scholarly journals INVASIVE MECHANICAL VENTILATION WITH HIGH CONCENTRATION OXYGEN THERAPY FOR AECOPD PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A958 ◽  
Author(s):  
Jiao Jun ◽  
Lei Sun ◽  
Ying Wang ◽  
Fuzhou Liu ◽  
Guoru Yang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mechanical Ventilation ◽  
Oxygen Therapy ◽  
Invasive Mechanical Ventilation ◽  
High Concentration

High-concentration oxygen for acute myocardial infarction

1966 ◽  
Vol 4 (14) ◽  
pp. 55-56
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Output ◽  
Oxygen Transfer ◽  
Oxygen Therapy ◽  
Acute Hypoxia ◽  
Blood Oxygen ◽  
Pulmonary Congestion ◽  
High Concentration ◽  
Low Cardiac Output

The amount of oxygen delivered to the tissues depends on the product of cardiac output and blood oxygen content. Acute hypoxia can occur early in severe myocardial infarction1 2 not only because a low cardiac output reduces the rate of oxygen transport from the lungs, but also because it causes pulmonary congestion which reduces oxygen transfer to the blood. Bare survival requires at least one quarter of the oxygen carried in health at rest,3 and efficient high-concentration oxygen therapy may therefore be essential. Carbon dioxide retention, which can make oxygen therapy hazardous, is unusual in patients with myocardial infarction.

scholarly journals Percutaneous coronary intervention assisted by invasive mechanical ventilation and intra-aortic balloon pump for acute myocardial infarction with cardiogenic shock: Retrospective cohort study and meta-analysis

2019 ◽  
Author(s):  
Yin Liu ◽  
Chang-Ping Li ◽  
Peng-Ju Lu ◽  
Xu-Ying Wang ◽  
Jian-Yong Xiao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Cardiogenic Shock ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality

The aim of this study was to compare the mortality outcome in patients with acute myocardial infarction and cardiogenic shock who were treated with percutaneous coronary intervention (PCI) assisted by intra-aortic balloon pump (IABP) + invasive mechanical ventilation (IMV) with historical controls. From January 1, 2016 to June 1, 2017, 60 patients were retrospectively enrolled at Tianjin Chest Hospital. Out of these, 88.3% of patients achieved thrombolysis in myocardial infarction flow 3 after PCI. The all-cause mortality rate in-hospital and at 1 year was 25% (95% CI: 0.14–0.36) and 33.9% (0.22–0.46), respectively. A systematic review followed by meta-analysis was performed with 4 historical studies of patients treated by PCI + IMV with partial IABP, which found an in-hospital mortality rate of 66.0% (95% CI: 0.62–0.71). Recently, a meta-analysis of patients receiving PCI + IABP with partial IMV showed that the 1 year mortality rate was 52.2% (95% CI: 0.47–0.58). In Cox regression analysis of patient data from the current study, lactic acid level ≥4.5 mmol/L, hyperuricemia, and thrombolysis in myocardial infarction flow <3 were independent predictors of death at 1 year. All-cause mortality, in-hospital and at 1 year, in patients with acute myocardial infarction and cardiogenic shock treated with PCI + IABP and IMV was lower than in those treated with PCI + partial IABP or IMV. Larger, longer-term direct comparisons are warranted.

scholarly journals Children with Congenital Zika Syndrome: the complexity of nursing care during hospitalization

2021 ◽  
Vol 74 (3) ◽  
Author(s):  
Mariana Cardim Novaes ◽  
Monique de Sales Norte Azevedo ◽  
Carolina Fernandes Falsett ◽  
Adriana Teixeira Reis
Keyword(s):  
Mechanical Ventilation ◽  
Nursing Care ◽  
Health Professionals ◽  
Public Hospital ◽  
Oxygen Therapy ◽  
Invasive Mechanical Ventilation ◽  
Non Invasive ◽  
Continuous Care ◽  
Airway Clearance ◽  
Congenital Zika Syndrome

ABSTRACT Objectives: to classify the degree of dependence on nursing care required by children with Congenital Zika Syndrome during hospitalization and to analyze their complexity. Methods: this is a descriptive, observational and quantitative study carried out in a pediatric ward of a public hospital in Rio de Janeiro. Data were collected from hospitalization records between June 2017 and April 2018. Results: 54% of the population studied showed a degree of dependence equivalent to semi-intensive care. On 37.5% of hospitalization days, patients required non-invasive or invasive mechanical ventilation; 31.5% had spontaneous breathing requiring airway clearance by aspiration and/or oxygen therapy. Conclusion: Congenital Zika Syndrome represents a challenge for health professionals due to its uniqueness. In this study, it is expressed by demands for complex and continuous care in hospitalization and in preparation for discharge, requiring semi-intensive nursing care.

Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials

Heart ◽  
2018 ◽  
Vol 104 (20) ◽  
pp. 1691-1698 ◽  
Author(s):  
Nariman Sepehrvand ◽  
Stefan K James ◽  
Dion Stub ◽  
Ardavan Khoshnood ◽  
Justin A Ezekowitz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Infarct Size ◽  
Oxygen Therapy ◽  
Meta Analysis ◽  
Normal Pressure ◽  
Supplemental Oxygen ◽  
Usual Practice ◽  
Supplemental Oxygen Therapy ◽  
Suspected Acute Myocardial Infarction

BackgroundAlthough oxygen therapy has been used for over a century in the management of patients with suspected acute myocardial infarction (AMI), recent studies have raised concerns around the efficacy and safety of supplemental oxygen in normoxaemic patients.ObjectiveTo synthesise the evidence from randomised controlled trials (RCTs) that investigated the effects of supplemental oxygen therapy compared with room air in patients with suspected or confirmed AMI.MethodsFor this aggregate data meta-analysis, multiple databases were searched from inception to 30 September 2017. RCTs with any length of follow-up and any outcome measure were included if they studied the use of supplemental O2 therapy administered by any device at normal pressure compared with room air. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an investigator assessed all the included studies and extracted the data. Outcomes of interests included mortality, troponin levels, infarct size, pain and hypoxaemia.ResultsEight RCTs with a total of 7998 participants (3982 and 4002 patients in O2 and air groups, respectively) were identified and pooled. In-hospital and 30-day death occurred in 135 and 149 patients, respectively. Oxygen therapy did not reduce the risk of in-hospital (OR, 1.11 (95% CI 0.69 to 1.77)) or 30-day mortality (OR, 1.09 (95% CI 0.80 to 1.50)) in patients with suspected AMI, and the results remained similar in the subgroup of patients with confirmed AMI. The infarct size (based on cardiac MRI) in a subgroup of patients was not different between groups with and without O2 therapy. O2 therapy reduced the risk of hypoxaemia (OR, 0.29 (95% CI 0.17 to 0.47)).ConclusionAlthough supplemental O2 therapy is commonly used, it was not associated with important clinical benefits. These findings from eight RCTs support departing from the usual practice of administering oxygen in normoxaemic patients.

Emergency Pediatric Noninvasive Ventilation and Invasive Mechanical Ventilation

2020 ◽  
pp. 51-63
Author(s):  
Garrett S. Pacheco
Keyword(s):  
Mechanical Ventilation ◽  
Emergency Physician ◽  
Oxygen Therapy ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Supportive Treatment ◽  
Airway Clearance Therapy ◽  
Respiratory Complaints ◽  
Ventilator Settings

Respiratory complaints are common conditions for children to present to emergency departments. Typically, patients respond to simple supportive treatment, whether it is airway clearance therapy, oxygen therapy, or bronchodilators. When these patients are critically ill, they often require aggressive oxygenation/ventilation with noninvasive strategies, or even tracheal intubation. The use of noninvasive positive pressure ventilation has led to a significant reduction in the necessity for endotracheal intubation in children. The emergency physician should be familiar with the indications and appropriate application of these modalities. Furthermore, when patients require invasive mechanical ventilation, the emergency physician should have an understanding of initial ventilator settings, troubleshooting alarms, and an approach to the decompensating pediatric ventilated patient.

scholarly journals Oxygen therapy in suspected acute myocardial infarction and concurrent normoxemic chronic obstructive pulmonary disease: a prespecified subgroup analysis from the DETO2X-AMI trial

2019 ◽  
Vol 9 (8) ◽  
pp. 984-992 ◽  
Author(s):  
Pontus Andell ◽  
Stefan James ◽  
Ollie Östlund ◽  
Troels Yndigegn ◽  
David Sparv ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Obstructive Pulmonary Disease ◽  
Acute Myocardial Infarction ◽  
Pulmonary Disease ◽  
Subgroup Analysis ◽  
Oxygen Therapy ◽  
Ambient Air ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Suspected Acute Myocardial Infarction

