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Giordano G, Esquinas A, Alessandri F. Is Inspiratory Effort Monitoring Necessary When Designing Clinical Trials Concerning Noninvasive Mechanical Ventilation? Crit Care Med 2024; 52:e157-e158. [PMID: 38381023 DOI: 10.1097/ccm.0000000000006083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Giovanni Giordano
- Department of General and Specialistic Surgery, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Antonio Esquinas
- Department of Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Francesco Alessandri
- Department of General and Specialistic Surgery, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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2
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Alessandri F, Tozzi P, Esquinas A. To: The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study. Crit Care Sci 2023; 35:331-332. [PMID: 38133164 PMCID: PMC10734810 DOI: 10.5935/2965-2774.20230366-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/05/2022] [Indexed: 12/23/2023]
Affiliation(s)
- Francesco Alessandri
- Department of General and Specialistic Surgery, Sapienza
Università di Roma - Roma, Italy
| | - Pierfrancesco Tozzi
- Azienda Ospedaliero Universitaria Policlinico Umberto I, Faculty of
Medicine and Surgery, Sapienza Università di Roma - Roma, Italy
| | - Antonio Esquinas
- Azienda Ospedaliero Universitaria Policlinico Umberto I, Faculty of
Medicine and Surgery, Sapienza Università di Roma - Roma, Italy
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3
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Piazza I, Esquinas A, Cosentini R. Hospital mortality and failure of non-invasive ventilation in COVID-19: looking inside the predictive scores. Intern Emerg Med 2023; 18:681-682. [PMID: 36542303 PMCID: PMC9769552 DOI: 10.1007/s11739-022-03133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/11/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Isabelle Piazza
- Emergency Medicine Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Roberto Cosentini
- Emergency Medicine Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
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4
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Di Costanzo D, Mazza M, Ruggeri P, Blanco J, Mina B, Fiorentino G, Lazovic B, Scaramuzzo G, Esquinas A. Lung and diaphragm ultrasound in noninvasive respiratory support: A real tool or fashion? Tuberk Toraks 2023; 71:7-12. [PMID: 36912404 PMCID: PMC10795273 DOI: 10.5578/tt.20239902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/25/2023] [Indexed: 03/14/2023] Open
Abstract
Introduction Over the past few years, there has been an increase in lung and diaphragm ultrasound applications as a tool to evaluate the outcomes and settings of noninvasive respiratory supports. However, actual clinical practices in this field are yet to be known. The aim of this study was to investigate the current clinical utilization of ultrasound for noninvasive respiratory supports on an international level. Materials and Methods The study employed an online survey consisting of 32 items, which was sent via email to intensivists, pulmonologists, emergency medicine physicians, and other specialists with expertise in using ultrasound and/or noninvasive respiratory supports. Result We collected 52 questionnaires. The ultrasound study of diaphragm dysfunction was well-known by the majority of respondents (57.7%). Diaphragm performance was used as a weaning failure predictor (48.5%), as a predictor of noninvasive ventilation failure (38.5%) and as a tool for the ventilator settings adjustment (30.8%). In patients with acute respiratory failure, 48.1% used ultrasound to assess the damaged lung area to set up ventilatory parameters, 34.6% to monitor it after noninvasive ventilation application, and 32.7% to match it with the ventilatory settings for adjustment purposes. When administering high flow nasal cannula - oxygen therapy, 42.3% of participants used ultrasound to evaluate lung involvement and assess flow parameters. Conclusions Lung and diaphragm ultrasound is an established clinical practice to evaluate noninvasive respiratory supports outcomes and settings. Further studies are needed to evaluate the educational aspects to increase confidence and indications for its use.
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Affiliation(s)
- D. Di Costanzo
- Unit of Pulmonology and Respiratory Pathophysiology, Clinic of Medical
Sciences, Aorn Sant’Anna and San Sebastiano Hospital, Caserta, Italy
- Unit of Pulmonology, Department of Biomedical and Dental Sciences,
Messina University Faculty of Medicine, Messina, Italy
- Intensive Care Unit, Hospital Garcia de Orta, Almada, Portugal
- Clinic of Pulmonary and Critical Care, Lenox Hill Hospital, New York,
United States
- Clinic of Pathophysiology and Respiratory Rehabilitation, Monaldi Hospital
Azienda Ospedaliera Dei Colli, Napoli, Italy
- Pulmonogy Ward, University Clinical Hospital Center Zemun, Belgrade,
Serbia
- Department of Translational Medicine, Ferrara University Faculty of
Medicine, Ferrara, Italy
- Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
| | - M. Mazza
- Unit of Pulmonology and Respiratory Pathophysiology, Clinic of Medical
Sciences, Aorn Sant’Anna and San Sebastiano Hospital, Caserta, Italy
| | - P. Ruggeri
- Unit of Pulmonology, Department of Biomedical and Dental Sciences,
Messina University Faculty of Medicine, Messina, Italy
| | - J.B. Blanco
- Intensive Care Unit, Hospital Garcia de Orta, Almada, Portugal
| | - B. Mina
- Clinic of Pulmonary and Critical Care, Lenox Hill Hospital, New York,
United States
| | - G. Fiorentino
- Clinic of Pathophysiology and Respiratory Rehabilitation, Monaldi Hospital
Azienda Ospedaliera Dei Colli, Napoli, Italy
| | - B. Lazovic
- Pulmonogy Ward, University Clinical Hospital Center Zemun, Belgrade,
Serbia
| | - G. Scaramuzzo
- Department of Translational Medicine, Ferrara University Faculty of
Medicine, Ferrara, Italy
| | - A. Esquinas
- Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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Bhattacharya D, Mandal M, Esquinas A. Commentary: Barotrauma in critically ill patients with COVID-19: miles to go to unwrap the pathophysiology. Anaesthesiol Intensive Ther 2023; 55:68. [PMID: 37306274 DOI: 10.5114/ait.2023.126223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Affiliation(s)
- Dipasri Bhattacharya
- Department of Anaesthesiology, Pain Medicine, and Critical Care, R.G. Kar Medical College, Kolkata, West Bengal, India
| | - Mohanchandra Mandal
- Department of Anesthesiology, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
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Blanco JB, Esquinas A. Commentary on "Integrated ultrasound protocol in predicting weaning success and extubation failure: a prospective observational study". Anaesthesiol Intensive Ther 2023; 55:136-137. [PMID: 37587883 PMCID: PMC10415599 DOI: 10.5114/ait.2023.129315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
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7
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Costa R, Esquinas A. Predictors of post-COVID syndrome. Getting ready for the future. Monaldi Arch Chest Dis 2022. [DOI: 10.4081/monaldi.2022.2421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Dear Editor,
We have read with interest the study by Gulian et al. where the authors describe the impact of prolonged symptoms or developing complications following an initial recovery from COVID-19, also called post-COVID syndrome. In this aspect there are a small amount of studies based on clinical extrapolation....
