Management of Acute Respiratory Failure Due to Pulmonary Edema With Nasal Positive Pressure Support

CHEST Journal ◽  
1994 ◽  
Vol 105 (1) ◽  
pp. 229-231 ◽  
Author(s):  
Stephen E. Lapinsky ◽  
David B. Mount ◽  
Dale Mackey ◽  
Ronald F. Grossman
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pulmonary Edema ◽  
Pressure Support ◽  
Positive Pressure

Barotrauma during non-invasive ventilation for acute respiratory distress syndrome caused by COVID-19: a balance between risks and benefits

2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Ventilatory support is vital for the management of severe forms of COVID-19. Non-invasive ventilation is often used in patients who do not meet criteria for intubation or when invasive ventilation is not available, especially in a pandemic when resources are limited. Despite non-invasive ventilation providing effective respiratory support for some forms of acute respiratory failure, data about its effectiveness in patients with viral-related pneumonia are inconclusive. Acute respiratory distress syndrome caused by severe acute respiratory syndrome-coronavirus 2 infection causes life-threatening respiratory failure, weakening the lung parenchyma and increasing the risk of barotrauma. Pulmonary barotrauma results from positive pressure ventilation leading to elevated transalveolar pressure, and in turn to alveolar rupture and leakage of air into the extra-alveolar tissue. This article reviews the literature regarding the use of non-invasive ventilation in patients with acute respiratory failure associated with COVID-19 and other epidemic or pandemic viral infections and the related risk of barotrauma.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

scholarly journals Spontaneous Pneumomediastinum an Unusual Complication of Covid-19 Infection in a Non-intubated Patient With Diffuse Bilateral Ground-glass Opacity: A Case Report of Progression of Disease During Self-isolation

2021 ◽  
Vol 11 (2) ◽  
pp. 32679-32679
Author(s):  
Khosrow Agin ◽  
◽  
Tahereh Naghiloo ◽  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Bacterial Infections ◽  
Laboratory Finding ◽  
Ground Glass Opacity ◽  
Positive Pressure ◽  
Unusual Complication ◽  
Spontaneous Pneumomediastinum ◽  
Abnormal Laboratory Finding ◽  
Progression Of Disease

Background: Spontaneous pneumomediastinum or mediastinal emphysema is relatively a rare disease that occurs in viral and bacterial infections with the benign entity. Case: The patient was a 57-year-old man who, after a week of self-isolation at home, coming to the COVID-19 triage center of the hospital with severe shortness of breath. He was admitted to the Intensive Care Unit (ICU) due to acute respiratory failure. The patient was treated as the protocol designed and respiratory support with high flow nasal oxygen and Non-Invasive Positive Pressure Ventilation (NIPPV). Spontaneous pneumomediastinum was developed during viral pneumonia infection. The known risk factors included age, male sex, and abnormal laboratory finding. All the biochemical and hematological findings such as lymphopenia, thrombocytopenia, raised CRP, LDH, and ferritin were detected in our cases. They indicate a possible prognosis for the development of acute respiratory failure and adverse clinical outcomes. Conclusion: Spontaneous pneumomediastinum has usually a benign outcome in COVID-19 Pneumonia and its prognosis is related to background conditions in patients.

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