Noninvasive positive pressure ventilation: Increasing use in acute care

Aboussouan, Loutfi S.; Ricaurte, Basma

doi:10.3949/ccjm.77a.09145

Cited by 29 publications

(31 citation statements)

References 63 publications

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“…Walls of the mixer and cannula were approximately 2-mm and 1-mm thick, respectively. Based on formulas to predict dried particle size, the initial concentration of AS in the nebulizer solution was estimated to produce an aerosol with a final dried MMAD of approximately 900 nm [mass median diameter (MMD) = 778 nm with q AS = 1.34 g/cm 3 ). Heated air was supplied to the system for approximately 2 min to allow the temperature at the air outlet to reach 39°C.…”

Section: Experimental Methodsmentioning

confidence: 99%

High-Efficiency Generation and Delivery of Aerosols Through Nasal Cannula During Noninvasive Ventilation

Longest

Walenga

Son

et al. 2013

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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Background: Previous studies have demonstrated the delivery of pharmaceutical aerosols through nasal cannula and the feasibility of enhanced condensational growth (ECG) with a nasal interface. The objectives of this study were to develop a device for generating submicrometer aerosols with minimal depositional loss in the formation process and to improve aerosol delivery efficiencies through nasal cannulas. Methods: A combination of in vitro experiments and computational fluid dynamics (CFD) simulations that used the strengths of each method was applied. Aerosols were formed using a conventional mesh nebulizer, mixed with ventilation gas, and heated to produce submicrometer sizes. An improved version of the mixer and heater unit was developed based on CFD simulations, and performance was verified with experiments. Aerosol delivery was considered through a commercial large-bore adult cannula, a divided (D) design for use with ECG, and a divided and streamlined (DS) design. Results: The improved mixer design reduced the total deposition fraction (DF) of drug within the mixer by a factor of 3 compared with an initial version, had a total DF of approximately 10%, and produced submicrometer aerosols at flow rates of 10 and 15 L/min. Compared with the commercial and D designs for submicrometer aerosols, the DS cannula reduced depositional losses by a factor of 2-3 and retained only approximately 5% or less of the nebulized dose at all flow rates considered. For conventional-sized aerosols (3.9 and 4.7 lm), the DS device provided delivery efficiencies of approximately 80% and above at flow rates of 2-15 L/min. Conclusions: Submicrometer aerosols can be formed using a conventional mesh nebulizer and delivered through a nasal cannula with total delivery efficiencies of 80-90%. Streamlining the nasal cannula significantly improved the delivery efficiency of both submicrometer and micrometer aerosols; however, use of submicrometer particles with ECG delivery resulted in overall lower depositional losses.

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Section: Experimental Methodsmentioning

confidence: 99%

High-Efficiency Generation and Delivery of Aerosols Through Nasal Cannula During Noninvasive Ventilation

Longest

Walenga

Son

et al. 2013

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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“…Among patients with spirometric data in their medical records (n, 500), the average forced expiratory volume in 1 second (FEV1) predicted value was 32.87% (9 -83%; CI, 61.63 -67. 19), FEV1/forced vital capacity (FVC) was 64.41% (11 -100%; SD, 18.47), and the mean forced expiratory flow at 25 -75% of FVC (FEF25-75%) was 52% (6-130%; SD, 22.69). There was a significant relationship between smoking and FEV1% (P = 0.00).…”

Section: Resultsmentioning

confidence: 99%

“…NIPPV is also associated with a lower rate of complications, such as ventilatorassociated pneumonia, sinusitis, and stress ulcers (18)(19)(20), and the costs are lower than IMV (21)(22)(23). Overall, the costs of IMV include use of trained staff (nurses and respiratory therapists), ICU admission, and management of the aforementioned complications (24,25).…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Positive-Pressure Ventilation: A Cross Sectional Descriptive Study of Our First Experience in Iran