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8
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Ruggeri P, Esquinas A. Fibrosis‑4 (FIB‑4) index and mortality in COVID‑19 patients admitted to the emergency department: a new interesting predictive index for patients with COVID-19 disease? Intern Emerg Med 2022; 17:2451-2452. [PMID: 35962270 PMCID: PMC9374285 DOI: 10.1007/s11739-022-03067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Paolo Ruggeri
- Pulmonology Unit, Department of Biomedical and Dental Sciences, Morphological and Functional Images (BIOMORF), University of Messina, Via Consolare Valeria 100, 98125, Messina, Italy.
| | - Antonio Esquinas
- Department of Intensive Care and Noninvasive Ventilatory Unit, Intensive Care Unit, Hospital Morales Meseguer Murcia, Murcia, Spain
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9
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Blanco JB, Esquinas A. Diaphragm Evaluation and Lung Ultrasound Score during Weaning. Indian J Crit Care Med 2022; 26:1054-1055. [PMID: 36213714 PMCID: PMC9492736 DOI: 10.5005/jp-journals-10071-24312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Blanco JB, Esquinas A. Diaphragm Evaluation and Lung Ultrasound Score during Weaning. Indian J Crit Care Med 2022;26(9):1054–1055.
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Affiliation(s)
- Jacobo Bacariza Blanco
- Department of Intensive Care Medicine Unit, Hospital Garcia de Orta, Almada, Setubal, Portugal
- Jacobo Bacariza Blanco, Department of Intensive Care Medicine Unit, Hospital Garcia de Orta, Almada, Setubal, Portugal, Phone: +351 00351916593806, e-mail:
| | - Antonio Esquinas
- Department of Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain
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10
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Laserna A, Barahona-Correa JE, Papadakos P, Esquinas A. High-Flow Nasal Cannula in COVID-19 Pneumonia: Practical Issues. Crit Care Med 2022; 50:e591-e592. [PMID: 35120045 PMCID: PMC9112501 DOI: 10.1097/ccm.0000000000005483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Andres Laserna
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY
| | - Julian E Barahona-Correa
- Department of Internal Medicine, School of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Peter Papadakos
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY
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11
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Costanzo DD, Mazza M, Esquinas A. Diaphragm ultrasound in weaning from mechanical ventilation: a last step to predict successful extubation? Acute Crit Care 2022; 37:681-682. [DOI: 10.4266/acc.2022.00227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022] Open
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12
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Barahona-Correa JE, Laserna A, Fowler C, Esquinas A. High-Flow Oxygen Therapy for Severe Hypoxemia: Moving Towards a More Inclusive Definition of ARDS. Am J Respir Crit Care Med 2022; 206:514-515. [PMID: 35549638 DOI: 10.1164/rccm.202201-0185le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Julián E Barahona-Correa
- Pontificia Universidad Javeriana, 27964, Department of Internal Medicine, Bogota, Colombia.,Hospital Universitario San Ignacio, 173049, Department of Internal Medicine, Bogota, Colombia
| | - Andres Laserna
- University of Rochester Medical Center, 6923, Department of Anesthesiology and Perioperative Medicine, Rochester, New York, United States
| | - Cosmo Fowler
- Case Western Reserve University, 2546, Department of Medicine, Cleveland, Ohio, United States
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13
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Alibrahim O, Esquinas A. Home HFNC in Children with Heart Disease: Is It Safe? Pediatr Cardiol 2022; 43:931. [PMID: 35366063 DOI: 10.1007/s00246-022-02892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Omar Alibrahim
- Division of Pediatric Critical Care Medicine, Duke University Medical Center, 2301 Erwin Road, Suite 5260Y, DUMC 3046, Durham, NC, 27710, USA.
| | - Antonio Esquinas
- Director International NIV School, Director Non-Invasive Ventilation Fellowship Program, Member ERS College of Experts, Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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14
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Ruggeri P, Nair AS, Esquinas A. Comments on "Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up" by De Michele et al. Monaldi Arch Chest Dis 2022; 92. [PMID: 35244354 DOI: 10.4081/monaldi.2022.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/18/2022] [Indexed: 11/23/2022] Open
Abstract
To the Editor, We read the original study by De Michele et al. titled "Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up" with great interest...
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Affiliation(s)
- Paolo Ruggeri
- Pulmonology Unit, Department of Biomedical and Dental Sciences, Morphological and Functional Images (BIOMORF), University of Messina.
| | - Abhijit S Nair
- Department of Anaesthesiology, Ibra Hospital, Ministry of Health-Oman.
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15
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Di Costanzo D, Mazza M, Esquinas A. Comment on "Usefulness of lung ultrasound in the early identification of severe COVID-19: results from a prospective study". Med Ultrason 2022; 24:3591. [PMID: 35174820 DOI: 10.11152/mu-3591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To EditorWe have read this article with great interest, where a pattern of correlation is established between lung ultrasound findings and the degree of respiratory failure and prognosis in patients with Coronavirus disease 2019. However, we think that some aspects of this study can be better analyzed.
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Affiliation(s)
- Domenica Di Costanzo
- Department of Respiratory Disease, AORN Sant'Anna e San Sebastiano di Caserta, Caserta, Italy.
| | - Mariano Mazza
- Department of Respiratory Disease, AORN Sant'Anna e San Sebastiano di Caserta, Caserta, Italy.
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Guia M, Alpay N, Gerardo A, Madney Y, Abdelrahim M, Saeed H, Harb H, Gonçalves G, Cabrita B, Alqahtani J, El-Khatib M, Gómez-Ríos M, Fakharian A, Ciobanu L, Karim HMR, Piervincenzi E, Scharffenberg M, Steiropoulos P, LeMaster W, Barjaktarevic I, Wittenstein J, Diaz-Abad M, Perren A, Nicolini A, Spadaro S, Garuti G, Petroianni A, Esquinas A. High-Flow Nasal Oxygen Therapy in Acute Hypoxemic Respiratory Failure: Concise Review on Technology and Initial Methodology. Turk Thorac J 2022; 22:494-500. [PMID: 35110267 DOI: 10.5152/turkthoracj.2021.20213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-flow nasal cannula oxygen therapy (HFNCOT) system consists of an air/oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 80 L/min. The system includes a blender, active humidifier, single heated tube, and nasal cannula. HFNCOT has many physiological advantages compared with other standard oxygen therapies, such as anatomical dead space washout, more constant fraction of inspired oxygen, positive end-expiratory (PEEP) effect, supplement of adequate humidification and maintenance of muco-ciliary function. HFNCOT is mostly used for hypoxemic acute respiratory failure, although it also has other indications. HFNCOT is a common choice of physicians as its technology makes it more silent and comfortable. Though HFNCOT is used in many clinical settings, there is a lack of publications addressing devices and initial settings. We present a review on HFNCOT, with focus on device and application methodology.
