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    1 OF 127

    Noninvasive estimation of alveolar pressure.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2721-2724
    This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation. Read More

    Noninvasive health condition monitoring device for workers at high altitudes conditions.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2349-2352
    This work presents the design and implementation of a continuous monitoring device to control the health state of workers, for instance miners, at high altitudes. The extreme ambient conditions are harmful for peoples' health; therefore a continuous control of the workers' vital signs is necessary. The developed system includes physiological variables: electrocardiogram (ECG), respiratory activity and body temperature (BT), and ambient variables: ambient temperature (AT) and relative humidity (RH). Read More

    Pediatric asthma severity score is associated with critical care interventions.
    World J Clin Pediatr 2017 Feb 8;6(1):34-39. Epub 2017 Feb 8.
    Danielle K Maue, Courtney M Rowan, Department of Pediatric Critical Care, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
    Aim: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU).

    Methods: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. Read More

    The Role of Heated Humidified High-flow Nasal Cannula as Noninvasive Respiratory Support in Neonates.
    Pediatr Neonatol 2017 Jan 17. Epub 2017 Jan 17.
    Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, Taipei, Taiwan. Electronic address:
    Recently, heated humidified high-flow nasal cannula (HHHFNC) has been introduced and applied as a noninvasive respiratory support in neonates. Although HHHFNC is widely used in neonates presenting with respiratory distress, the efficiency and safety when compared with nasal continuous positive airway pressure or noninvasive positive pressure ventilation are still controversial. This review aims to evaluate the performance and applications of HHHFNC in neonates. Read More

    Esogastric pressure measurement to assist noninvasive ventilation indication and settings in infants with hypercapnic respiratory failure: A pilot study.
    Pediatr Pulmonol 2017 Feb 21. Epub 2017 Feb 21.
    INSERM U 955, Equipe 13, 8 rue du Général Sarrail, Créteil, France.
    Objective: Noninvasive ventilation (NIV) in usually set on clinical parameters. The aim of the study was to assess the value of esophageal (PES ) and gastric pressure (PGAS ) measurements for the indication and optimal settings of NIV in infants with hypercapnic respiratory failure in whom the efficacy of NIV was uncertain on clinical noninvasive parameters.

    Design: A retrospective study. Read More

    Interventional pulmonology in chronic obstructive pulmonary disease.
    Curr Opin Pulm Med 2017 Feb 17. Epub 2017 Feb 17.
    aDepartment of Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg bCenter for Lung Research, Heidelberg, Germany.
    Purpose Of Review: Chronic obstructive pulmonary disease (COPD) and emphysema are widespread diseases associated with progressive dyspnea because of airflow limitation and hyperinflation. Fundamental therapeutic strategies consist of pulmonary rehabilitation, pharmacotherapy, long-term oxygen therapy, noninvasive ventilation, and surgical therapeutic approaches.

    Recent Findings: In the last 14 years, endoscopic therapeutic modalities emerged as a substantial part of severe COPD and emphysema treatment. Read More

    Noninvasive detection of alarming intracranial pressure changes by auditory monitoring in early management of brain injury: a prospective invasive versus noninvasive study.
    Crit Care 2017 Feb 21;21(1):35. Epub 2017 Feb 21.
    University Clermont Auvergne, Laboratory of Neurosensory Biophysics, UMR INSERM 1107, Clermont-Ferrand, France.
    Background: In brain-injured patients intracranial pressure (ICP) is monitored invasively by a ventricular or intraparenchymal transducer. The procedure requires specific expertise and exposes the patient to complications such as malposition, hemorrhage or infection. As inner-ear fluid compartments are connected to the cerebrospinal fluid space, ICP changes elicit subtle changes in the physiology of the inner ear. Read More

    Noninvasivepositive pressure ventilation vsinvasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure in cancer patients.
    J Crit Care 2017 Jan 20;39:56-61. Epub 2017 Jan 20.
    Department of Critical Care, University of Texas MD Anderson Cancer Center, Houston, TX.
    Purpose: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure.

    Material And Methods: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure.

