scholarly journals An Assessment Tool for Babies Requiring Continuous Positive Airway Pressure or High Flow

2016 ◽  
Vol 13 (01) ◽  
Author(s):  
Susan Lamburne
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Assessment Tool ◽  
Positive Airway Pressure ◽  
High Flow

scholarly journals Performance of EasyBreath Decathlon Snorkeling mask for delivering continuous positive airway pressure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alberto Noto ◽  
Claudia Crimi ◽  
Andrea Cortegiani ◽  
Massimiliano Giardina ◽  
Filippo Benedetto ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
High Performance ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Hospital Capacity ◽  
System Generator ◽  
Flow Generator ◽  
Full Face ◽  
Support Devices

AbstractDuring the COVID-19 pandemic, the need for noninvasive respiratory support devices has dramatically increased, sometimes exceeding hospital capacity. The full-face Decathlon snorkeling mask, EasyBreath (EB mask), has been adapted to deliver continuous positive airway pressure (CPAP) as an emergency respiratory interface. We aimed to assess the performance of this modified EB mask and to test its use during different gas mixture supplies. CPAP set at 5, 10, and 15 cmH2O was delivered to 10 healthy volunteers with a high-flow system generator set at 40, 80, and 120 L min−1 and with a turbine-driven ventilator during both spontaneous and loaded (resistor) breathing. Inspiratory CO2 partial pressure (PiCO2), pressure inside the mask, breathing pattern and electrical activity of the diaphragm (EAdi) were measured at all combinations of CPAP/flows delivered, with and without the resistor. Using the high-flow generator set at 40 L min−1, the PiCO2 significantly increased and the system was unable to maintain the target CPAP of 10 and 15 cmH2O and a stable pressure within the respiratory cycle; conversely, the turbine-driven ventilator did. EAdi significantly increased with flow rates of 40 and 80 L min−1 but not at 120 L min−1 and with the turbine-driven ventilator. EB mask can be safely used to deliver CPAP only under strict constraints, using either a high-flow generator at a flow rate greater than 80 L min−1, or a high-performance turbine-driven ventilator.

Bedeutung nicht-invasiver Verfahren in der Therapie des akuten hypoxämischen Versagens bei COVID-19

Pneumologie ◽  
2021 ◽  
Author(s):  
Wolfram Windisch ◽  
Bernd Schönhofer ◽  
Daniel Sebastian Majorski ◽  
Maximilian Wollsching-Strobel ◽  
Carl-Peter Criée ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Oxygen Therapy ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen ◽  
Invasive Verfahren

ZusammenfassungIn der Corona-Pandemie werden zunehmend nicht-invasive Verfahren zur Behandlung des akuten hypoxämischen Versagens bei COVID-19 eingesetzt. Hier stehen mit der HFOT (high-flow oxygen therapy), CPAP (continuous positive airway pressure) und der NIV (non-invasive ventilation) unterschiedliche Verfahren zur Verfügung, die das Ziel einer Intubationsvermeidung verfolgen. Der aktuelle Übersichtsartikel fasst die heterogene Studienlage zusammen. Wesentlich ist die Erkenntnis, dass diese nicht-invasiven Verfahren durchaus auch bei einem schweren, akuten hypoxämischen Versagen erfolgreich sein können und damit die Intubation wie auch Tubus-assoziierte Komplikationen vermeiden können. Demgegenüber bleibt aber ebenso zu betonen, dass die prolongierte unterstützte Spontanatmung ebenfalls zu Komplikationen führt und dass demzufolge insbesondere ein spätes NIV-Versagen mit erheblich verschlechterter Prognose einhergeht, was vor dem Hintergrund weiterhin hoher NIV-Versagensraten in Deutschland bedeutsam ist. Der aktuelle Artikel verweist schließlich auch auf einen Parallelartikel in dieser Ausgabe, der die medial in der Öffentlichkeit in Deutschland geführte Debatte zu diesem Thema aufgreift und deren inhaltliche Fragwürdigkeit, aber auch die negativen Auswirkungen auf die Gesellschaft und die Fachwelt adressiert. Gleichzeitig wird die Bedeutung von regelmäßig zu überarbeitenden Leitlinien untermauert.

scholarly journals FIRST-line support for assistance in breathing in children (FIRST-ABC): a master protocol of two randomised trials to evaluate the non-inferiority of high-flow nasal cannula (HFNC) versus continuous positive airway pressure (CPAP) for non-invasive respiratory support in paediatric critical care

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038002 ◽  
Author(s):  
Alvin Richards-Belle ◽  
Peter Davis ◽  
Laura Drikite ◽  
Richard Feltbower ◽  
Richard Grieve ◽  
...  
Keyword(s):  
Critical Care ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
First Line ◽  
Non Invasive ◽  
Paediatric Critical Care

IntroductionEven though respiratory support is a common intervention in paediatric critical care, there is no randomised controlled trial (RCT) evidence regarding the effectiveness of two commonly used modes of non-invasive respiratory support (NRS), continuous positive airway pressure (CPAP) and high-flow nasal cannula therapy (HFNC). FIRST-line support for assistance in breathing in children is a master protocol of two pragmatic non-inferiority RCTs to evaluate the clinical and cost-effectiveness of HFNC (compared with CPAP) as the first-line mode of support in critically ill children.Methods and analysisWe will recruit participants over a 30-month period at 25 UK paediatric critical care units (paediatric intensive care units/high-dependency units). Patients are eligible if admitted/accepted for admission, aged >36 weeks corrected gestational age and <16 years, and assessed by the treating clinician to require NRS for an acute illness (step-up RCT) or within 72 hours of extubation following a period of invasive ventilation (step-down RCT). Due to the emergency nature of the treatment, written informed consent will be deferred to after randomisation. Randomisation will occur 1:1 to CPAP or HFNC, stratified by site and age (<12 vs ≥12 months). The primary outcome is time to liberation from respiratory support for a continuous period of 48 hours. A total sample size of 600 patients in each RCT will provide 90% power with a type I error rate of 2.5% (one sided) to exclude the prespecified non-inferiority margin of HR of 0.75. Primary analyses will be undertaken separately in each RCT in both the intention-to-treat and per-protocol populations.Ethics and disseminationThis master protocol received favourable ethical opinion from National Health Service East of England—Cambridge South Research Ethics Committee (reference: 19/EE/0185) and approval from the Health Research Authority (reference: 260536). Results will be disseminated via publications in peer-reviewed medical journals and presentations at national and international conferences.Trial registration numberISRCTN60048867

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