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Affiliation(s)
- Miguel Guia
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal
| | - Nilgun Alpay
- Department of Anesthesiology and Reanimation, Dentistry Faculty, Çukurova University, Adana, Turkey
| | - António Gerardo
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal
| | - Yasmin Madney
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Mohamed Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Haitham Saeed
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Hadeer Harb
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Gil Gonçalves
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bruno Cabrita
- Pulmonology Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Jaber Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Mohamad El-Khatib
- Department of Anesthesiology, Director of Respiratory Therapy, American University of Beirut, Beirut, Lebanon
| | - Manuel Gómez-Ríos
- Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Galicia, Spain
| | - Atefeh Fakharian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Laura Ciobanu
- Department of Internal Medicine, University of Medicine and Pharmacy "Grigore T Popa", Iasi, Romania
| | - Habib Md Reazaul Karim
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India
| | - Edoardo Piervincenzi
- Department of Anesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy
| | - Martin Scharffenberg
- Department of Anaesthesiology and Intensive Care Medicine University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
| | | | - William LeMaster
- Division of Pulmonary and Critical Care Medicine, UCLA David Geffen School of Medicine, Los Angeles, USA
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, UCLA David Geffen School of Medicine, Los Angeles, USA
| | - Jakob Wittenstein
- Department of Anaesthesiology and Intensive Care Medicine University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
| | - Montserrat Diaz-Abad
- Division of Pulmonary and Critical Care Medicine University of Maryland School of Medicine Baltimore, USA
| | - Andreas Perren
- Primario Medicina Intensiva, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland
| | - Antonello Nicolini
- Respiratory Diseases Unit, General Hospital Sestri Levante, Sestri Levante, Italy
| | - Savino Spadaro
- Department Morphology, Surgery And Experimental Medicine, Intensive Care Unit, University of Ferrara, Ferrara, Italy
| | | | - Angelo Petroianni
- Respiratory Diseases Unit, Respiratory Intensive Care Unit, Policlinico Umberto I Sapienza University of Rome, Italy
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Ruggeri P, Esquinas A. Is it time to use HFNC oxygen therapy during exercise in IPF patients? Respirology 2022; 27:316-317. [PMID: 35112423 DOI: 10.1111/resp.14220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Paolo Ruggeri
- Pulmonology Unit, Department of Biomedical and Dental Sciences, Morphological and Functional Images (BIOMORF), University of Messina, Messina, Italy
| | - Antonio Esquinas
- Department of Intensive Care and Noninvasive Ventilatory Unit, Intensive Care Unit, Hospital Morales Meseguer Murcia, Murcia, Spain
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18
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Araújo M, Esquinas A, Carrillo A. Non-invasive ventilation in post-extubation respiratory failure due to Reinke's edema. Pulmonology 2022; 28:310-311. [DOI: 10.1016/j.pulmoe.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 10/19/2022] Open
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Nair A, Esquinas A. To: Epistaxis as a complication of high-flow nasal cannula therapy in adults. Rev Bras Ter Intensiva 2022. [DOI: 10.5935/0103-507x.20220047-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nair A, Esquinas A. The feasibility of ROX index to predict intubation in patients initiated on high-flow oxygenation. Saudi J Anaesth 2022; 16:264-265. [PMID: 35431756 PMCID: PMC9009567 DOI: 10.4103/sja.sja_67_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/04/2022] Open
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Nair A, Esquinas A. Para: Epistaxe como complicação de tratamento com cânula nasal de alto fluxo em adultos. Rev Bras Ter Intensiva 2022; 34:396-397. [DOI: 10.5935/0103-507x.20220047-pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
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22
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Nair A, Esquinas A. HACOR score to predict failure of non-invasive ventilation in patients with acute hypoxemic respiratory failure: When simplicity is best. Saudi J Anaesth 2022; 16:267-268. [PMID: 35431731 PMCID: PMC9009566 DOI: 10.4103/sja.sja_88_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
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Dmitrović R, Lazović B, Simonović I, Esquinas A, Mulić M. Primary spontaneous partial pneumothorax in a patient with COVID-19 pneumonia. Have We underestimated this complication?: A case report. Sanamed 2022. [DOI: 10.5937/sanamed17-36543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction and case report: We described a case of primary spontaneous partial pneumothorax in a middle-aged man with COVID-19 pneumonia who presented with fever, loss of appetite, and malaise. Laboratory results revealed higher levels of inflammatory markers, as well as sterile urine and blood cultures. On admission, a chest X-ray revealed bilateral patchy consolidations in the lung parenchyma, as well as a left-sided partial pneumothorax. Throughout his hospitalization, the patient was closely examined by a thoracic surgeon, and a chest X-ray was taken on multiple occasions. There was spontaneous resorption of air from the pleural space. Conclusion: Pneumothorax is a rare but serious complication of the COVID-19 infection that has recently been documented in patients with no comorbidities, requiring various types of ventilatory support. The precise mechanism of primary spontaneous pneumothorax in COVID-19 infection is unknown, but it will undoubtedly pose a challenge to future researchers.