    Results: Of the 1614 patients included, the NIPPV failure group had the greatest hospital length of stay, ICU length of stay, ICU mortality (71. Read More

    My night on call in Poland.
    Breathe (Sheff) 2016 Sep;12(3):291-292
    Uniwersyteckie Centrum Kliniczne im prof. Kornela Gibińskiego Śląskiego Uniwersytetu Medycznego, Katowice, Poland.
    I am a young doctor who graduated from the Medical University of Silesia in 2014. After 13 months of postgraduate training, passing a state examination and successful completion of the admission process I made a decision to specialise in Respiratory Medicine. I started working in a large clinical hospital that provides junior doctors with excellent opportunities for training and career development. Read More

    Emergency Department Initiated Home Oxygen for Bronchiolitis: A Prospective Study of Community Follow-up, Caregiver Satisfaction and Outcomes.
    Acad Emerg Med 2017 Feb 16. Epub 2017 Feb 16.
    University of Colorado Denver, Department of Pediatrics, Section of Emergency Medicine.
    Objective: Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences.

    Methods: This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014). Read More

    Medication Reconciliation Failures in Children and Young Adults With Chronic Disease During Intensive and Intermediate Care.
    Pediatr Crit Care Med 2017 Feb 14. Epub 2017 Feb 14.
    1Department of Medicine, Boston Children's Hospital, Boston, MA. 2Department of Pharmacy, Boston Children's Hospital, Boston, MA. 3Center for Patient Safety and Quality Research, Boston Children's Hospital, Boston, MA. 4Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA.
    Objectives: Although medication reconciliation has become standard during hospital admission, rates of unintentional medication discrepancies during intensive care of pediatric patients with chronic disease are unknown. Such discrepancies are an important cause of adverse drug events in adults with chronic illness and are associated with unintentional discontinuation of chronic medications. We sought to determine the rate, type, timing, and predictors of potentially harmful unintentional medication discrepancies in children and young adults with chronic disease. Read More

    Mechanical Ventilation, Weaning Practices, and Decision Making in European PICUs.
    Pediatr Crit Care Med 2017 Feb 14. Epub 2017 Feb 14.
    1University of Central Lancashire, College of Health and Wellbeing, Preston, United Kingdom. 2PICU, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom. 3Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, The University of Groningen, Groningen, The Netherlands. 4Critical Care, Anaesthesiology, Peri-operative and Emergency medicine (CAPE), The University of Groningen, Groningen, The Netherlands. 5Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland. 6Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 7Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. 8Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 9Provincial Centre of Weaning Excellence, Toronto East General Hospital, Toronto, ON, Canada.
    Objectives: This survey had three key objectives: 1) To describe responsibility for key ventilation and weaning decisions in European PICUs and explore variations across Europe; 2) To describe the use of protocols, spontaneous breathing trials, noninvasive ventilation, high-flow nasal cannula use, and automated weaning systems; and 3) To describe nurse-to-patient staffing ratios and perceived nursing autonomy and influence over ventilation decision making.

    Design: Cross-sectional electronic survey.

    Setting: European PICUs. Read More

    IL-8 predicts early mortality in patients with acute hypercapnic respiratory failure treated with noninvasive positive pressure ventilation.
    BMC Pulm Med 2017 Feb 8;17(1):35. Epub 2017 Feb 8.
    The Department of Clinical Sciences Malmo, Faculty of Medicine, Lund University, Lund, Sweden.
    Background: Patients with Acute Hypercapnic Respiratory Failure (AHRF) who are unresponsive to appropriate medical treatment, are often treated with Noninvasive Positive Pressure Ventilation (NPPV). Clinical predictors of the outcome of this treatment are scarce. Therefore, we evaluated the role of the biomarkers IL-8 and GDF-15 in predicting 28-day mortality in patients with AHRF who receive treatment with NPPV. Read More

    Sequential PET estimation of cerebral oxygen metabolism with spontaneous respiration of (15)O-gas in mice with bilateral common carotid artery stenosis.
    J Cereb Blood Flow Metab 2017 Jan 1:271678X17692815. Epub 2017 Jan 1.
    1 Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, Japan.
    Positron emission tomography with (15)O-labeled gases ((15)O-PET) is important for in vivo measurement of cerebral oxygen metabolism both in clinical and basic settings. However, there are currently no reports concerning (15)O-PET in mice. Here, we developed an (15)O-PET method applicable to mice with spontaneous respiration of (15)O-gas without a tracheotomy catheter. Read More

