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Gonçalves G, Saeed H, Abdelrahim ME, Harb HS, Madney YM, Eng K, Karim HMR, El-Khatib M, Mina B, Skoczyński S, Sarc I, Caldeira V, Cabral SM, Cabrita B, Guia M, Duan J, Barjaktarevic I, Fiorentino G, Piervincenzi E, Köksal G, Sarin SO, Papadakos PJ, Bayrakci B, Hadda V, Laier-Groeneveld G, Burns KEA, Scala R, Alcaraz AC, Esquinas AM. Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights. Adv Respir Med 2021; 88:233-244. [PMID: 32706107 DOI: 10.5603/arm.2020.0110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/27/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed.
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Affiliation(s)
- Gil Gonçalves
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Haitham Saeed
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Mohamed E Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Hadeer S Harb
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Yasmin M Madney
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Kevin Eng
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, United States
| | - Habid M R Karim
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Mohamad El-Khatib
- Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Bushra Mina
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwell Health, Lenox Hill Hospital, New York, United States
| | - Szymon Skoczyński
- Department of Pulmonology, Faculty of Medical Sciences in Katowice, Medical University of Silesia - Katowice, Poland
| | - Irena Sarc
- Noninvasive Ventilation Department, University Clinic for Pulmonary and Allergic Diseases, Golnik, Slovenia
| | - Vânia Caldeira
- Pulmonology Department, Santa Marta Hospital, Lisbon, Portugal
| | - Sara M Cabral
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bruno Cabrita
- Pulmonology Department, Pedro Hispano Hospital, Matosinhos, Portugal
| | - Miguel Guia
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Jun Duan
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, United States
| | | | | | - Güniz Köksal
- Department of Anaesthesiology and Reanimation, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Sibel O Sarin
- Internal Medicine, Istanbul Umraniye Research Hospital, Istanbul, Turkey
| | - Peter J Papadakos
- Department of Anesthesiology, University of Rochester, Rochester, United States
| | - Benan Bayrakci
- Pediatric Intensive Care Department, Hacettepe University, Ankara, Turkey
| | - Vijay Hadda
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - G Laier-Groeneveld
- Pneumology, Clinical and Home Ventilatory Support and Sleep, Schellstrasse, Bochum, Germany
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Raffaele Scala
- Pulmonology and Respiratory Intensive Care Unit, S Donato Hospital, Arezzo, Italy
| | - Andres C Alcaraz
- Intensive Care and Noninvasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain
| | - Antonio M Esquinas
- Intensive Care and Noninvasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain
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Akyol Beyoğlu Ç, Özdilek A, Erbabacan E, Özmumcu EA, Ekici B, Köksal G, Altıntaş F, Purisa S. Evaluation of the effects of subcostal transversus abdominis plane block on acute and subacute pain development following inguinal herniography: Randomized clinical study. Agri 2018; 30:123-129. [PMID: 30028478 DOI: 10.5505/agri.2018.49344] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The effect of subcostal transversus abdominis plane (TAP) block on postoperative pain is contradictive. The aim of this study was to evaluate the effect of subcostal TAP block on subacute pain in patients who have undergone inguinal herniography. METHODS Patients aged between 18 and 75 years with American Society of Anesthesiologists 1-3 and who were to undergo elective unilateral inguinal herniography with mesh under general anesthesia were included. Fifty patients were under an intravenous analgesic regimen (group I) and 50 patients underwent subcostal TAP block postoperatively in addition to the intravenous analgesic regimen (group II). The primary outcome measure was pain scores 1 month postoperatively by comparing Numerical Rating Scale values with the Mann-Whitney U test between groups I and II. Secondary outcome measures were life qualification scores 1 month postoperatively and pain scores 24 h and 15 days postoperatively. RESULTS Postoperative 15th-min; 1st-, 6th-, 12th-, and 24th-h; 15th-day (p=0.00); and 1st-month Numerical Rating Scale values were significantly lower in group II than in group I (p=0.02). No significant difference was observed between the groups in terms of LQS 15 days postoperatively (p=0.013). On group comparison, LQS was higher in the 1st month than at the 15th day postoperatively in group I (p=0.201). CONCLUSION Subcostal TAP block provides an effective postoperative pain treatment in the acute period and in the 1st postoperative month in patients undergoing inguinal herniography.
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Affiliation(s)
- Çiğdem Akyol Beyoğlu
- Department of Anesthesiology and Reanimation, Istanbul University Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.
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Ozalp I, Coşkun T, Tokatli A, Kalkanoğlu HS, Dursun A, Tokol S, Köksal G, Ozgüc M, Köse R. Newborn PKU screening in Turkey: at present and organization for future. Turk J Pediatr 2001; 43:97-101. [PMID: 11432505] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
At present, pkenylketonuria screening is a national child health program in Turkey which is carried out collaboratively by the Ministry of Health and three University Children's Hospitals in Ankara, Istanbul and Izmir. Since 1986 the number of cities included in the screening program has gradually increased, now and it covers all the metropolises the country. A total of 383 babies were found with persistent hyperphenylalaninemia (1:4,172) among 1,605,582 babies screened by the Guthrie test at the Hacettepe Screening Center in Ankara. By taking into account pretreatment phenylalanine levels and phenlyalanine tolerances at five years of age, the numbers of classical and mild-moderate phenylketonuria and mild hyperphenylalaninemia cases were 216, 102 and 58, respectively. The major problems encountered in the screening program and in management of the detected cases were unsatisfactory sample collection, early discharge from maternity hospitals, difficulties in reaching some detected cases, and noncompliance with dietary therapy due to illiterate parents or to lack of social insurance. To screen and treat all newborns for phenylketonuria and to include at least hypothyroidism in the screening program, there is a need for a more disciplinary intersectoral approach than exists at present.
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Affiliation(s)
- I Ozalp
- Department of Pediatrics, School of Health Technology, Hacettepe University, Ankara, Turkey
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