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Demirkiran H, Bahar İ, Esquinas A. High-flow nasal cannula failure in the Pediatric Emergency Department: Remarks and questions to explore the predictive factors. Turk J Pediatr 2022; 64:1165-1166. [PMID: 36583902 DOI: 10.24953/turkjped.2022.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Hilmi Demirkiran
- Intensive Care Unit, Private Lokman Hekim Van Hospital, Van, Türkiye
| | - İlhan Bahar
- Intensive Care Unit, Cigli Training and Research Hospital, Bakircay University, İzmir, Türkiye
| | - Antonio Esquinas
- Intensive Care Unit, Hospital General University Morales Meseguer, Avenida Marqués de Los Velez, Murcia, Spain
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Şahin Duyar S, Esquinas A. Desperate times call for desperate measures. Am J Emerg Med 2021; 56:300-301. [PMID: 34391585 PMCID: PMC8324407 DOI: 10.1016/j.ajem.2021.07.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sezgi Şahin Duyar
- Pulmonology, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
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Guia MF, Boléo-Tomé JP, Imitazione P, Polistina GE, Alves C, Ishikawa O, Ballenberger M, Mina B, Fiorentino G, Esquinas A, Scala R. Usefulness of the HACOR score in predicting success of CPAP in COVID-19-related hypoxemia. Respir Med 2021; 187:106550. [PMID: 34333389 PMCID: PMC8313899 DOI: 10.1016/j.rmed.2021.106550] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/13/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022]
Abstract
Introduction In COVID-19 associated hypoxemic acute respiratory failure (ARF) without mandatory indication for urgent endotracheal intubation, a trial of CPAP may be considered. We aimed to evaluate HACOR (heart rate, acidosis, consciousness, oxygenation, respiratory rate) score performance in these patients as predictor of CPAP failure. Methods Prospective observational multicentric study (three centers in different countries), including adult patients with SARS-CoV-2 pneumonia admitted to a respiratory intermediate care unit, presenting PaO2/FiO2 < 300 and PaCO2 < 45 mmHg, who received CPAP. One hour after starting CPAP, HACOR was calculated. Results We enrolled 128 patients, mean age 61,7 years. Mean HACOR at 1 h after starting CPAP was 3,27 ± 3,84 and mean PaO2/FiO2 was 203,30 ± 92,21 mmHg; 35 patients (27,3 %) presented CPAP failure: 29 underwent oro-tracheal intubation and 6 died due to COVID-19 (all having a do-not-intubate order). HACOR accuracy for predicting CPAP failure was 82,03 %, while PaO2/FiO2 accuracy was 81,25 %. Conclusion Although HACOR score had a good diagnostic performance in predicting CPAP failure in COVID-19-related ARF, PaO2/FiO2 has also shown to be a good predictor of failure.
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Affiliation(s)
- Miguel Filipe Guia
- Pulmonology Department, Hospital Prof. Doutor Fernando Fonseca; IC19, 2720-276 Amadora, Portugal.
| | - José Pedro Boléo-Tomé
- Pulmonology Department, Hospital Prof. Doutor Fernando Fonseca; IC19, 2720-276 Amadora, Portugal
| | - Pasquale Imitazione
- Pulmonology Department, Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, Italy
| | | | - Carlos Alves
- Pulmonology Department, Hospital Prof. Doutor Fernando Fonseca; IC19, 2720-276 Amadora, Portugal
| | - Oki Ishikawa
- Pulmonary Critical Care Division, Lung Center, Northwell/Lenox Hill Hospital, 100 E 77th St., New York, USA
| | - Matthew Ballenberger
- Pulmonary Critical Care Division, Lung Center, Northwell/Lenox Hill Hospital, 100 E 77th St., New York, USA
| | - Bushra Mina
- Pulmonary Critical Care Division, Lung Center, Northwell/Lenox Hill Hospital, 100 E 77th St., New York, USA
| | - Giuseppe Fiorentino
- Pulmonology Department, Monaldi Hospital, Via Leonardo Bianchi, 80131 Naples, Italy
| | - Antonio Esquinas
- Intensive Care Unit, Morales Meseguer Hospital; Av Marqués de Los Vélez, S/n, 30008 Murcia, Spain
| | - Raffaele Scala
- Pulmonology Department and Respiratory Intensive Care Unit, San Donato Hospital; Via Pietro Nenni, 20/22, 52100 Arezzo, Italy
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Hadda V, Suri TM, Pahuja S, El-Khatib M, Ciobanu LD, Cabrita B, Karim HMR, Barjaktarevic I, Crimi C, Garuti G, Mittal S, Tiwari P, Madan K, Mohan A, Karakurt Z, Esquinas A. Secretion management in patients with ineffective airway clearance with non-invasive mechanical ventilation use: Expert guidance for clinical practice. Monaldi Arch Chest Dis 2021; 91. [PMID: 34121373 DOI: 10.4081/monaldi.2021.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 04/17/2021] [Indexed: 11/23/2022] Open
Abstract
Non-invasive ventilation (NIV) is a mainstay of management of chronic respiratory failure in many disorders which are known to cause abnormal airway secretion clearance. Currently, there is no guidance regarding either the secretion handling during NIV use or the role of NIV in secretion management in these patients. The aim of this document was to provide an overview of the various techniques available in the management of respiratory secretions and their use in conjunction with NIV. Literature search was performed using the keywords, "(secretion OR secretions) AND (noninvasive ventilation OR NIV)" on PubMed and EMBASE. The search yielded 1681 and 509 titles from PubMed and EMBASE, respectively. After screening, 19 articles were included in this review. Suggestions of the expert panel were formulated by mutual consensus after reviewing the relevant literature. The draft of the expert panel's suggestions was circulated among all authors via electronic mail for comments. Any conflicts were resolved by mutual discussion to achieve agreement. The final document was approved by all. This document by the International Network for Airway Secretions Management in NIV describes various airway secretion clearance techniques. It provides the expert panel's suggestions for the use of these techniques in conjunction with NIV for patients with muco-obstructive and neuromuscular disorders.
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Affiliation(s)
- Vijay Hadda
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute Of Medical Sciences, New Delhi.
| | - Tejas Menon Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute Of Medical Sciences, New Delhi.
| | - Sourabh Pahuja
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute Of Medical Sciences, New Delhi.
| | - Mohamad El-Khatib
- Department of Respiratory Therapy, American University of Beirut Medical Center, Beirut.
| | - Laura D Ciobanu
- Department of Internal Medicine, University of Medicine and Pharmacy "Grigore T. Popa", Iasi.
| | - Bruno Cabrita
- Pulmonology Department, Hospital Pedro Hispano, Matosinhos.
| | - Habib Md Reazaul Karim
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur.
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care, David Geffen School of Medicine at University of California, Los Angeles, CA.
| | - Claudia Crimi
- Respiratory Medicine Unit, A.O.U. "Policlinico-Vittorio Emanuele", Catania.
| | | | - Saurabh Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute Of Medical Sciences, New Delhi.
| | - Pawan Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute Of Medical Sciences, New Delhi.
| | - Karan Madan
- All India Institute of Medical Sciences, New Delhi.
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute Of Medical Sciences, New Delhi.
| | - Zuhal Karakurt
- Respiratory Intensive Care Unit, Sureyyapasa Chest Diseases and Surgery Hospital, Istanbul.
