Non-invasive pressure support ventilation in patients with acute respiratory failure after bilateral lung transplantation

Rocco, Monica; Conti, Giorgio; Antonelli, Massimo; Bufi, M.; Costa, M. G.; Alampi, Daniela; Ruberto, Franco; Stazi, Giulia; Pietropaoli, P

doi:10.1007/s001340101063

Cited by 78 publications

(33 citation statements)

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“…Several studies looked at the use of NIV after lung surgery [64][65][66]. AURIANT et al [64] conducted a randomised controlled trial in patients who experienced respiratory distress after lung resection.…”

Section: Immunosuppressed Patientsmentioning

confidence: 99%

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Mechanical ventilation: invasiveversusnoninvasive: Table 1—

Brochard¹

2003

Eur Respir J

106

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Mechanical ventilation is the most widely used supportive technique in intensive care units. Several forms of external support for respiration have long been described to assist the failing ventilatory pump, and access to lower airways through tracheostomy or endotracheal tubes had constituted a major advance in the management of patients with respiratory distress. More recently, however, new “noninvasive” ventilation (NIV) techniques, using patient/ventilator interfaces in the form of facial masks, have been designed.The reasons for promoting NIV include a better understanding of the role of ventilatory pump failure in the indications for mechanical ventilation, the development of ventilatory modalities able to work in synchrony with the patient, and the extensive recognition of complications associated with endotracheal intubation and standard mechanical ventilation.NIV has been used primarily for patients with acute hypercapnic ventilatory failure, and especially for acute exacerbation of chronic obstructive pulmonary disease. In this population, the use of NIV is associated with a marked reduction in the need for endotracheal intubation, a decrease in complication rate, a reduced duration of hospital stay and a substantial reduction in hospital mortality. Similar benefits have also been demonstrated in patients with asphyxic forms of acute cardiogenic pulmonary oedema. In patients with primarily hypoxemic forms of respiratory failure, the level of success of NIV is more variable, but major benefits have also been demonstrated in selected populations with no contraindications such as multiple organ failure, loss of consciousness or haemodynamic instability.One important factor in success seems to be the early delivery of noninvasive ventilation during the course of respiratory failure. Noninvasive ventilation allows many of the complications associated with mechanical ventilation to be avoided, especially the occurrence of nosocomial infections. The current use of noninvasive ventilation is growing up, and is becoming a major therapeutic tool in the intensive care unit.

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Section: Immunosuppressed Patientsmentioning

confidence: 99%

“…A reduction in ETI rate and a clear benefit in terms of hospital survival was observed with NIV. A noncontrolled study suggested interesting results using NIV after bilateral lung transplantation [65].…”

Section: Immunosuppressed Patientsmentioning

confidence: 99%

Mechanical ventilation: invasiveversusnoninvasive: Table 1—

Brochard¹

2003

Eur Respir J

106

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“…This aspect increased the interest for the application of NIV techniques, which seem able to decrease the rate of nosocomial infectious complications, with a similar level of efficacy in terms of gas exchanges improvement and patients acceptation. In a recent prospective nonrandomised study ROCCO et al [26] evaluated the role of NIV in a group of 21 patients developing ARF after bilateral lung transplantation. All the patients received noninvasive pressure support ventilation (NIPSV) through a face mask.…”

Section: Noninvasive Ventilation In the Treatment Of Hypoxaemic Acutementioning

confidence: 99%

“…Eighteen patients (86%) avoided intubation. No patient treated successfully with NIV died [26]. ANTONELLI et al [23] conducted a randomised study to compare NIV delivered through a face mask to standard treatment with supplemental oxygen administration as a modality to avoid ETI in 40 solid organ transplant recipients with acute hypoxaemic respiratory failure.…”

Section: Noninvasive Ventilation In the Treatment Of Hypoxaemic Acutementioning

confidence: 99%

New advances in the use of noninvasive ventilation for acute hypoxaemic respiratory failure

Antonelli

Pennisi²,

Conti³

2003

Eur Respir J

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Noninvasive ventilation (NIV) includes various techniques for augmenting alveolar ventilation without an endotracheal airway. The theoretical advantages of this approach include avoiding the complications associated with endotracheal intubation, improving patient comfort, preserving airway defence mechanisms, speech and swallowing.The successful application of NIV in hypoxaemic acute respiratory failure (ARF) of varied etiologies has been extensively described but success rate is strictly dependent on ARF etiology and until today the application of NIV strategies in the setting of hypoxaemic ARF is controversial. Larger, controlled studies are required to clarify the role of NIV in the setting of hypoxaemic ARF.The correct choice of the patient ventilator interface is a crucial issue in noninvasive ventilation. The study of new interfaces could improve tolerability reducing the noninvasive ventilation failure rate. Eur Respir J 2003; 22: Suppl. 42, 65s-71s.

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“…More recently, some papers have suggested that NIV can be successfully used in other conditions, such as ARF in immunocompromised patients, pulmomary oedema and after bilateral lung transplantation [34][35][36][37]. The confirmation of such data through the use of NIV on a higher number of patients will widen the field of application of NIV and, consequently, create the need to implement RICUs.…”

Section: Discussionmentioning

confidence: 99%