    Social and Economic Impacts of Managing Sleep Hypoventilation Syndromes.
    Sleep Med Clin 2017 Mar 23;12(1):87-98. Epub 2016 Dec 23.
    Department of Medicine, Center for Sleep Medicine, Weill Cornell Medical College, Cornell University, 425 East 61st Street, 5th Floor, New York, NY 10065, USA.
    Hypoventilation during sleep is often an early indicator of the development of respiratory failure. Alterations in ventilation are more pronounced during sleep and often present before the onset of daytime symptoms. This article discusses the most common sleep-related hypoventilatory disorders and recommended treatment approaches for obesity hypoventilation, chronic obstructive pulmonary disease, and neuromuscular disorders. Read More

    Sympathetic crashing acute pulmonary edema.
    Indian J Crit Care Med 2016 Dec;20(12):719-723
    Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.
    Sympathetic crashing acute pulmonary edema (SCAPE) is the extreme end of the spectrum of acute pulmonary edema. It is important to understand this disease as it is relatively common in the emergency department (ED) and has better outcomes when managed appropriately. The patients have an abrupt redistribution of fluid in the lungs, and when treated promptly and effectively, these patients will rapidly recover. Read More

    Evaluation of carbon dioxide rebreathing during exercise assisted by noninvasive ventilation with plateau exhalation valve.
    Int J Chron Obstruct Pulmon Dis 2017 16;12:291-298. Epub 2017 Jan 16.
    State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.
    Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29. Read More

    Respiratory viruses in acute exacerbations of chronic obstructive pulmonary disease.
    Lung India 2017 Jan-Feb;34(1):29-33
    National Institute of Virology, Pune, Maharashtra, India.
    Objective: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) cause significant morbidity, mortality, and an inexorable decline of lung function. Data from developed countries have shown viruses to be important causes of AECOPD, but data from developing countries like India are scant. We set out to determine the contribution of viruses in the causation of hospitalized patients with AECOPD. Read More

    Noninvasive Ventilation in Patients With Hematologic Malignancy.
    J Intensive Care Med 2017 Jan 1:885066617690725. Epub 2017 Jan 1.
    3 Interdepartmental Division of Critical Care Medicine, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
    Introduction: Noninvasive ventilation (NIV) is commonly used as first-line therapy for immunocompromised patients with acute respiratory failure. However, it may not be appropriate for all patients, as failure of NIV and delayed endotracheal intubation (ETI) may increase mortality. We report our center's experience and outcomes for patients with active hematologic malignancy (HM) treated with NIV. Read More

    Noninvasive ventilation for acute exacerbations of asthma: A systematic review of the literature.
    Aust Crit Care 2017 Jan 27. Epub 2017 Jan 27.
    School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Boorooma St, Locked Bag 588, Wagga Wagga, NSW, 2678, Australia.
    Background: Asthma is a chronic disease characterised by reversible airway obstruction caused by bronchospasm, mucous and oedema. People with asthma commonly experience acute exacerbations of their disease requiring hospitalisation and subsequent utilisation of economic and healthcare resources. Noninvasive ventilation has been suggested as a treatment for acute exacerbations of asthma due to its ability to provide airway stenting, optimal oxygen delivery and decreased work of breathing. Read More

    Respiratory muscle activity and patient-ventilator asynchrony during different settings of noninvasive ventilation in stable hypercapnic COPD: does high inspiratory pressure lead to respiratory muscle unloading?
    Int J Chron Obstruct Pulmon Dis 2017 11;12:243-257. Epub 2017 Jan 11.
    Department of Pulmonary Diseases and Home Mechanical Ventilation, University Medical Centre Groningen.
    Introduction: High-intensity noninvasive ventilation (NIV) has been shown to improve outcomes in stable chronic obstructive pulmonary disease patients. However, there is insufficient knowledge about whether with this more controlled ventilatory mode optimal respiratory muscle unloading is provided without an increase in patient-ventilator asynchrony (PVA).

    Patients And Methods: Ten chronic obstructive pulmonary disease patients on home mechanical ventilation were included. Read More

    High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study).
    Intensive Care Med 2017 Feb 26;43(2):209-216. Epub 2017 Jan 26.
    Pediatric Intensive Care Unit, Département de Pédiatrie Néonatale et Réanimations, CHU de Montpellier, Arnaud de Villeneuve University Hospital, 371 Avenue du Doyen G. Giraud, 34295, Montpellier Cedex 5, France.
    Purpose: Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute viral bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants.