Fakharian

Masouleh

Karimzadeh

et al. 2017

Iran Red Crescent Med J

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“…La ventilación mecánica no invasora se ha utilizado mayoritariamente como una opción previa a las ventilación mecánica o en el tratamiento del edema pulmonar agudo 74 . No obstante, en las últimas décadas se han publicado varios trabajos buscando apoyar el éxito del weaning (desconexión) de la ventilación mecánica no invasora, siendo los resultados de éstos, polémicos y contradictorios.…”

Section: La Ventilación Mecánica No Invasora ¿Logra Disminuir La Frecunclassified

Actualización Consenso Neumonía asociada a ventilación mecánica: Segunda parte. Prevención

Chacón

et al. 2011

Rev. chil. infectol.

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Update. Consensus on Ventilator Associated Pneumonia.Second Part: ProphylaxisVentilator associated pneumonia is a life threatening disease, in spite of advances in its treatment, consequently the development of prevention strategies is a key factor in improving the morbidity and mortality in intensive care units (ICU). The new developments in this fi eld in the last years led to the need to update the recommendations done in 2001. Then, a new search and analysis of scientifi c literature was performed. The obtained data support different strategies highlighting: semi-recumbent position at 45° of patients; incorporation of routinely oral hygiene procedures with chlorhexidine; preference of orotracheal intubation; performing subglotic aspiration; use of standard hand hygiene techniques; not routine change of ventilator circuits; and defi ning bundles to organize the work at ICU. Some strategies were recommended for being of similar effi cacy to others but cost-effective as: use of heat and moisture humidifi cators; and changing humidifi cators every 5 to 7 days. The use of open or closed endotracheal suctioning system does not affect the incidence of pneumonia. Some recommendations were not incorporated because of lack of evidence supporting effectiveness, controversial data or doubtful application to our country as selective digestive decontamination.Key words: Prevention, ventilator-associated pneumonia, guidelines, mechanical ventilation, consensus. Palabras clave: Prevención, neumonía asociada a ventilación mecánica, guías clínicas, ventilación mecánica, consenso. Universidad Austral de Chile, Valdivia (MCA).Hospital San Borja Arriarán, Santiago (LDM).Hospital Padre Hurtado, Santiago. Enfermera Control de IAAS (ECV).Hospital Clínico Universidad IntroducciónL a neumonía asociada a ventilación mecánica (NAVM) se mantiene como una entidad de alta mortalidad que afecta a las poblaciones sometidas a este procedimiento. A pesar de que se han diseñado estrategias para iniciar un tratamiento oportuno y apropiado, mejorando el pronóstico de mortalidad de los enfermos, no es menos cierto que la mortalidad atribuible es aún elevada con una terapia adecuada. Por esto, el desarrollo y ejecución de medidas de prevención adecuadas parece ser uno de los esfuerzos más acertados para la disminución de la morbi-mortalidad asociada a este cuadro.En los últimos nueve años, el desarrollo de la literatura científi ca enfocada a este aspecto ha sido enorme y muy variado, incluyendo nuevos tipos de intervenciones, a la vez que ha intentado esclarecer la utilidad de las más antiguas; por otro lado, en otras se ha logrado tener un mejor dato respecto a su evidencia, así como en algunas, por el poco tiempo de desarrollo que llevan, no ha sido posible dar una recomendación con la misma calidad de fundamento.Como se ha mencionado previamente, este artículo es parte de la actualización del consenso realizado, con anterioridad, por la Sociedad Chilena de Infectología en el año 2001. La metodología nuevamente ha buscado realizar recomendacio...

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Noninvasive positive pressure ventilation: Increasing use in acute care

Cited by 29 publications

References 63 publications

High-Efficiency Generation and Delivery of Aerosols Through Nasal Cannula During Noninvasive Ventilation

High-Efficiency Generation and Delivery of Aerosols Through Nasal Cannula During Noninvasive Ventilation

Noninvasive Positive-Pressure Ventilation: A Cross Sectional Descriptive Study of Our First Experience in Iran

Actualización Consenso Neumonía asociada a ventilación mecánica: Segunda parte. Prevención

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