Background: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial did not find any benefit of oxygen therapy compared to ambient air in normoxemic patients with suspected acute myocardial infarction. Patients with chronic obstructive pulmonary disease may both benefit and be harmed by supplemental oxygen. Thus we evaluated the effect of routine oxygen therapy compared to ambient air in normoxemic chronic obstructive pulmonary disease patients with suspected acute myocardial infarction. Methods and results: A total of 6629 patients with suspected acute myocardial infarction were randomly assigned in the DETO2X-AMI trial to oxygen or ambient air. In the oxygen group ( n=3311) and the ambient air group ( n=3318), 155 and 141 patients, respectively, had chronic obstructive pulmonary disease (prevalence of 4.5%). Patients with chronic obstructive pulmonary disease were older, had more comorbid conditions and experienced a twofold higher risk of death at one year (chronic obstructive pulmonary disease: 32/296 (10.8%) vs. non-chronic obstructive pulmonary disease: 302/6333 (4.8%)). Oxygen therapy compared to ambient air was not associated with improved outcomes at 365 days (chronic obstructive pulmonary disease: all-cause mortality hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.50–1.99, Pinteraction=0.96); cardiovascular death HR 0.80, 95% CI 0.32–2.04, Pinteraction=0.59); rehospitalisation with acute myocardial infarction or death HR 1.27, 95% CI 0.71–2.28, Pinteraction=0.46); hospitalisation for heart failure or death HR 1.08, 95% CI 0.61–1.91, Pinteraction=0.77]); there were no significant treatment-by-chronic obstructive pulmonary disease interactions. Conclusions: Although chronic obstructive pulmonary disease patients had twice the mortality rate compared to non-chronic obstructive pulmonary disease patients, this prespecified subgroup analysis from the DETO2X-AMI trial on oxygen therapy versus ambient air in normoxemic chronic obstructive pulmonary disease patients with suspected acute myocardial infarction revealed no evidence for benefit of routine oxygen therapy consistent with the main trial’s findings. Clinical Trials Registration: NCT02290080

Noninvasive Oxygenation Strategies in Immunocompromised Patients With Acute Hypoxemic Respiratory Failure: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 35 (11) ◽  
pp. 1216-1225 ◽  
Author(s):  
Yazan Zayed ◽  
Momen Banifadel ◽  
Mahmoud Barbarawi ◽  
Babikir Kheiri ◽  
Adam Chahine ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Oxygen Therapy ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Controlled Trials ◽  
Immunocompromised Patients ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Randomized Controlled

Introduction: Acute hypoxemic respiratory failure (AHRF) is a leading cause of intensive care unit (ICU) admission among immunocompromised patients. Invasive mechanical ventilation is associated with increased morbidity and mortality. Objective: To evaluate the efficacy of various oxygenation strategies including noninvasive ventilation (NIV), high-flow nasal cannula (HFNC), and conventional oxygen therapy in immunocompromised patients with AHRF. Methods: Electronic databases including PubMed, Embase, and the Cochrane Library were reviewed from inception to December 2018. We included all randomized controlled trials (RCTs) comparing different modalities of initial oxygenation strategies in immunocompromised patients with AHRF. Our primary outcome was the need for intubation and invasive mechanical ventilation while secondary outcomes were ICU acquired infections and short- and long-term mortality. Data were extracted separately and independently by 2 reviewers. We performed a Bayesian network meta-analysis to calculate odds ratio (OR) and Bayesian 95% credible intervals (CrIs). Results: Nine RCTs were included (1570 patients, mean age 61.1 ± 13.8 years with 64% male). Noninvasive ventilation was associated with a significantly reduced intubation rate compared with standard oxygen therapy (OR: 0.53; 95% CrI: 0.26-0.91). There were no significant reductions of intubation between NIV versus HFNC (OR: 0.83; 95% CrI: 0.35-2.11) or HFNC versus standard oxygen therapy (OR: 0.65; 95% CrI: 0.26-1.24). There were no significant differences between all groups regarding short-term (28-day or ICU) mortality or long-term (90-day or hospital) mortality or ICU-acquired infections ( P > 0.05). Conclusion: Among immunocompromised patients with AHRF, NIV was associated with a significant reduction of intubation compared with standard oxygen therapy. There were no significant differences among all oxygenation strategies regarding mortality and ICU-acquired infections.

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