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Türktan M, Esquinas A. Treatment approach to apnestic breathing in Arnold Chiari malformation: any role of non-invasive ventilation? Tuberk Toraks 2020; 68:463-464. [DOI: 10.5578/tt.70017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Alqahtani JS, Mendes RG, Aldhahir A, Rowley D, AlAhmari MD, Ntoumenopoulos G, Alghamdi SM, Sreedharan JK, Aldabayan YS, Oyelade T, Alrajeh A, Olivieri C, AlQuaimi M, Sullivan J, Almeshari MA, Esquinas A. Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey. J Multidiscip Healthc 2020; 13:1635-1648. [PMID: 33239884 PMCID: PMC7680685 DOI: 10.2147/jmdh.s279031] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As the global outbreak of COVID-19 continues to ravage the world, it is important to understand how frontline clinicians manage ventilatory support and the various limiting factors. METHODS An online survey composed of 32 questions was developed and validated by an international expert panel. RESULTS Overall, 502 respondents from 40 countries across six continents completed the survey. The mean number (±SD) of ICU beds was 64 ± 84. The most popular initial diagnostic tools used for treatment initiation were arterial blood gas (48%) and clinical presentation (37.5%), while the national COVID-19 guidelines were the most used (61.2%). High flow nasal cannula (HFNC) (53.8%), non-invasive ventilation (NIV) (47%), and invasive mechanical ventilation (IMV) (92%) were mostly used for mild, moderate, and severe COVID-19 cases, respectively. However, only 38.8%, 56.6% and 82.9% of the respondents had standard protocols for HFNC, NIV, and IMV, respectively. The most frequently used modes of IMV and NIV were volume control (VC) (36.1%) and continuous positive airway pressure/pressure support (CPAP/PS) (40.6%). About 54% of the respondents did not adhere to the recommended, regular ventilator check interval. The majority of the respondents (85.7%) used proning with IMV, with 48.4% using it for 12-16 hours, and 46.2% had tried awake proning in combination with HFNC or NIV. Increased staff workload (45.02%), lack of trained staff (44.22%) and shortage of personal protective equipment (PPE) (42.63%) were the main barriers to COVID-19 management. CONCLUSION Our results show that general clinical practices involving ventilatory support were highly heterogeneous, with limited use of standard protocols and most frontline clinicians depending on isolated and varied management guidelines. We found increased staff workload, lack of trained staff and shortage of PPE to be the main limiting factors affecting global COVID-19 ventilatory support management.
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Affiliation(s)
- Jaber S Alqahtani
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Renata G Mendes
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | - Abdulelah Aldhahir
- UCL Respiratory, University College London, London, UK
- Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Daniel Rowley
- Pulmonary Diagnostics & Respiratory Therapy Services, University of Virginia Medical Center, Charlottesville, VA, USA
| | - Mohammed D AlAhmari
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
- Dammam Health Network, Dammam, Saudi Arabia
| | - George Ntoumenopoulos
- Consultant Physiotherapist, Physiotherapy Department St Vincent’s Hospital Sydney, Sydney, NSW, Australia
| | - Saeed M Alghamdi
- National Heart and Lung Institute, Imperial College London, London, UK
- Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Jithin K Sreedharan
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | - Tope Oyelade
- UCL Institute for Liver and Digestive Health, London, UK
| | - Ahmed Alrajeh
- Respiratory Care, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Carlo Olivieri
- Emergency Department, Ospedale Sant’Andrea, Vercelli13100, Italy
| | - Maher AlQuaimi
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jerome Sullivan
- President, International Council for Respiratory Care, Professor Emeritus & Respiratory Care Program Director, The University of Toledo, Toledo, OH, USA
| | - Mohammed A Almeshari
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Antonio Esquinas
- Director International NIV School, Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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Carrillo A, Lopez A, Carrillo L, Caldeira V, Guia M, Alonso N, Renedo A, Quintana ME, Sanchez JM, Esquinas A. Validity of a clinical scale in predicting the failure of non-invasive ventilation in hypoxemic patients. J Crit Care 2020; 60:152-158. [PMID: 32814270 DOI: 10.1016/j.jcrc.2020.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/09/2020] [Accepted: 08/06/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The HACOR scale is a clinical score that can predict early failure of NIV in hypoxemic acute respiratory failure (ARF) The aim of this study is to analyze the validity of the HACOR scale. METHODS A retrospective study of a cohort of over 2749 episodes on 2711 consecutive patients requiring NIV for hypoxemic ARF in a polyvalent intensive care unit. The scale was measured before starting NIV and at 1, 6, 12, 24 and 48 h after the initiation of NIV. RESULTS NIV failure occurred in 963 patients (35%). The value of the HACOR scale before NIV did not differ between success and failure. However, at 1, 6, 12, 24 and 48 h of NIV, the scale values clearly differed between the two groups. The HACOR scale at NIV initiation accurately predicts NIV failure in the first hour, with an optimal cut-off value of 8 points. The AUC for predicting NIV failure with HACOR at 1 h is greater than 0.9 in patients with pneumonia and adult respiratory distress syndrome (ARDS). CONCLUSIONS The HACOR scale measured at 1 h after NIV initiation accurately predicts NIV failure, especially in pneumonia and ARDS.
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Affiliation(s)
- Andrés Carrillo
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Antonia Lopez
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Luna Carrillo
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Vania Caldeira
- Pulmonology Department, Hospital Santa Marta - Centro Hospitalar Lisboa Central, R. de Santa Marta 50, 1169-024 Lisboa, Portugal
| | - Miguel Guia
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, IC19, 2720-276 Amadora, Lisbon, Portugal.
| | - Nuria Alonso
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Ana Renedo
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Maria E Quintana
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Juan M Sanchez
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Antonio Esquinas
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
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Karim HM, Alpay N, Esquinas A. How are Thermoregulation and Ventilatory Modes Linked? Some Methodological Views. Turk J Anaesthesiol Reanim 2020; 48:348-349. [PMID: 32864657 PMCID: PMC7434342 DOI: 10.5152/tjar.2020.64920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Habib MdR Karim
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India
| | - Nilgün Alpay
- Department of Anaesthesiology and Reanimation, Çukurova University Faculty of Dentistry, Adana, Turkey
| | - Antonio Esquinas
- Department of Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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Karim HMR, Esquinas A, Singha SK. Morphine therapy in acute heart failure is associated with increased mechanical ventilation and mortality: Adverse dose-dependent effect or inevitable consequence? Int J Cardiol 2019; 297:92. [PMID: 31839199 DOI: 10.1016/j.ijcard.2019.07.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/23/2019] [Indexed: 11/30/2022]
Affiliation(s)
- H M R Karim
- Department of Anaesthesia, AIIMS, Raipur, CG, India
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Bhakta P, Karim HMR, O'Brien B, Esquinas A. Letter to the editor: Aeration changes induced by high flow nasal cannula are more homogeneous than those generated by non-invasive ventilation in healthy subjects. J Crit Care 2019; 57:275-276. [PMID: 31757577 DOI: 10.1016/j.jcrc.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Pradipta Bhakta
- Department of Anaesthesia and Intensive Care, Temple Street Children's University Hospital, Dublin, Ireland.
