Literature DB >> 9757921

Physiologic evaluation of non-invasive pressure support ventilation in trauma patients with acute respiratory failure.

C Gregoretti1, F Beltrame, U Lucangelo, L Burbi, G Conti, M Turello, D Gregori.   

Abstract

OBJECTIVE: To investigate the effectiveness of noninvasive (face mask) versus invasive (endotracheal tube) equal pressure values on blood gases and respiratory pattern and to evaluate the feasibility of using mask ventilation after the short term physiologic study.
DESIGN: Open, prospective, physiologic study and uncontrolled clinical study.
SETTING: Intensive care unit of a trauma center. PATIENTS: 22 intubated trauma patients were studied.
INTERVENTIONS: Patients were intubated and ventilated in a pressure support mode (IPSV) of 13.5 +/- 1.5 cmH2O and a post end-expiratory pressure (PEEP) of 5.8 +/- 2.57 cmH2O. After a T-piece trial to assess patient's ability to breath spontaneously, patients were switched over to noninvasive pressure support (NIPSV). The pressure levels were set as during IPSV. Blood gases and respiratory parameters were measured during IPSV, during the T-piece trial, and after 1 h of NIPSV. After the physiologic study, all patients were asked if they wished to continue on NIPSV. The patient's subjective compliance with IPSV and NIPSV was measured by means of an arbitrary score. A successful outcome was defined as no need for reintubation. MEASUREMENTS AND
RESULTS: IPSVand NIPSV showed no statistical differences for blood gas and respiratory parameters by using the same values of PSV (13 +/- 5 vs 12.8 +/- 1.7 cmH2O, NS) and PEEP (5.8 +/- 2.5 and 5.2 +/- 2.2 cmH2O NS). The median length of time on NIPSV was 47 h (range 6 to 144). All patients wished to continue on NIPSV, but 9 patients (40.9%) were reintubated after 54 +/- 54 h. Six of them died after 36 +/- 13 days while still on mechanical ventilation. There was no statistically significant difference in compliance score between IPSVand NIPSV.
CONCLUSIONS: NIPSV is comparable to IPSV in terms of blood gases and respiratory pattern. The clinical uncontrolled study indicates that NIPSV could be used in selected trauma patients.

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Mesh:

Year:  1998        PMID: 9757921     DOI: 10.1007/s001340050666

Source DB:  PubMed          Journal:  Intensive Care Med        ISSN: 0342-4642            Impact factor:   17.440


  22 in total

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2.  Noninvasive Ventilation in Hypoxemic Patients: an Ongoing Soccer Game or a Lost One?

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4.  Facial skin breakdown in patients with non-invasive ventilation devices: report of two cases and indications for treatment and prevention.

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Review 5.  Time of non-invasive ventilation.

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Journal:  Intensive Care Med       Date:  2006-02-14       Impact factor: 17.440

Review 6.  Non-Invasive Mechanical Ventilation in Critically Ill Trauma Patients: A Systematic Review.

Authors:  Annia Schreiber; Fatma Yıldırım; Giovanni Ferrari; Andrea Antonelli; Pablo Bayoumy Delis; Murat Gündüz; Marcin Karcz; Peter Papadakos; Roberto Cosentini; Yalım Dikmen; Antonio M Esquinas
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7.  Ten important articles on noninvasive ventilation in critically ill patients and insights for the future: A report of expert opinions.

Authors:  A Cortegiani; V Russotto; M Antonelli; E Azoulay; A Carlucci; G Conti; A Demoule; M Ferrer; N S Hill; S Jaber; P Navalesi; P Pelosi; R Scala; C Gregoretti
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8.  Sequential use of noninvasive ventilation and high flow nasal therapy after early extubation in chest trauma patients recovering from acute hypoxaemic respiratory failure.

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