Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
Use of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2Cystic fibrosisCOPDChronic obstructive pulmonarydiseaseCPAPContinuous positive airway pressureETIEndotracheal intubationFEV1Flow expiratory volumeinthefirstsecondICƯIntensive care unitILDInterstitial lung diseaseLTLung transplantationNIVNoninvasive mechanicalventilation27.1 IntroductionLung transpla Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2ntation (LT) is a consolidated therapeutic strategy in cases of end-stage pulmonary diseases such as chronic obstructive pulmonary disease (COPD). difEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
fuse interstitial diseases, or vascular diseases. Noninvasive mechanical ventilation (NIV) is one of the ventilatory support techniques that has achieUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2care units, and recovery units. In this chapter. the role of NIV in the management of lung transplant patients in the pretransplant period, in the early postoperative period, and with LT complications, or to carry out diagnostic and therapeutic techniques in transplant patients, is reviewed.A. Herna Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2ndez Voth, MD (E3) • p Benavides Martas. MD • J. Sayas Catalan. MD Pulmonology Service. Hospital Universitario 12 de Octubre. Madrid. Spain e-mail: anEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
ahvoth@gmail.conv. pedrobenavides79@yahoo.es: jsayascat@gmail.com© Springer International Publishing Switzerland 2016213A.M. Esquinas (ed.). NoninvasiUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2et al.27.2Discussion and Analysis27.2.1NIV in LT Indication DiseasesMany candidates for LT have a chronic domiciliary .XIV indication as part of their underlying lung disease treatment. There is evidence of NIV benefit as a bridge to LT in two obstructive pathologies: COPD and cystic fibrosis (CF).C Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2OPD exacerbation is a situation where the use of NIV has a higher degree of evidence, particularly in severe exacerbations that develop respiratory acEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
idosis. These exacerbations are frequent in patients with COPD on the waiting list for LT, and NIV can decrease mortality in up to 50 % cases of COPD Use of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2of pharmacological treatments used in COPD exacerbations, and it has a high degree of evidence to be recommended.N1V usefulness in stable COPD is more controversial. In patients with chronic hypercapnic respiratory failure, several studies with contradictory results have been published. Some of them Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2 show a slight increase in survival of patients with COPD with hypercapnic respiratory insufficiency, whereas others have not found any differences inEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
terms of exacerbations or survival. Nevertheless, although there is no conclusive scientific evidence about its usefulness in stable COPD, it is one Use of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2parameter (an increase of 0.20±0.18 1 (liters) in FEV1) has been described, along with a small increase in survival while on the waiting list for LT [2]. However, these are limited data because of the absence of a control group and the presence of important selection bias in their results. Functiona Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2l improvement has been achieved in very severe COPD by using NI V prior to an oncologic thoracic surgery, which can be extrapolated to very severe COPEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
D patients on the wailing list for LT.NIV in CF patients has shown short-term improvement in oxygen saturation and in pCO2 levels, as well as a decreaUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2. When these patients have a severe exacerbation that requires ventilatory support, invasive mechanical ventilation has a bad prognosis associated with infectious complications from frequent bronchial colonization, as ventilator-associated pneumonia. As a bridge to LT. NIV in CF can reduce mortality Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2 from this cause.27.2.2NIV in the LT Early Postoperative PeriodGenerally, after thoracic surgery there are strong effects on respiratory function thatEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
relate to postoperative prolonged mechanical ventilation requirements. In the particular case of LT. there are also other associated factors: the usuUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2ive diaphragm involvement due to phrenic nerve damage.27 Use of Noninvasive Mechanical Ventilation in Lung Transplantation215NIV use has been considered in the LT early postoperative period with three major objectives: to facilitate early extubation, to prevent reintubation due to postsurgery ventil Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2atory failure, and to treat ventilatory failure once it is established [5].27.2.2.1 NIV as a Tool in Early ExtubationEarly extubation is of particularEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
interest in immunosuppressed patients to avoid infectious consequences of prolonged mechanical ventilation, but also to avoid airway complications. PUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2to bronchial anastomosis infection.Consequences of reintubation due to postsurgical ventilatory failure may result in a remarkable increase of mortality.Hypoxemia, hypercapnia and muscle fatigue due to an increase in breathing work are the most common causes of failed extubation. Furthermore, at the Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2 time of extubation, there is a loss of the intrathoracic positive pressure maintained so far. This induces hemodynamic changes, increasing venous retEbook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2
urn to the right ventricle, left cardiac septum displacement, and a possible increase in pulmonary artery pressure and pulmonary capillary wedge pressUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFC Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2 some degree of positive end-expiratory pressure can offset these effects, even applying ventilation in the noninvasive mode.NIV can represent a helpful tool in extubation of patients who do not succeed a T-tube trial. Thus, early weaning protocols have been developed in LT including epidural analge Ebook Noninvasive mechanical ventilation and difficult weaning in critical care: Part 2sia, early seating position, intensive physiotherapy, and NIV [6].Use of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFCUse of Noninvasive Mechanical Ventilation in Lung TransplantationAna Hernandez Voth, Pedro Benavides Manas, and Javier Sayas Catalan27AbbreviationsCFCGọi ngay
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