Abstract:
BACKGROUND:Beneficial effects of high-flow nasal cannula (HFNC) oxygen on oxygenation and respiratory parameters have been reported in a small number of subjects with acute respiratory failure (ARF). We aimed to evaluate its effect in subjects with ARDS. METHODS:This was an observational single-center study. Prospectively obtained data were retrospectively analyzed. All patients admitted over 1 y to a university hospital medicosurgical ICU were included. Classification was according to the highest ventilatory support required. HFNC indications were reviewed, and demographics, clinical characteristics, and course of subjects with ARDS according to intubation need were compared. RESULTS:Of 607 subjects admitted, 560 required ventilatory or oxygen support, among whom 180 received noninvasive ventilatory support. HFNC was used in 87 subjects and as first-line treatment in 51 subjects (29% of first-line noninvasively treated subjects), 45 of which had ARDS (PaO2 /FIO2 of 137 mm Hg; 22 men, 57.9 y of age). Pneumonia accounted for 82% of ARDS causes. The intubation rate in these subjects was 40%. Higher Simplified Acute Physiology Score II (SAPS II; 46 vs 29, P=.001), occurrence of additional organ failure (76% vs 26%, P=.002), mainly hemodynamic (50% vs 7%, P=.001) or neurological (22% vs 0, P=.01), and trends toward lower PaO2 /FIO2 and higher breathing frequency after HFNC initiation were evidenced in subjects who failed HFNC. Higher SAPS II scores were associated with HFNC failure in multivariate analysis. CONCLUSIONS:In daily care, over one fourth of subjects requiring noninvasive ventilatory support were treated via HFNC, with a high success rate in subjects with severe ARDS. We conclude that HFNC may be considered as first-line therapy in ARF, including patients with ARDS.
journal_name
Respir Carejournal_title
Respiratory careauthors
Messika J,Ben Ahmed K,Gaudry S,Miguel-Montanes R,Rafat C,Sztrymf B,Dreyfuss D,Ricard JDdoi
10.4187/respcare.03423subject
Has Abstractpub_date
2015-02-01 00:00:00pages
162-9issue
2eissn
0020-1324issn
1943-3654pii
respcare.03423journal_volume
60pub_type
杂志文章相关文献
Respiratory Care文献大全abstract::In 2013, the United States Centers for Disease Control and Prevention redefined surveillance for quality of care in ventilated patients by shifting from ventilator-associated pneumonia (VAP) definitions to ventilator-associated event (VAE) definitions. VAE definitions were designed to overcome many of the limitations ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.07059
更新日期:2019-08-01 00:00:00
abstract::NOD is a common event in patients with symptomatic COPD who are not hypoxemic while awake. Up to 45% of these patients may have significant oxyhemoglobin desaturation during sleep, and most have evidence of pulmonary arterial hypertension. Although intuitively it would seem that supplemental oxygen during sleep should...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00
abstract:INTRODUCTION:There is a need to develop simple, noninvasive, and sensitive outcome measures for respiratory therapy. Adventitious respiratory sounds (ie, crackles and wheezes) can be objectively characterized with computerized respiratory sound analysis (CORSA) and have been shown to contribute for diagnosis purposes; ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.02765
更新日期:2014-05-01 00:00:00
abstract::An electronic literature search for articles published between January 1990 and October 2009 was conducted by using MEDLINE, CINAHL, and Cochrane Library databases. The update of this clinical practice guideline is the result of reviewing a total of 114 clinical trials, 62 reviews and 6 meta-analyses on endotracheal s...
journal_title:Respiratory care
pub_type: 杂志文章,实务指引
doi:
更新日期:2010-06-01 00:00:00
abstract:HYPOTHESIS:We hypothesized that aerosol distribution in the lungs of patients with cystic fibrosis changes with positive expiratory pressure (PEP). METHODS:Eight patients were randomized to one of 2 conditions. On one study day, patients inhaled saline aerosol containing 99mtechnetium generated by a Pari LC Plus nebul...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:In patients with COPD, early detection and rapid treatment are essential to prevent its progression and exacerbations. OBJECTIVE:To identify factors that delay COPD detection. METHODS:We conducted a cross-sectional study of elderly COPD patients and healthy subjects in rural Japan. We measured respiratory ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01109
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Many healthcare professionals performing spirometry in primary care have had less than half a day's training in spirometry practice, and the validity of the test results is questionable. Longer training periods, with or without follow-up training, may improve test validity. OBJECTIVE:To determine if a 14-ho...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Switching patients affected by early severe ARDS and undergoing extracorporeal membrane oxygenation (ECMO) from controlled ventilation to spontaneous breathing can be either beneficial or harmful, depending on how effectively the breathing pattern is controlled with ECMO. Identifying the factors associated w...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07391
更新日期:2020-07-01 00:00:00
abstract::The presence of bronchiectasis (BR) in patients with rheumatoid arthritis (RA) has been recognized for many decades; nevertheless, little research has been undertaken in this area. It is important to recognize that BR coexistent with RA differs from the other types of BR. The purpose of this descriptive review was to ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.01857
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The 2005 American Thoracic Society/European Respiratory Society guidelines on spirometry emphasize examination of the inspiratory curve of the flow-volume loop for evidence of intrathoracic or extrathoracic upper airway obstruction. We sought to determine how frequently evaluations are performed for abnormal...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Pneumoperitoneum and Trendelenburg position affect respiratory system mechanics and oxygenation during elective pelvic robotic surgery. The primary aim of this randomized pilot study was to compare the effects of a conventional low tidal volume ventilation with PEEP guided by gas exchange (VGas-guided) versu...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.07238
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The impulse oscillometry system (IOS) is increasingly used to evaluate lung function, but individual results must be compared with appropriate reference values. We aimed to obtain such reference values in Mexican children and adolescents. METHODS:Healthy subjects were recruited from kindergartens and school...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03374
更新日期:2015-01-01 00:00:00
