Intermittent Abdominal Pressure Ventilation: An Alternative for Respiratory Support

Fiorentino, Giuseppe; Annunziata, Anna; Coppola, Antonietta; Marotta, Antonella; Simioli, Francesca; Imitazione, Pasquale; Lanza, Maurizia; Cauteruccio, Rosa; Esquinas, António M.

doi:10.1155/2021/5554765

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…In fact, IAPV aims at a specific group of restrictive respiratory failure. Neuromuscular diseases, chest wall abnormalities, kyphoscoliosis, paresis, diaphragm weakness, or respiratory muscle paralysis are suggested indications [ 9 , 10 ], especially when other NIV types are impossible. Nevertheless, the presence of concomitant diseases should not discourage its application.…”

Section: Discussionmentioning

confidence: 99%

Versatility of Intermittent Abdominal Pressure Ventilation in a Case of Complicated Restrictive Respiratory Failure and COVID-19

et al. 2022

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Background: The intermittent abdominal pressure ventilation (IAPV) is a non-invasive ventilation (NIV) technique that avoids facial interfaces and is a diurnal ventilatory support alternative for neuromuscular patients during stable chronic phases of the disease. Coronavirus disease 2019 (COVID-19) is a novel infection possibly causing acute respiratory distress syndrome (ARDS). Neuromuscular diseases (NMD) and preexisting respiratory failure can be exacerbated by respiratory infection and progress to severe disease and ICU admission with a poor prognosis. Aim: To report on the versatility and feasibility of IAPV in acute restrictive respiratory failure exacerbated by COVID-19. Patient: We describe the case of a 33-year-old man with spastic tetraparesis, kyphoscoliosis, and impaired cough, eventually leading to a restrictive ventilation pattern. COVID-19 exacerbated respiratory failure and seizures. An NIV trial failed because of inadequate interface adhesion and intolerance. During NIV, dyspnea and seizures worsened. He underwent a high flow nasal cannula (HFNC) with a fluctuating benefit on gas exchange. IAPV was initiated and although there was a lack of cooperation and inability to sit; the compliance was good and a progressive improvement of gas exchange, respiratory rate, and dyspnea was observed.Conclusions: IAPV is a versatile type of NIV that can be adopted in complicated restrictive respiratory failure. COVID-19 exacerbates preexisting conditions and is destined to be a disease of frailty. COVID-19 is not a contraindication to IAPV and this kind of ventilation can be employed in selected cases in a specialistic setting. Moreover, this report suggests that IAPV is safe when used in combination with HFNC. This hybrid approach provides the opportunity to benefit from both therapies, and, in this particular case, prevented the intubation with all connected risks.

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Section: Discussionmentioning

confidence: 99%

Versatility of Intermittent Abdominal Pressure Ventilation in a Case of Complicated Restrictive Respiratory Failure and COVID-19

et al. 2022

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“…The settings usually suggested are no PEEP or back-up respiratory rate, a low trigger and a tidal volume according to the respiratory abilities and needs of the patient (500–1500 mL). Regarding intermittent abdominal pressure ventilation [ 128 , 129 ], there is a lack of expert consensus guidelines on its indication, titration, management, and follow-up.…”

Section: State-of-the-art In Home Mechanical Ventilationmentioning

confidence: 99%

ERS International Congress 2022: highlights from the Respiratory Intensive Care Assembly

et al. 2023

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Early Career Members of Assembly 2 (Respiratory Intensive Care) attended the 2022 European Respiratory Society Annual Congress in Barcelona. The conference covered acute and chronic respiratory failure. Sessions of interest to our Assembly members and to those interested in respiratory critical care included the state-of-the-art session on respiratory critical care, the journal session (ERS/Lancet) on acute respiratory distress syndrome (ARDS) phenotyping into precision medicine, specificity of COVID-19 ARDS and its post critical care. A symposium on treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease and innovations in mechanical ventilation either in intensive care unit or at home were also reported. These sessions are summarized in this article.

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“…At that point, the options available become either continuous Non-invasive Ventilation Support (NVS) via a nasal/oronasal/mouthpiece/abdominal band inter-face, or sometimes in combination, either invasive mechanical ventilation (IMV) via a tracheostomy and a tracheal tube. Both these forms of ventilation allow patients to continue to live at home with different impacts on Quality of Life (QoL) [3][4][5][6]. The improvements in the intensive care setting with the lower complications of peri-tracheotomy procedures and the advances in the ventilators available have allowed Home Invasive Mechanical Ventilation (HIMV) to become increasingly available for patients surviving life-threatening illnesses.…”

Section: Introductionmentioning

confidence: 99%

Life Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19

Volpato

Pierucci

Candia

et al. 2023

Journal of Neuromuscular Diseases

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Background: The management of tracheotomy at home can be very complex, affecting the patient’s quality of life. Objectives: This case series study aimed to explore the experiences of patients affected by neuromuscular diseases (NMD) concerning tracheostomy and Invasive Mechanical Ventilation (IMV) management at home during the COVID-19 health emergency in Italy. Methods: Semi-structured interviews and the following instruments were used: Connor and Davidson Resilience Scale (CD-RISC-25); Acceptance and Action Questionnaire-II (AAQ-II); State-Trait Anxiety Inventory (STAI); Langer Mindfulness Scale (LMS). Descriptive analyses, correlations, and qualitative analyses were carried out. Results: 22 patients [50% female, mean age = 50.2 (SD = 21.2)] participated in the study. Participants who showed high levels of dispositional mindfulness in terms of novelty-seeking (r = 0.736, p = 0.013) and novelty production (r = 0.644, p = 0.033) were those with higher resilience. The main emotion that emerged was the fear of contagion (19 patients, 86.36%), due to the previous fragile condition, leading to a significant sense of abandonment. The tracheostomy’s perception is seen in extremes as a lifesaver or a condemnation. The relationship with the health professionals moves from satisfaction to a feeling of abandonment with a lack of preparation. Conclusions: The relationship between resilience, flexibility, state anxiety and dispositional mindfulness offers ways to reinforce tracheostomy management at home, even in critical periods when going to the hospital may be difficult.

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Intermittent Abdominal Pressure Ventilation: An Alternative for Respiratory Support

Cited by 5 publications

References 13 publications

Versatility of Intermittent Abdominal Pressure Ventilation in a Case of Complicated Restrictive Respiratory Failure and COVID-19

Versatility of Intermittent Abdominal Pressure Ventilation in a Case of Complicated Restrictive Respiratory Failure and COVID-19

ERS International Congress 2022: highlights from the Respiratory Intensive Care Assembly

Life Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19

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