta Cattaneo,1 Cristiano Bonacina,1 Gian Galeazzo Riario-Sforza,2 Walter Casali1 1Pneumology Unit, Ospedale Civile, Vimercate, 2Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy Abstract: Noninvasive ventilation (NIV) was introduced as an alternative to invasive mechanical ventilation for acute respiratory failure caused from exacerbations of chronic obstructive pulmonary disease in the 1980s, and its use gradually rose worldwide. Seventy-eight patients (57 males, mean age 78.3 ± 9.2 years) undergoing NIV were evaluated. Of them, 48 (62.3%) had acute hypercapnic respiratory failure because of a chronic obstructive pulmonary disease exacerbation, and the remaining 30 had acute hypercapnic respiratory failure from other causes, mainly cardiac failure. All patients were treated by NIV using the bi-level positive airway pressure set up at high pressure/high backup rate. NIV was successful in 67 subjects (85.9%) and the patients were discharged, 57 of whom continued NIV at home and ten had spontaneous breathing. NIV was unsuccessful in eleven patients, ten of whom died and one was successfully treated by invasive mechanical ventilation. Significant differences were detected for a higher basal Glasgow Coma Scale score in successfully treated patients (P = 0.007), a higher basal Acute Physiology and Chronic Health Evaluation score in unsuccessfully treated patients (P = 0.004), and a lower pH after 1 hour in unsuccessfully treated patients (P = 0.015). These findings show a very high rate of success of NIV in patients with acute hypercapnic respiratory failure not only from chronic obstructive pulmonary disease but also from cardiac failure. This suggests that the use of invasive mechanical ventilation may be further reduced, with a decrease in its known complications as well. Keywords: invasive ventilation, noninvasive ventilation, acute respiratory failure
Shrinking the room for invasive ventilation in hypercapnic respiratory failure
Scarpazza P, Incorvaia C, Melacini C, Cattaneo R, Bonacina C, Riario-Sforza GG, Casali W
International Journal of Chronic Obstructive Pulmonary Disease , 2013, DOI: http://dx.doi.org/10.2147/COPD.S41374
Abstract: inking the room for invasive ventilation in hypercapnic respiratory failure Rapid Communication (260) Total Article Views Authors: Scarpazza P, Incorvaia C, Melacini C, Cattaneo R, Bonacina C, Riario-Sforza GG, Casali W Published Date March 2013 Volume 2013:8 Pages 135 - 137 DOI: http://dx.doi.org/10.2147/COPD.S41374 Received: 10 December 2012 Accepted: 21 January 2013 Published: 15 March 2013 Paolo Scarpazza,1 Cristoforo Incorvaia,2 Chiara Melacini,1 Roberta Cattaneo,1 Cristiano Bonacina,1 Gian Galeazzo Riario-Sforza,2 Walter Casali1 1Pneumology Unit, Ospedale Civile, Vimercate, 2Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy Abstract: Noninvasive ventilation (NIV) was introduced as an alternative to invasive mechanical ventilation for acute respiratory failure caused from exacerbations of chronic obstructive pulmonary disease in the 1980s, and its use gradually rose worldwide. Seventy-eight patients (57 males, mean age 78.3 ± 9.2 years) undergoing NIV were evaluated. Of them, 48 (62.3%) had acute hypercapnic respiratory failure because of a chronic obstructive pulmonary disease exacerbation, and the remaining 30 had acute hypercapnic respiratory failure from other causes, mainly cardiac failure. All patients were treated by NIV using the bi-level positive airway pressure set up at high pressure/high backup rate. NIV was successful in 67 subjects (85.9%) and the patients were discharged, 57 of whom continued NIV at home and ten had spontaneous breathing. NIV was unsuccessful in eleven patients, ten of whom died and one was successfully treated by invasive mechanical ventilation. Significant differences were detected for a higher basal Glasgow Coma Scale score in successfully treated patients (P = 0.007), a higher basal Acute Physiology and Chronic Health Evaluation score in unsuccessfully treated patients (P = 0.004), and a lower pH after 1 hour in unsuccessfully treated patients (P = 0.015). These findings show a very high rate of success of NIV in patients with acute hypercapnic respiratory failure not only from chronic obstructive pulmonary disease but also from cardiac failure. This suggests that the use of invasive mechanical ventilation may be further reduced, with a decrease in its known complications as well.