abstract::Emerging antibiotic resistance has created a major public health dilemma, compounded by a dearth of new antibiotic options. Multidrug-resistant Gram-negative organisms have received less attention than Gram-positive threats, such as methicillin-resistant Staphylococcus aureus, but are just as menacing. Pathogens such ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Aspiration is a serious clinical concern in patients with long-term artificial airways. The purpose of this study was to determine the reliability of a bedside colored dye assessment of aspiration in tracheostomized patients and to determine its comparability to a more sophisticated videofluoroscopic study. ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Dynamic airway resistance from obstructive disease causes a concavity in the mid-expiratory portion of the spirometric flow-volume loop. We developed a simple model to measure the exponential decay in air flow during forced exhalation to quantify the extent of dynamic airway obstruction and facilitate the de...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04850
更新日期:2017-07-01 00:00:00
abstract::The role of the respiratory therapist (RT) is expanding with the growing acceptance and use of the disease-management paradigm for managing chronic diseases. RTs are key members of the asthma disease-management team, in acute-care settings, patients' homes, out-patient clinics, emergency departments, and in the commun...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2008-06-01 00:00:00
abstract::Congenital parenchymal lung malformations have an estimated incidence at 1:25,000-1:35,000 births. We present a case of this rare congenital abnormality in a 38 year-old male, review the current literature with discussion of proposed causes, malignant potential, and management strategies. A 38-year-old white male pre...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.00727
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Spirometry is important for the differential diagnosis of dyspnea. However, some patients cannot exhale for ≥6 s to achieve the American Thoracic Society/European Respiratory Society criteria. The aim of this study was to demonstrate the reliability of a new parameter that quantifies the degree of concavity ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05016
更新日期:2017-03-01 00:00:00
abstract:INTRODUCTION:We investigated whether decreasing ventilator circuit changes from every 2 days to every 7 days would impact ventilator-associated pneumonia rates at our institution. METHODS:All mechanically ventilated patients at Peking Union Medical College Hospital were studied over a 21 month period. From March 1998 ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::As hospitals begin to implement electronic medical records, the inadequacies of legacy paper charting systems will become more evident. One area of particular concern for respiratory therapists is the charting of mechanical ventilator settings. Our profession's lack of a standardized and generally accepted taxonomy fo...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Blow-by, a common form of nebulizer therapy, in which the device is held away from a child's face, has been dismissed as ineffective because studies have demonstrated incremental aerosol drop-off with increasing distances from the face. Many of these studies do not take into account differences among nebuliz...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01653
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Field walking tests are commonly used in patients with chronic pulmonary diseases for assessment of functional capacity. However, the physiological demands and magnitude of desaturation on 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) have not been inves...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07171
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Patterns of pulmonary function tests (PFTs) and flow-volume loops among patients with clinically important tracheobronchomalacia (TBM) are not well described. Small studies suggest 4 main flow-volume loop morphologies: low maximum forced expiratory flow, biphasic expiratory curve, flow oscillations, and notc...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02277
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Inhaled sedation is efficient and easily controllable; in low concentrations it causes minimal changes in the patient and very little interference with hemodynamics. Awakening after inhaled sedation is quick and predictable. The major reason inhaled sedation has not become widely used in intensive care is th...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Health-care providers often diagnose and empirically treat COPD without a confirmative pulmonary function test (PFT) or even despite a PFT that is not diagnostic of obstructive lung disease. We hypothesized that a portion of patients continue to carry a persistent empiric COPD diagnosis and receive treatment...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04647
更新日期:2016-09-01 00:00:00
abstract::Emergency ventilation techniques used during CPR have been refined over the last 40 years. The methods and equipment for emergency ventilation all have their advantages and disadvantages (Table 5), and the appropriate technique varies with the training and experience of the rescuer. Problems encountered during CPR wit...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:1992-07-01 00:00:00
abstract:INTRODUCTION:Electrostatic attraction of aerosolized particles to the inner walls of an aerosol holding chamber (HC) made from a nonconducting material can reduce medication delivery, particularly if there is a delay between actuation and inhalation. OBJECTIVE:Compare total emitted mass and fine-particle mass (mass of...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2006-05-01 00:00:00
abstract::We describe a unique presentation of polymyositis-associated pneumonitis. A 45-year-old man with a history of polymyositis presented with an episode of fever, cough, dyspnea, rapidly progressive respiratory failure, and unilateral pulmonary infiltrates. Although bacterial pneumonia was initially suspected, all culture...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2007-12-01 00:00:00
abstract::Gorham syndrome is a rare disease that presents as progressive osteolysis, and may affect any part of the skeleton. The pathologic process involves the replacement of normal bone by aggressively expanding but non-neoplastic vascular tissue, resulting in massive osteolysis of the adjacent bone. If the spine and ribs ar...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02355
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Patients with Guillain-Barré syndrome are commonly exposed to prolonged mechanical ventilation. Specific data on ventilatory management of these patients have been limited. OBJECTIVE:To describe the practice of mechanical ventilation in patients with Guillain-Barré syndrome and evaluate risk factors for mor...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2006-12-01 00:00:00