Posts Tagged ‘arterial blood gas’

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (21)

Nevertheless, it remains quite possible that another technique, particularly PSV,* where the airway pressure mostly depends on the patients demand for air during the inspiratory time, would be better tolerated than AC-IPPV; in IPPV inspiration stops when a preset volume or pressure is reached; this feature can sometimes induce an active expiratory effort, which can […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (20)

It is therefore possible that by adding this extra amount of nurse/patient ratio for one or a few patients, a given ICU might become “saturated” and that the treatment of all patients in this ICU could be compromised; a superimposed ratio of around 0.20 may represent almost 50 percent of the average nursing task force […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (19)

There are few data on the amount of time spent by ICU teams with patients classically intubated and mechanically ventilated that we could use for comparison with the amount of extra work caused by acute NPPV; however, we know that stable ICU patients, assessed by TISS and APACHE 221 scores of 19.0 ± 6.7 and […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (18)

Today, we are faced with a scarcity of both experienced ICU nurses and financial resources, this being particularly crucial in North America, from what we can perceive from Europe; in recent years the average number of nursing hours for ICU patients has decreased drastically (ie, around 40 percent) for patients with a similar degree of […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (17)

Secondly, when the electromyographic activity of the diaphragm was recorded in a few acutely ill patients submitted to NPPV the mean amplitude of this signal decreased more in restrictive than in obstructive disease at a similar level of nasal mask pressure delivered by the respirator. It seems therefore that if one of the goals of […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (16)

Discussion Several elements of information can be derived from our study. First, NPPV is feasible in acute respiratory failure, when only the possibility of lowering an increased PaC02 is considered; however, in some patients, particularly the obstructive group, intubation appears to be ultimately unavoidable. It is unlikely that this technique will be considered as a […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (15)

In addition, the peak airway pressure recorded on the pressure monitor of the respirator was clearly higher in the “failure-obstructive” group than in the “success-restrictive” group (33 ±4 vs 22 ±6 cm H20, respectively) (p<0.05; unpaired f-test). In Table 4, it can be seen not only that the number of days during which NPPV could […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (14)

Results Considered as a group, all six patients suffered from severe respiratory impairment (mean FEVX <1L) and acute-on-chronic respiratory acidosis (mean FaC02, 9.8 kPa [74 mm Hg]) with a marked gas exchange abnormality (mean P[A-a]02, 11 kPa [82 mm Hg]) (Table 2). In all patients, it was possible to lower the PaC02 to some extent […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (13)

A classic monitoring ICU system was in use in all patients; an indwelling arterial catheter was inserted into the radial artery for continuous recording of arterial blood pressure and frequent blood gas analysis, the Sa02 was continuously monitored via pulse oximeter, and the ECG and respiratory rate were continuously recorded by classic means. A specialized […]

Nasal Positive Pressure Ventilation in Patients with Acute Respiratory Failure (12)

Techniques For NPPV, we used respirators specifically designed for chronic domiciliary nocturnal ventilation, a technique with which we are accustomed (ie, Bennett Companion 2000, Kontron ABT 4100, or Draeger EV 800). All of these ventilators were used in the same way: assist-control mode; without PEEP; and breathing frequency, tidal volume, inspiratory:expiratory time ratio, and “trigger” […]

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