Prevalence of and risk factors for retinopathy of prematurity in a cohort of preterm infants treated exclusively with non-invasive ventilation in the first week after birth
SK van der Merwe, N Freeman, A Bekker, J Harvey, J Smith
South African Medical Journal , 2013,
Abstract: Objectives. To determine the current prevalence of retinopathy of prematurity (ROP) in premature babies treated with non-invasive ventilation at Tygerberg Children’s Hospital, Parow, Cape Town, South Africa, and to identify risk factors associated with the development of ROP. Methods. A retrospective medical records review of infants screened for ROP during a 2-year period (January 2009 - December 2010). Infants who did not receive invasive ventilation during the first week of life were included. Twenty-four previously reported risk factors for the development of ROP were identified for use in a multivariate logistic regression (MLR) analysis. Results. A total of 356 patients were included. The overall prevalence of ROP was 21.8% and that of clinically significant ROP (CSROP) 4.4%. The risk factors with a statistically significant association with the development of ROP on MLR analysis were severe apnoea (p=0.0005) and decreasing birth weight (p=0.0382). Conclusions. There is a low prevalence of ROP in the cohort of preterm infants treated exclusively with non-invasive ventilation in the first week of life. The risk factors of importance in our population were severe apnoea and lower birth weight. Birth weight is a practical and reproducible variable that can be used to aid development of ROP screening criteria.
Invasive pulmonary aspergillosis caused by Aspergillus versicolor in a patient on mechanical ventilation  [PDF]
MV Pravin Charles,Noyal Mariya Joseph1,Joshy M Easow1,M Ravishankar2
Australasian Medical Journal , 2011,
Abstract: Aspergillus spp. often colonise the respiratory tract of critically ill patients in intensive care units and subsequently cause invasive disease. The risk of developing invasive disease is more in immunocompromised patients. Here we report a case of fatal invasive pulmonary aspergillosis caused by Aspergillus versicolor in a post-operative patient on mechanical ventilation, who did not respond to intravenous itraconazole. We then discuss the challenges involved in the accurate diagnosis of this condition and appropriate management.
Invasive home mechanical ventilation, mainly focused on neuromuscular disorders
Geiseler, Jens,Karg, Ortrud,B?rger, Sandra,Becker, Kurt
GMS Health Technology Assessment , 2010,
Abstract: Introduction and background: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborate and technology-dependent ventilation is carried out via an artificial airway (tracheal cannula) to the trachea. Exact numbers about the incidence of home mechanical ventilation are not available. Patients with neuromuscular diseases represent a large portion of it. Research questions: Specific research questions are formulated and answered concerning the dimensions of medicine/nursing, economics, social, ethical and legal aspects. Beyond the technical aspect of the invasive home, mechanical ventilation, medical questions also deal with the patient’s symptoms and clinical signs as well as the frequency of complications. Economic questions pertain to the composition of costs and the differences to other ways of homecare concerning costs and quality of care. Questions regarding social aspects consider the health-related quality of life of patients and caregivers. Additionally, the ethical aspects connected to the decision of home mechanical ventilation are viewed. Finally, legal aspects of financing invasive home mechanical ventilation are discussed. Methods: Based on a systematic literature search in 2008 in a total of 31 relevant databases current literature is viewed and selected by means of fixed criteria. Randomized controlled studies, systematic reviews and HTA reports (health technology assessment), clinical studies with patient numbers above ten, health-economic evaluations, primary studies with particular cost analyses and quality-of-life studies related to the research questions are included in the analysis. Results and discussion: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia) are rare. Mobile home ventilators are available for the implementation of the ventilation. Their technical performance however, differs regrettably. Studies comparing the economic aspects of ventilation in a hospital to outpatient ventilation, describe home ventilation as a more cost-effective alternative to in-patient care in an intensive care unit, however, more expensive in comparison to a noninvasive (via mask) ventilation. Higher expenses arise due to the necessary equipment and the high expenditure of time for the partial 24-hour care of the affected patients through highly qualified personnel. However, none of the stud
Social and practical representations in pneumonia associated to ventilation mechanics
Giovane Mendieta I,Amparo E. Cristancho M
Revista Facultad Nacional de Salud Pública , 2009,
Abstract: Objective: To identify the practice and social representations of the respiratory therapists, on the strategies of prevention of pneumonia associated to mechanical ventilation, of the unit intensive care of the Kennedy Hospital. Methodology:Qualitative inquiry, descriptive and explanatory character, the population, respiratorys therapist of the unit’s intensives cares, with a sample of captive type for convenience, conformed by seventeen respiratorys therapists who were applied a semistructured interview, applying the content analysis technique for their study. Results: Practices and social representations, are given around the patient, and therefore avoid prolonged mechanical ventilation, the suction procedure should be carried out by means of aseptic technique, on the other and, the strict execution of handling protocols of airway; as long as it should be norm for the whole personnel, hand washing. Conclusions:it is observed the strategies of prevention are influenced by the theoretical references, however, these actors don’t know the full prevention strategies, likewise the represented practices are related with the prevention through asepsis transmission of pathogens, and has an effect on the construction of social representations and therefore the knowledge of new practices will change the structure of representation.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.