Does anesthetic provide similar neuroprotection to therapeutic hypothermia after cardiac arrest?

Zhang, Hong

doi:10.1186/cc8923

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…However, our hypothesis, that lower expiratory pressures associated with BiPAP and improved expiratory function would ameliorate hypercapnia was not demonstrated. As was observed during CPAP ( 13 ), the observed increases in PaCO 2 and pH in the current study were modest, and consistent with current ventilation strategies that accept increased arterial CO 2 tension and hypercapnic acidosis (“permissive hypercapnia”) as acceptable consequences without adverse effects on outcome ( 30 , 31 ), and with possible therapeutic effects ( 32 ). Sedation, and the supraphysiological PaO 2 values observed in the current study, might have contributed to the observed hypercapnia.…”

Section: Discussionsupporting

confidence: 87%

Bi-Level Positive Airway Pressure for Non-invasive Respiratory Support of Foals

et al. 2021

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Respiratory insufficiency and pulmonary health are important considerations in equine neonatal care. As the majority of foals are bred for athletic pursuits, strategies for respiratory support of compromised foals are of particular importance. The administration of supplementary oxygen is readily implemented in equine practice settings, but does not address respiratory insufficiency due to inadequate ventilation and is no longer considered optimal care for hypoxia in critical care settings. Non-invasive ventilatory strategies including continuous or bi-level positive airway pressure are effective in human and veterinary studies, and may offer improved respiratory support in equine clinical practice. The current study was conducted to investigate the use of a commercial bi-level positive airway pressure (BiPAP) ventilator, designed for home care of people with obstructive respiratory conditions, for respiratory support of healthy foals with pharmacologically induced respiratory insufficiency. A two sequence (administration of supplementary oxygen with, or without, BiPAP), two phase, cross-over experimental design was used in a prospective study with six foals. Gas exchange and mechanics of breathing (increased tidal volume, decreased respiratory rate and increased peak inspiratory flow) were improved during BiPAP relative to administration of supplementary oxygen alone or prior studies using continuous positive airway pressure, but modest hypercapnia was observed. Clinical observations, pulse oximetry and monitoring of expired carbon dioxide was of limited benefit in identification of foals responding inappropriately to BiPAP, and improved methods to assess and monitor respiratory function are required in foals.

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Section: Discussionsupporting

confidence: 87%

Bi-Level Positive Airway Pressure for Non-invasive Respiratory Support of Foals

et al. 2021

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Rescue Therapy With a Pumpless Extracorporeal Lung Assist Device in a Patient With Acute Interstitial Lung Disease and Severe Refractory Hypercapnia

Petzoldt¹,

Braune

Bittmann

et al. 2012

Respir Care

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Idiopathic interstitial pneumonia frequently causes severe pulmonary restriction that in turn makes mechanical ventilation difficult. We report the case of a 44-year-old woman who developed a refractory severe hypercapnic respiratory failure (P(aCO(2)) 281 mm Hg, pH 6.77) despite mechanical ventilation with high inspiratory pressure and PEEP. A pumpless extracorporeal lung assist device, Novalung, was used as rescue therapy for carbon dioxide removal, enabling lung-protective ventilation and normalization of life-threatening acidosis. Open lung biopsy revealed an idiopathic interstitial pneumonia with histological features of a nonspecific interstitial pneumonia. Corticosteroid therapy led to progressive improvement of pulmonary function, soon permitting cessation of mechanical ventilation and extracorporeal therapy. The patient was discharged from the intensive care unit after 20 days. This case demonstrates the successful use of pumpless extracorporeal lung assist as an alternative device to pump-driven extracorporeal membrane oxygenation in severe hypercapnic respiratory failure secondary to nonspecific interstitial pneumonia.

show abstract

Does anesthetic provide similar neuroprotection to therapeutic hypothermia after cardiac arrest?

Cited by 2 publications

References 15 publications

Bi-Level Positive Airway Pressure for Non-invasive Respiratory Support of Foals

Bi-Level Positive Airway Pressure for Non-invasive Respiratory Support of Foals

Rescue Therapy With a Pumpless Extracorporeal Lung Assist Device in a Patient With Acute Interstitial Lung Disease and Severe Refractory Hypercapnia

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