| | - Habib Md Reazaul Karim
- Department of Anaesthesia and Critical Care, All India Institute of Medical Sciences, Raipur, India
| | - Brian O'Brien
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - Antonio Esquinas
- Department of Cardiac Anesthesia and Intensive Care, Intensive Care Unit; Hospital Morales Meseguer, Murcia, Spain
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Singha SK, Karim HM, Esquinas A. Poor outcome of laparoscopic cholecystectomy in patients with COPD: how determinant it is? [Letter]. Int J Chron Obstruct Pulmon Dis 2019; 14:2131-2132. [PMID: 31564859 PMCID: PMC6746304 DOI: 10.2147/copd.s222557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 08/01/2019] [Indexed: 11/23/2022] Open
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Serin SO, Işıklar A, Karaören G, El-Khatib MF, Caldeira V, Esquinas A. Atelectasis in Bariatric Surgery: Review Analysis and Key Practical Recommendations. Turk J Anaesthesiol Reanim 2019; 47:431-438. [PMID: 31828239 DOI: 10.5152/tjar.2019.66564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/14/2019] [Indexed: 11/22/2022] Open
Abstract
Obesity is a condition that affects multiple organ systems, particularly the cardiovascular and respiratory system. In recent years, bariatric surgery has been reported to be the gold standard in the treatment of morbid obesity. Body mass index alone is insufficient to predict risks related to anaesthesia and surgery. Obesity contributes to significant postoperative atelectasis and is considered an independent risk factor for postoperative atelectasis owing to decreased functional residual capacity. The treatment and reversibility of atelectasis developed in obese patients undergoing bariatric surgery are challenging. Therefore, an optimisation of pulmonary functions before surgery, lung-sparing ventilation during the perioperative period, awareness of potential postoperative complications and knowledge about preventive measures and therapeutic approaches have become increasingly important in bariatric surgery. The aim of this review was to aid clinicians in the management of atelectasis in patients undergoing bariatric surgery during the perioperative and postoperative period.
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Affiliation(s)
- Sibel Ocak Serin
- Department of Internal Medicine, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Aysun Işıklar
- Department of Internal Medicine, Martyr Professor İlhan Varank Sancaktepe Training and Research Hospital, İstanbul, Turkey
| | - Gülşah Karaören
- Department of Anaesthesiology and Reanimation, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey
| | - Mohamed Fawzy El-Khatib
- Department of Anaesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Vania Caldeira
- Department of Pneumology, Hospital Santa Maria, Lisboa, Portugal
| | - Antonio Esquinas
- Department of Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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Ruggeri P, Profazio C, Esquinas A. Post‐intensive care unit respiratory failure in older patients: Can we predict intensive care unit discharge properly? Geriatr Gerontol Int 2019; 19:838. [DOI: 10.1111/ggi.13720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Paolo Ruggeri
- Pulmonology Unit, Department of Biomedical and Dental Sciences, Morphological and Functional Images (BIOMORF)University of Messina Messina Italy
| | - Claudia Profazio
- Department of NeurosciencesNemo Sud Clinical Center for Neuromuscular Disorders Messina Italy
| | - Antonio Esquinas
- Department of Intensive Care and Noninvasive Vnetilatory UnitIntensive Care Unit, Hospital Morales Meseguer Murcia Murcia Spain
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Hadda V, Madan M, Mittal S, Madan K, Esquinas A. Severe community acquired pneumonia: Prediction of outcome. J Crit Care 2019; 54:287. [PMID: 31405539 DOI: 10.1016/j.jcrc.2019.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/28/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Vijay Hadda
- Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, Room no. 8, Pota-Cabin, Third Floor, New Private Wards Delhi, New Delhi 110029, India.
| | - Manu Madan
- Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, Room no. 8, Pota-Cabin, Third Floor, New Private Wards Delhi, New Delhi 110029, India
| | - Saurabh Mittal
- Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, Room no. 8, Pota-Cabin, Third Floor, New Private Wards Delhi, New Delhi 110029, India
| | - Karan Madan
- Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, Room no. 8, Pota-Cabin, Third Floor, New Private Wards Delhi, New Delhi 110029, India
| | - Antonio Esquinas
- Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, Room no. 8, Pota-Cabin, Third Floor, New Private Wards Delhi, New Delhi 110029, India
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Diaz de Teran T, Barbagelata E, Cilloniz C, Nicolini A, Perazzo T, Perren A, Ocak Serin S, Scharffenberg M, Fiorentino G, Zaccagnini M, Khatib MI, Papadakos P, Rezaul Karim HM, Solidoro P, Esquinas A. Non-invasive ventilation in palliative care: a systematic review. Minerva Med 2019; 110:555-563. [PMID: 31359741 DOI: 10.23736/s0026-4806.19.06273-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION An ageing population and steady increase in the rates of neoplasms and chronic degenerative diseases poses a challenge for societies and their healthcare systems. Because of the recent and continued advances in therapies, such as the development and widespread use of non-invasive ventilation (NIV), survival rates have increased for these pathologies. For patients with end-stage chronic respiratory diseases, the use of NIV following the onset of acute or severe chronic respiratory failure is a valid option when intubation has been excluded. EVIDENCE ACQUISITION The following electronic databases were searched from their inception to January 2000 to December 2017: MEDLINE, EMBASE, CINHAIL, CENTRAL (Cochrane Central register of Controlled Trials), DARE (Database of Abstracts of Reviews of Effectiveness), the Cochrane Database of Systematic Reviews, ACP Journal Club database. EVIDENCE SYNTHESIS The available evidence strongly supports the use of NIV in patients presenting with an exacerbation of chronic obstructive pulmonary disease, as well end-stage neuromuscular disease. Few studies support the use of NIV in end-stage interstitial lung disease and in morbid obesity patients. In patients with cancer has been recommend offering NIV as palliative care to improve dyspnea. CONCLUSIONS The decision regarding the treatment should be made by the patient, ideally before reaching the terminal stage and after having a frank dialogue with healthcare professionals and family members.