    Methods: A randomized controlled trial was performed in five pediatric intensive care units (PICUs) to compare 7 cmH2O nCPAP with 2 L/kg/min oxygen therapy administered with HFNC in infants up to 6 months old with moderate to severe AVB. Read More

    Noninvasive Ventilation For Patients In Acute Respiratory Distress: An Update.
    Emerg Med Pract 2017 Feb 1;19(2):1-20. Epub 2017 Feb 1.
    Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA.
    Over the last 20 years, noninvasive ventilation (NIV) strategies have been used with increasing frequency. The ease of use of NIV makes it applicable to patients presenting in a variety of types of respiratory distress. In this review, the physiology of positive pressure ventilation is discussed, including indications, contraindications, and options for mask type and fit. Read More

    Mouthpiece ventilation in Duchenne muscular dystrophy: a rescue strategy for noncompliant patients.
    J Bras Pneumol 2016 Nov-Dec;42(6):453-456
    . Unidad de Terapia Intensiva, Hospital General Morales Meseguer, Murcia, España.
    Objective:: To evaluate mouthpiece ventilation (MPV) in patients with Duchenne muscular dystrophy (DMD) who are noncompliant with noninvasive ventilation (NIV).

    Methods:: We evaluated four young patients with DMD who had previously refused to undergo NIV. Each patient was reassessed and encouraged to try MPV. Read More

    Successful tracheostomy decannulation after complete or sensory incomplete cervical spinal cord injury.
    Spinal Cord 2017 Jan 24. Epub 2017 Jan 24.
    Department of Rehabilitation Medicine, Pulmonary Rehabilitation Center, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea.
    Study Design: Retrospective study.

    Objectives: To report the successful tracheostomy decannulation/extubation in cervical spinal cord injury (C-SCI) patients.

    Setting: Tertiary university hospital, pulmonary rehabilitation center. Read More

    Oxygen therapy devices and portable ventilators for improved physical activity in daily life in patients with chronic respiratory disease.
    Expert Rev Med Devices 2017 Feb 31;14(2):103-115. Epub 2017 Jan 31.
    a Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy , Universidade Estadual de Londrina (UEL) , Londrina , Brazil.
    Introduction: Patients with hypoxemia and chronic respiratory failure may need to use oxygen therapy to correct hypoxemia and to use ventilatory support to augment alveolar ventilation, reverse abnormalities in blood gases (in particular hypercapnia) and reduce the work of breathing. Areas covered: This narrative review provides an overview on the use of oxygen therapy devices or portable ventilators for improved physical activity in daily life (PADL) as well as discusses the issue of lower mobility in daily life among stable patients with chronic respiratory disease who present indication for long-term oxygen therapy (LTOT) or home-based noninvasive ventilation (NIV). A literature review of these concepts was performed by using all related search terms. Read More

    Risk factors for noninvasive ventilation failure in patients with acute cardiogenic pulmonary edema: A prospective, observational cohort study.
    J Crit Care 2017 Jan 6. Epub 2017 Jan 6.
    Department of Respiratory and Critical Care Medicine, Beijing Engineering Research Center of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, 5 Jingyuan Road, Shijingshan District, Beijing 100043, China. Electronic address:
    Purpose: We identified risk factors for noninvasive ventilation (NIV) failure in patients with acute cardiogenic pulmonary edema (ACPE).

    Materials And Methods: We conducted an observational cohort study over a 3-year period in a 28-bed emergency intensive care unit (EICU) and prospectively included all consecutive patients in whom NIV was attempted as initial ventilatory support for ACPE. The primary outcome variables were NIV failure rate and risk factors for NIV failure. Read More

    Efficacy of High-Flow Nasal Cannula Therapy in Intensive Care Units.
    J Intensive Care Med 2017 Jan 1:885066616689043. Epub 2017 Jan 1.
    1 Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA.
    Purpose: We conducted a meta-analysis to compare the physiological and clinical outcomes of high-flow nasal cannula (HFNC) with standard oxygen (O2) or conventional noninvasive ventilation (NIV) in intensive care units (ICUs).

    Procedures: We selected the full-text prospective studies comparing HFNC with standard O2 or NIV in ICU. The continuous variables were analyzed with sample size-adjusted pooled t test. Read More

    Ability of ICU Health-Care Professionals to Identify Patient-Ventilator Asynchrony Using Waveform Analysis.
    Respir Care 2017 Feb 25;62(2):144-149. Epub 2016 Oct 25.
    Department of Respiratory Care, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas.
    Background: Waveform analysis by visual inspection can be a reliable, noninvasive, and useful tool for detecting patient-ventilator asynchrony. However, it is a skill that requires a properly trained professional.

