Critical care in the emergency department: acute respiratory failure

Née, Patrick; Al-Jubouri, Mohammad; Gray, Alasdair; O'Donnell, C; Strong, Dan

doi:10.1136/emj.2005.030643

Cited by 13 publications

(8 citation statements)

References 28 publications

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“…Data of patients affected by severe ARF observed at our Intensive Care Unit (ICU) from January 2004 to December 2013 were retrospectively reviewed. Failure of oxygenation, carbon dioxide clearance, or both of these, associated with an increase plasma hydrogen ions concentration (pH < 7.30) were considered as the main ARF diagnostic criteria [21,22]. In every case severe ARF following thyroid surgery with failed extubation on awakening from anaesthesia and need of tracheal reintubation was the admission diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Nasotracheal prolonged safe extubation in acute respiratory failure post-thyroidectomy: An efficacious technique to avoid tracheotomy? A retrospective analysis of a large case series

Ferraro

Gambardella

Testa

et al. 2017

International Journal of Surgery

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Section: Methodsmentioning

confidence: 99%

Nasotracheal prolonged safe extubation in acute respiratory failure post-thyroidectomy: An efficacious technique to avoid tracheotomy? A retrospective analysis of a large case series

Ferraro

Gambardella

Testa

et al. 2017

International Journal of Surgery

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“…LRN impairment was diagnosed by laryngoscopy. Failure of oxygenation, carbon dioxide clearance, or both of these, associated with an increase in hydrogen ion concentration in the plasma (pH<7.30) were considered as acute respiratory failure [16,17]. Each patient was treated by PSE; if ARF did not recover after the 4 th endoscopic check (8 days), a tracheotomy was placed.…”

Section: Methodsmentioning

confidence: 99%

Nasotracheal Prolonged Safe Extubation Reduces the Need of Tracheotomy in Patients with Acute Respiratory Failure following Thyroidectomy

Ferraro¹

2014

J Anesth Clin Res

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Objectives: Acute respiratory failure (ARF) is a complication following thyroid surgery; its incidence is reported as high as 0.9%. Through an illustrative case series, we present an alternative treatment of this peculiar ARF: the nasotracheal Prolonged Safe Extubation (PSE). Methods:Patients treated at our Intensive Care Unit for ARF following thyroid surgery from January 2004 to December 2009, were reviewed. Demographic data including gender, age, clinical presentation, laryngoscopic findings, management and outcome during a 24-months follow-up after treatment were collected and evaluated. The strategy for prolonged nasotracheal safe extubation is presented.Results: Twelve out of the 1713 patients scheduled for thyroid surgery (0.7%) at our university hospital, developed post-operative ARF. All of them were treated by nasotracheal prolonged safe extubation. The success rate in avoiding highly invasive treatment was of 83.3%, since only 2 patients needed tracheotomy (16.7%). Conclusions:The prolonged safe extubation reduced the amount of expected tracheotomies in patients with ARF following thyroid surgery. Thanks to its minimal invasiveness, and to the high degree of comfort, it was well tolerated.

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“…spezialisierten Beatmungsein-heiten. Einige Untersuchungen zeigen aber, dass ein früher Einsatz bereits in der Notaufnahme oder sogar präklinisch auf dem Notarztwagen möglich und e ektiv ist [12,13]. Dementsprechend stehen entsprechende Beatmungsgeräte, mit denen eine NIV durchgeführt werden kann, auf vielen Einsatzfahrzeugen bereits zur Verfügung.…”

Section: Praktische Und Technische Aspekte Der Nivunclassified

Nicht invasive Beatmung

Budweiser¹

2015

Pneumo News

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Die nicht invasive Positivdruck-Beatmung hat in den letzten Jahren eine dynamische Entwicklung vollzogen. Dies betrifft sowohl den Einsatz in der Akut-bzw. Intensivmedizin als auch die außerklinische Beatmung. Dieser Artikel gibt den aktuellen Stand wieder, stellt aber neuere Aspekte, auch aus der kürzlich erschienenen S3-Leitlinie zur akuten respiratorischen Insuffizienz, in den Vordergrund. Pathophysiologie und Therapieprinzipien der respiratorischen InsuffizienzFunktionell betrachtet besteht das respiratorische System aus dem Organ Lunge, als der eigentlichen gasaustauschenden Funktionseinheit, und der sogenannten Atempumpe (Atemzentrum, Nerven, oraxwand und Atemmuskulatur), welche die Ventilation gewährleistet. Während eine isolierte Störung auf pulmonaler Ebene vor allem eine arterielle Hypoxämie und -aufgrund kompensatorischer Hyperventilation -o erniedrigten Kohlendioxidpartialdruck (PaCO 2 ) zur Folge hat, resultiert bei einer Atempumpeninsu zienz (ventilatorische Insu zienz) vordergründig ein Anstieg des PaCO 2 und eher begleitend eine Hypoxämie. Die ausschließliche Hypoxämie kann bis zu einem gewissen Grad durch ein verbessertes Sauersto angebot (z. B. Sauersto gabe) kompensiert werden kann. Demgegenüber erfordert die Atempumpeninsu zienz vorrangig eine Unterstützung der Ventilation durch Beatmung, die invasiv (Endotrachealtubus, ggf. Trachealkanüle) oder eben auch nicht invasiv (z. B. Beatmungsmaske) erfolgen kann.

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Critical care in the emergency department: acute respiratory failure

Cited by 13 publications

References 28 publications

Nasotracheal prolonged safe extubation in acute respiratory failure post-thyroidectomy: An efficacious technique to avoid tracheotomy? A retrospective analysis of a large case series

Nasotracheal prolonged safe extubation in acute respiratory failure post-thyroidectomy: An efficacious technique to avoid tracheotomy? A retrospective analysis of a large case series

Nasotracheal Prolonged Safe Extubation Reduces the Need of Tracheotomy in Patients with Acute Respiratory Failure following Thyroidectomy

Nicht invasive Beatmung

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