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Affiliation(s)
- Teresa Diaz de Teran
- Unit of Sleep and Non-Invasive Ventilation, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Elena Barbagelata
- Department of Internal Medicine, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy
| | - Catia Cilloniz
- Department of Pneumology, Clinical Institute of Thoracic Surgery, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clínic, Barcelona, University of Barcelona (UB), Barcelona, Spain.,Unit SGR 911, Center for Biomedical Network Research for Respiratory Diseases (CIBERES), Barcelona, Spain
| | - Antonello Nicolini
- Department of Respiratory Diseases, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy -
| | - Tommaso Perazzo
- Department of Respiratory Diseases, General Hospital of Sestri Levante, Sestri Levante, Genoa, Italy
| | - Andreas Perren
- Department of Intensive Care, Regional Hospital of Bellinzona, Bellinzona, Switzerland
| | - Sibel Ocak Serin
- University of Health Science, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Martin Scharffenberg
- Department of Anesthesiology and Critical Care Medicine, Carl Gustav Carus Faculty of Medicine, Technical University of Dresden, Dresden, Germany
| | - Giuseppe Fiorentino
- Unit of Respiratory Pathophysiology, Diseases, and Rehabilitation, Monaldi Hospital, Ospedali dei Colli, Naples, Italy
| | - Marco Zaccagnini
- Department of Anesthesia and Critical Care, McGill University Health Center, Montreal, QC, Canada
| | - Mohamad I Khatib
- Department of Anesthesiology, School of Medicine, American University of Beirut, Beirut, Lebanon
| | - Peter Papadakos
- Department of Anesthesiology, University of Rochester, Rochester, NY, USA
| | - Habib M Rezaul Karim
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India
| | - Paolo Solidoro
- Unit of Pneumology U, Department of Cardiovascular and Thoracic Surgery, Molinette Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Antonio Esquinas
- Unit of Intensive Care, Morales Meseguer Hospital, Murcia, Spain
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Bhakta P, O’Brien B, Karim HMR, Esquinas A. Trial of Noninvasive Ventilation with Pressure or Adaptive Support in Acute Exacerbation of COPD by Sehgal IS et al: Further Considerations. COPD 2019; 16:303-304. [PMID: 31357894 DOI: 10.1080/15412555.2019.1639148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Pradipta Bhakta
- Department of Anaesthesia and Intensive Care, University Hospital Limerick, Limerick, Ireland
| | - Brian O’Brien
- Department of Anaesthesia and Intensive Care, Cork University Hospital, Cork, Ireland
| | - Habib Md Reazaul Karim
- Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, Raipur, India
| | - Antonio Esquinas
- Department of Cardiac Anesthesia and Intensive Care, Intensive Care Unit; Hospital Morales Meseguer, Murcia, Spain
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Tibullo L, Esquinas A. Outcomes difference in non-invasive ventilation in 'very old' patients with acute respiratory failure: occult gender effect? Emerg Med J 2019; 36:514. [PMID: 31217179 DOI: 10.1136/emermed-2019-208692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 01/07/2023]
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Nicolini A, Diaz de Teran T, Barbagelata E, Esquinas A. Non-invasive positive pressure ventilation in pneumonia outside ICU. Can it be definitely justified? Eur J Intern Med 2019; 64:e8. [PMID: 31202478 DOI: 10.1016/j.ejim.2019.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/20/2019] [Indexed: 11/17/2022]
Affiliation(s)
| | - Teresa Diaz de Teran
- Hospital Universitario Marqués de Valdecilla, Sleep and Non Invasive Ventilation Unit, Pulmonary, Santander, Spain
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Ferrone G, Spinazzola G, Hadda V, Esquinas A. Proportional assist ventilation plus (PAVAV+) from weaning to assist control ventilation: insights for caution on issue. Minerva Anestesiol 2019; 85:1141-1142. [PMID: 31124627 DOI: 10.23736/s0375-9393.19.13733-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giuliano Ferrone
- Department of Anesthesia and Intensive Care, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Giorgia Spinazzola
- Department of Anesthesia and Intensive Care, A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Vijay Hadda
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India -
| | - Antonio Esquinas
- Unit of Intensive Care, Morales Meseguer Hospital, Murcia, Spain
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Suri TM, Esquinas A, Hadda V, Mohan A. HVNI vs NIPPV in the treatment of acute decompensated heart failure: Is acute stabilization enough? Am J Emerg Med 2019; 37:1588-1589. [PMID: 31085011 DOI: 10.1016/j.ajem.2019.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 05/07/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tejas Menon Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Vijay Hadda
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Isiklar A, Serin SO, Esquinas A. Wyniki badań radiologicznych a odpowiedź na nieinwazyjną wentylację. Adv Respir Med 2019. [DOI: 10.5603/arm.63818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mimo że nieinwazyjna wentylacja (NIV) jest prostą oraz użyteczną metodą, obserwuje się znaczne zróżnicowanie w jej stosowaniu pomiędzy krajami, regionami czy nawet szpitalami. Pacjent powinien być oceniony zarówno w stosunku do odpowiedzi subiektywnej (niewydolność oddechowa, świadomość, problemy związane z maską oraz przepływem powietrza), fizjologicznej (częstość oddechów, wysiłek oddechowy, przeciek powietrza), jak i zgodności z respiratorem (wymiana gazowa, pulsoksymetria, gazometria krwi tętniczej). Normalizacja częstości oddechów w ciągu 1 lub 2 godzin po rozpoczęciu leczenia jest jednym z najważniejszych wykładników postępów leczenia. Celem jest utrzymanie częstości oddechów między 20 a 30 oddechami na minutę. Zmniejszenie skurczów międzyżebrowych i nadobojczykowych, oddychania paradoksalnego czy aktywności współczulnej wskazują na powodzenie terapii. Gazometrię krwi tętniczej oznacza się w ciągu pierwszych 2 godzin w celu oceny pH i CO2; a w razie potrzeby także później. Ogólnie rzecz ujmując, NIV ocenia się za pomocą gazometrii krwi tętniczej, parametrów hemodynamicznych i kilku testów laboratoryjnych. Liczba badań dotyczących NIV jest ograniczona. Autorzy niniejszej pracy postawili sobie za cel ocenę radiologicznych implikacji dystrybucji gazu w tkance płucnej w trakcie terapii NIV.
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Fiorentino G, Annunziata A, Gaeta AM, Lanza M, Esquinas A. Continuous noninvasive ventilation for respiratory failure in patients with amyotrophic lateral sclerosis: current perspectives. Degener Neurol Neuromuscul Dis 2018; 8:55-61. [PMID: 30233272 PMCID: PMC6130289 DOI: 10.2147/dnnd.s170771] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Respiratory failure is a recognized late complication of amyotrophic lateral sclerosis. It is related to the neurological progression of the diseases with the impairment of the respiratory musculature. Survival and quality of life of amyotrophic lateral sclerosis patients is improved by using noninvasive mechanical ventilation. The rate of long-term mechanical ventilation is different within and between countries. Cultural factors, socioeconomic conditions, and physician attitude often influence the decision to start noninvasive ventilation. Technical elements, like the choice of the correct interface, solid caregivers support, and the communication between the patient and the physician are essential for achieving therapeutic goals, especially in the case of continuous treatment.
