Noninvasive ventilation in acute respiratory failure due to H1N1 influenza: A word of caution

Singh, Akashdeep; Singh, Jaspreet

doi:10.4103/0970-2113.80340

Cited by 12 publications

(5 citation statements)

References 4 publications

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“…49,50 Physicians should be aware of the pulmonary complications of H1N1 influenza and carefully select patients suitable for NIV. They should also understand that an inappropriate use of NIV for too long (>24 h in cases of worsening clinical and hemogasanalytical profiles) 51 could lead to death due to excessive delay in intubation. 46 A recent study by Masclans et al did, however, show that failure of NIV in patients with severe respiratory failure caused by pneumonia from influenza A H1N1 virus has been associated with mortality rates similar to those reported for patients who underwent immediate intubation.…”

Section: Discussionmentioning

confidence: 99%

Management of severe respiratory failure following influenza A H1N1 pneumonia

et al. 2013

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The use of non-invasive ventilation (NIV) in severe hypoxemic respiratory failure (PaO 2 /FIO 2 ≤250) due to H1H1 virus pneumonia is controversial. In this prospective study, we aimed to assess the efficacy of NIV in avoiding endotracheal intubation and to identify predictors of success or failure. Nineteen patients with H1N1 viral pneumonia had severe respiratory failure (PaO 2 /FIO 2 ratio ≤250). Five patients with PaO 2 /FIO 2 lower than 150 and simplified acute physiology score (SAPS II) lower than 34 underwent NIV and were admitted to the Intensive Care Unit and received NIV as first-line therapy. NIV failed in 2 of the 14 patients but had a good outcome in 12. None of the patients treated with NIV died. The duration of NIV was 5.0±1.9 days and the hospital stay was 11.3±1.2 days. The average PaO 2 /FIO 2 ratio after 1 h of NIV was 239.1+38.7. No patient had multi-organ failure. PaO 2 /FIO 2 ratio after 1 h and SAPS II at admission were independent variables correlated with the success of NIV. In our study, NIV was successful in 12 of the 14 patients (85.7%) and this is one of the highest success rates in the literature. In our opinion, the reason for these results is the strict selection of patients with severe respiratory failure (PaO 2 /FIO 2 ratio ≥150) and the strict following of predictors of success for NIV such as SAPS II of 34 or lower and PaO 2 /FIO 2 ratio of 175 or lower after 1 h of NIV. Clinicians should be aware of pulmonary complications of influenza A H1N1 and strictly select the patients to undergo NIV. NIV could have an effective and safe role in reducing the high demand for critical care beds, particularly during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Management of severe respiratory failure following influenza A H1N1 pneumonia

et al. 2013

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“…Four similar treatment trials have begun or been proposed (see Table 1 ). Guidelines for obstructive sleep apnea, nasal positive airway pressure (PAP) therapy, and oral appliance therapy have been reviewed [ 16 ], primarily based on expert opinions from sleep societies and experience with prior severe respiratory infections [ 17 , 18 ]. There were no available controlled trials of sedative hypnotic agents or wake promoting agents in COVID-19, but an extensive review discussed the pathology and potential repurposing of psychiatric agents with anti-inflammatory properties [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…In view of limited research on the management of sleep during the pandemic, clinicians will need to rely on their best judgment while adapting the established standards of care for common sleep disorders as defined by professional organizations ( Table 2 ). There have been efforts to modify the guidelines for positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) to enhance safety and prevent aerosol droplets of SARS-CoV-2 [ 16 ] based on experience with previous respiratory infections [ 17 , 18 , 54 ]. PAP therapy is considered first-line for the hypersomnic OSA patient [ 55 ].…”

Section: Applying Guidelines In the Care Of Clinical Patientsmentioning

confidence: 99%

Overview of sleep management during COVID-19

Becker

2022

Sleep Medicine

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The sleep of millions has suffered during the global COVID-19 pandemic. Prevalence rates of 20–45% are reported globally for insomnia symptoms during the pandemic. Affected populations include the public and health care workers. A sleep deprived society faces the increased burden of COVID-related economic disruption, psychosocial problems, substance abuse, and suicide. Disordered sleep is not expected to disappear with control of infection, making interventions acutely necessary. The question becomes how to manage the sleep dysfunction during and after the pandemic. Depression and anxiety are prominent complaints during pandemic restrictions. Insomnia symptoms and fatigue continue even as mood improves in those who are in recovery from COVID-19 infection. Management of disturbed sleep and mental health is particularly needed in frontline health care workers. This overview describes 53 publications, as of February 2021, on disturbed sleep during the pandemic, treatment studies on COVID-related sleep disturbance, and need to rely on current treatment guidelines for common sleep disorders. The available research during the first year of COVID-19 has generally described symptoms of poor sleep rather than addressing treatment strategies. It covers digital cognitive behavioral therapy for insomnia (CBT-i) for the public and frontline workers, recognizing the need of greater acceptance and efficacy of controlled trials of CBT for affected groups. Recommendations based on a tiered public health model are discussed.

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“…We thank Singh and colleagues for highlighting the weakness of noninvasive ventilator (NIV) in acute respiratory failure due to H1N1 infection. [ 1 ] We highly appreciate their comments and are happy to share and debate the controversy in light of the arguments. Awareness of the limitations and advantages of NIV is crucial for patient management.…”

mentioning

confidence: 99%

“…[1] We highly appreciate their comments and are happy to share and debate the controversy in light of the arguments. Awareness of the limitations and advantages of NIV is crucial for patient management.…”

mentioning

confidence: 99%