    Methods: This observational study was conducted in 17 urban ICUs. Read More

    What prevents critically ill patients with respiratory failure from using non-invasive positive pressure ventilation: A mixed-methods study.
    Jpn J Nurs Sci 2017 Jan 20. Epub 2017 Jan 20.
    Internal Medicine, St. Luke's International Hospital, Tokyo, Japan.
    Aim: To identify the factors that prevent patients in respiratory failure from using noninvasive positive pressure ventilation (NPPV). The following were evaluated: (i) the patients who converted from NPPV to endotracheal intubation; and (ii) the patients who abandoned NPPV.

    Methods: Patients were interviewed regarding their experience with NPPV. Read More

    Vocal Cord Palsy in Children With Cancer: A 10-Year Analysis of UK Pediatric Intensive Care Admissions.
    J Pediatr Hematol Oncol 2017 Jan 17. Epub 2017 Jan 17.
    *Cancer Section, UCL Great Ormond Street Institute of Child Health †Department of Ears, Nose and Throat, Northwick Park Hospital Departments of ‡Ears, Nose and Throat §Paediatric Intensive Care, St. George's University Hospitals NHS Foundation Trust, London ∥The Royal Marsden NHS Foundation Trust, Sutton ¶Department of Paediatric Oncology and Haematology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
    Vocal cord palsy (VCP) is a rare but potentially life-threatening complication in children with cancer. This study reviews UK Intensive Care admissions for children with cancer and VCP using data obtained from the Pediatric Intensive Care Audit Network (PICANet) database. 26 children with cancer and VCP were admitted to intensive care from 2002 to 2012. Read More

    Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature.
    J Anaesthesiol Clin Pharmacol 2016 Oct-Dec;32(4):431-439
    Department of Anaesthesiology and Critical Care, All Institute of Medical Sciences, Jodhpur, Rajasthan, India.
    Physiological changes of pregnancy imposes higher risk of acute respiratory failure (ARF) with even a slight insult and remains an important cause of maternal and fetal morbidity and mortality. Although pregnant women have different respiratory physiology and different causes of ARF, guidelines specific to ventilatory settings, goals of oxygenation and weaning process could not be framed due to lack of large-scale randomized controlled trials. During the 2009 H1N1 pandemic, pregnant women had higher morbidity and mortality compared to nonpregnant women. Read More

    Paediatric ED BiPAP continuous quality improvement programme with patient analysis: 2005-2013.
    BMJ Open 2017 Jan 16;7(1):e011845. Epub 2017 Jan 16.
    Department of Pediatrics, University of Arkansas School of Medicine.
    Objective: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Read More

    Can high-flow nasal cannula reduce the rate of endotracheal intubation in adult patients with acute respiratory failure compared with conventional oxygen therapy and noninvasive positive pressure ventilation? A systematic review and meta-analysis.
    Chest 2017 Jan 13. Epub 2017 Jan 13.
    Department of Respiratory and Critical Care medicine. Electronic address:
    Background: The effects of high flow nasal cannula (HFNC) on adult patients with acute respiratory failure (ARF) are controversial. We aimed to further determine the effectiveness of HFNC in reducing the rate of endotracheal intubation in adult patients with ARF by comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT).

    Methods: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled studies that compared HFNC with NIPPV and COT in adult patients having ARF. Read More

    Monitoring Noninvasive Ventilation in Patients with Obesity Hypoventilation Syndrome: Comparison between Ventilator Built-in Software and Respiratory Polygraphy.
    Respiration 2017 14;93(3):162-169. Epub 2017 Jan 14.
    Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
    Background: Polygraphy (PG) remains the standard method of assessing noninvasive ventilation (NIV) effectiveness. Built-in software (BIS) of recent NIV equipment provides estimates of some ventilator parameters, but their usefulness is unclear.