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Affiliation(s)
| | - Anna Annunziata
- Division of Respiratory Physiopathology, Monaldi Hospital, Naples, Italy,
| | - Anna Michela Gaeta
- Respiratory Department, Arnau de Vilanova and Santa Maria Universitary Hospital, IRBLleida, Lleida, Spain
| | - Maurizia Lanza
- Division of Respiratory Physiopathology, Monaldi Hospital, Naples, Italy,
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Yıldırım F, Piervincenzi E, Meyancı Köksal G, Esquinas A. Noninvasive auto-titrating ventilation (AVAPS-AE) versus average volume-assured pressure support (AVAPS) ventilation in hypercapnic respiratory failure patients: comment. Intern Emerg Med 2018; 13:979-980. [PMID: 29876870 DOI: 10.1007/s11739-018-1888-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 05/30/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Fatma Yıldırım
- Intensive Care Unit, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey.
| | - Edoardo Piervincenzi
- Department of Anesthesiology and Critical Care, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Güniz Meyancı Köksal
- Department of Anesthesiology and Reaniamtion, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Cavalleri M, Barbagelata E, Diaz de Teran T, Ferraioli G, Esquinas A, Nicolini A. Noninvasive and invasive ventilation in severe pneumonia: Insights for the noninvasive ventilatory approach. J Crit Care 2018; 48:479. [PMID: 30126747 DOI: 10.1016/j.jcrc.2018.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | - Elena Barbagelata
- Internal Medicine Department, General Hospital, Sestri Levante, Italy
| | - Teresa Diaz de Teran
- Hospital Universitario Marqués de Valdecilla, Sleep and Non Invasive Ventilation Unit, Pulmonary, Santander, Spain
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Takir HB, Esquinas A. Hospitals' Patterns of Noninvasive Ventilation in Asthma: Evidence or Deep Recommendations Needed? Chest 2018; 150:468-9. [PMID: 27502983 DOI: 10.1016/j.chest.2016.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 04/19/2016] [Accepted: 04/22/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
- Huriye Berk Takir
- Sureyyapasa Chest Disease and Research Hospital-Intensive Care Unit, Istanbul, Turkey.
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Abstract
Humidification therapy is widely used in patients during invasive ventilation and the importance of heating and humidifying the inhaled air is well defined in both the acute and long term setting. On the other hand the continuous usage of humidification in noninvasive ventilation is controversial and the long term effects are still not well defined. The usage of noninvasive ventilation is especially important in hypercapnic Chronic obstructive pulmonary disease (COPD) and also the obstructive sleep apnea syndrome (OSAS) patients and compliance to this treatment is essential in long term. Limited number of studies have shown that heated humidification is preferred by COPD patients and might help in mucus clearance, reduce mucus viscosity and help in expectoration, but there was shown no priority as far as concerns the lung function or blood gas parameters. Humidification might also be important in long term oxygen treatment since the inhalation of dry air can lead to ciliary dysfunction, alterations in mucus properties and mucociliary clearance impairment. Studies concerning OSAS patients showed that humidification helps to reduce the nasal symptoms but plays no role in increasing the compliance of patients in long term. Multi-center studies with large number of patients are needed to identify patients' groups who are likely to benefit from the addition of humidification to noninvasive therapy.
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Affiliation(s)
- Dorina Esendağlı
- Clinic of Chest Diseases, Ankara Hospital, Baskent University, Ankara, Turkey
| | - Sevinç Sarınç Ulaşlı
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Faverio P, De Giacomi F, Sardella L, Fiorentino G, Carone M, Salerno F, Ora J, Rogliani P, Pellegrino G, Sferrazza Papa GF, Bini F, Bodini BD, Messinesi G, Pesci A, Esquinas A. Management of acute respiratory failure in interstitial lung diseases: overview and clinical insights. BMC Pulm Med 2018; 18:70. [PMID: 29764401 PMCID: PMC5952859 DOI: 10.1186/s12890-018-0643-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/04/2018] [Indexed: 01/15/2023] Open
Abstract
Background Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. Methods A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017). Results In managing ARF, it is important to establish an adequate diagnostic and therapeutic management depending on whether the patient has an underlying known chronic ILD or ARF is presenting in an unknown or de novo ILD. In the first case both primary causes, such as acute exacerbations of the disease, and secondary causes, including concomitant pulmonary infections, fluid overload and pulmonary embolism need to be investigated. In the second case, a diagnostic work-up that includes investigations in regards to ILD etiology, such as autoimmune screening and bronchoalveolar lavage, should be performed, and possible concomitant causes of ARF have to be ruled out. Oxygen supplementation and ventilatory support need to be titrated according to the severity of ARF and patients’ therapeutic options. High-Flow Nasal oxygen might potentially be an alternative to conventional oxygen therapy in patients requiring both high flows and high oxygen concentrations to correct hypoxemia and control dyspnea, however the evidence is still scarce. Neither Non-Invasive Ventilation (NIV) nor Invasive Mechanical Ventilation (IMV) seem to change the poor outcomes associated to advanced stages of ILDs. However, in selected patients, such as those with less severe ARF, a NIV trial might help in the early recognition of NIV-responder patients, who may present a better short-term prognosis. More invasive techniques, including IMV and Extracorporeal Membrane Oxygenation, should be limited to patients listed for lung transplant or with reversible causes of ARF. Conclusions Despite the overall poor prognosis of ARF in ILDs, a personalized approach may positively influence patients’ management, possibly leading to improved outcomes. However, further studies are warranted.
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Affiliation(s)
- Paola Faverio
- Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900, Monza, Italy.
| | - Federica De Giacomi
- Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900, Monza, Italy
| | - Luca Sardella
- Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900, Monza, Italy
| | - Giuseppe Fiorentino
- UOC di Fisiopatologia e Riabilitazione Respiratoria, AO Ospedali dei Colli Monaldi, Naples, Italy
| | - Mauro Carone
- UOC Pulmonology and Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS di Cassano Murge (BA), Cassano delle Murge, Italy
| | - Francesco Salerno
- UOC Pulmonology and Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS di Cassano Murge (BA), Cassano delle Murge, Italy
| | - Jousel Ora
- Division of Respiratory Medicine, University Hospital Tor Vergata, Rome, Italy
| | - Paola Rogliani
- Division of Respiratory Medicine, University Hospital Tor Vergata, Rome, Italy
| | - Giulia Pellegrino
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | | | - Francesco Bini
- Department of Internal Medicine, UOC Pulmonology, Ospedale ASST-Rhodense, Garbagnate Milanese, Italy
| | - Bruno Dino Bodini
- Pulmonology Unit, Ospedale Maggiore della Carità, University of Piemonte Orientale, Novara, Italy
| | - Grazia Messinesi
- Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900, Monza, Italy
| | - Alberto Pesci
- Dipartimento Cardio-Toraco-Vascolare, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST di Monza, Via Pergolesi 33, 20900, Monza, Italy
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