    Objectives: To assess the reliability of BIS compared with PG in a cohort of obesity hypoventilation syndrome (OHS) patients on NIV. Read More

    Cardiovascular Events in Moderately to Severely Obese Obstructive Sleep Apnea Patients on Positive Airway Pressure Therapy.
    Respiration 2017 13;93(3):179-188. Epub 2017 Jan 13.
    Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy.
    Background: In moderately to severely obese patients with obstructive sleep apnea (OSA), the effects of long-term positive airway pressure (PAP) treatment on cardiovascular risk are poorly defined.

    Purpose: To assess the effect of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) on the occurrence of cardiovascular events in obese OSA patients.

    Methods: We performed a noninterventional observational study in obese OSA patients recruited between 2007 and 2010 at the Sleep Center, University of Grenoble, treated with CPAP or NIV, and followed for 5. Read More

    Aerosol Drug Delivery During Noninvasive Positive Pressure Ventilation: Effects of Intersubject Variability and Excipient Enhanced Growth.
    J Aerosol Med Pulm Drug Deliv 2017 Jan 11. Epub 2017 Jan 11.
    2 Department of Pharmaceutics, Virginia Commonwealth University , Richmond, Virginia.
    Background: Nebulized aerosol drug delivery during the administration of noninvasive positive pressure ventilation (NPPV) is commonly implemented. While studies have shown improved patient outcomes for this therapeutic approach, aerosol delivery efficiency is reported to be low with high variability in lung-deposited dose. Excipient enhanced growth (EEG) aerosol delivery is a newly proposed technique that may improve drug delivery efficiency and reduce intersubject aerosol delivery variability when coupled with NPPV. Read More

    Delirium after cardiac surgery: A pilot study from a single tertiary referral center.
    Ann Card Anaesth 2017 Jan-Mar;20(1):76-82
    Department of Anaesthesia, Postgraduate Institute for Medical Education and Research, Chandigarh, India.
    Background: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. Read More

    Relationship between polycythemia and in-hospital mortality in chronic obstructive pulmonary disease patients with low-risk pulmonary embolism.
    J Thorac Dis 2016 Nov;8(11):3119-3131
    Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China.
    Backgrounds: Pulmonary embolism (PE) is frequent in subjects with chronic obstructive pulmonary disease (COPD) and associated with high mortality. This multi-center retrospective study was performed to investigate if secondary polycythemia is associated with in-hospital mortality in COPD patients with low-risk PE.

    Methods: We identified COPD patients with proven PE between October, 2005 and October, 2015. Read More

    Use of noninvasive ventilation in immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis.
    Crit Care 2017 Jan 7;21(1). Epub 2017 Jan 7.
    Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
    Background: Acute respiratory failure (ARF) remains a common hazardous complication in immunocompromised patients and is associated with increased mortality rates when endotracheal intubation is needed. We aimed to evaluate the effect of early noninvasive ventilation (NIV) compared with oxygen therapy alone in this patient population.

    Methods: We searched for relevant studies in MEDLINE, EMBASE, and the Cochrane database up to 25 July 2016. Read More

    Hemodynamic monitoring in thoracic surgical patients.
    Curr Opin Anaesthesiol 2017 Jan 3. Epub 2017 Jan 3.
    Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA.
    Purpose Of Review: This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population.

    Recent Findings: Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics. Strong clinical outcomes data support the use of these devices in patients undergoing major surgical procedures although these studies generally do not target thoracic surgical procedures specifically. Read More

    Noninvasive ventilation during the weaning process in chronically critically ill patients.
    ERJ Open Res 2016 Oct 28;2(4). Epub 2016 Oct 28.
    Servicio de Neumología, Hospital San Pedro Alcántara, Cáceres, Spain; Centro de Investigación Biomédica de Enfermedades Respiratorias (CIBERES), University Carlos III, Madrid, Spain.
    Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process. Read More

    Electromagnetic inductance plethysmography is well suited to measure tidal breathing in infants.
    ERJ Open Res 2016 Oct 24;2(4). Epub 2016 Nov 24.
    Dept of Pediatrics, Haukeland University Hospital, Bergen, Norway; Dept of Clinical Science, Faculty of Medicine and Odontology, University of Bergen, Bergen, Norway.
    Reliable, accurate and noninvasive methods for measuring lung function in infants are desirable. Electromagnetic inductance plethysmography has been used to perform infant spirometry and VoluSense Pediatrics (VSP) (VoluSense, Bergen, Norway) represents an updated version of this technique. We aimed to examine its accuracy compared to a validated system measuring airflow via a facemask using an ultrasonic flowmeter. Read More

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