The Experts below are selected from a list of 11694 Experts worldwide ranked by ideXlab platform
Giorgio Conti - One of the best experts on this subject based on the ideXlab platform.
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Noninvasive Ventilation in intensive care unit patients
Current Opinion in Critical Care, 2000Co-Authors: Massimo Antonelli, Giorgio ContiAbstract:Current knowledge regarding Noninvasive Ventilation (NIV) and some technical aspects of the subject are discussed. In patients with chronic obstructive pulmonary disease, NIV can prevent endotracheal intubation and reduce mortality. A trial of NIV could be recommended in the early phases of acute exacerbation of chronic obstructive pulmonary disease, before eventual intubation. Some promising preliminary results propose Noninvasive Ventilation as a possible first line intervention for acute hypoxemic respiratory failure. However, the use of Noninvasive Ventilation in patients with acute respiratory failure still remains controversial. Large randomized multicenter studies are still needed before extensive clinical application of NIV is used in patients with acute hypoxemic respiratory failure.
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Noninvasive Ventilation for acute exacerbations of chronic obstructive pulmonary disease
The New England Journal of Medicine, 1995Co-Authors: Laurent Brochard, Giorgio Conti, J. Mancebo, Marc Wysocki, F Lofaso, Alain Rauss, Gerald Simonneau, S Benito, A Gasparetto, Francois LemaireAbstract:Background. In patients with acute exacer- bations of chronic obstructive pulmonary disease, nonin- vasive Ventilation may be used in an attempt to avoid en- dotracheal intubation and complications associated with mechanical Ventilation. Methods. We conducted a prospective, randomized study comparing Noninvasive pressure-support ventila- tion delivered through a face mask with standard treat- ment in patients admitted to five intensive care units over a 15-month period. Results. A total of 85 patients were recruited from a larger group of 275 patients with chronic obstructive pulmonary disease admitted to the intensive care units in the same period. A total of 42 were randomly as- signed to standard therapy and 43 to Noninvasive venti- lation. The two groups had similar clinical characteris- tics on admission to the hospital. The use of Noninvasive Ventilation significantly reduced the need for endotra- cheal intubation (which was dictated by objective cri- teria): 11 of 43 patients (26 percent) in the noninva- sive-Ventilation group were intubated, as compared with 31 of 42 (74 percent) in the standard-treatment group (P � 0.001). In addition, the frequency of complications was significantly lower in the Noninvasive-Ventilation group (16 percent vs. 48 percent, P � 0.001), and the mean ( � SD) hospital stay was significantly shorter for patients receiving Noninvasive Ventilation (23 � 17 days vs. 35 � 33 days, P � 0.005). The in-hospital mortality rate was also significantly reduced with Noninvasive Ventilation (4 of 43 patients, or 9 percent, in the nonin- vasive-Ventilation group died in the hospital, as com- pared with 12 of 42, or 29 percent, in the standard-treat- ment group; P � 0.02). Conclusions. In selected patients with acute exacer- bations of chronic obstructive pulmonary disease, nonin- vasive Ventilation can reduce the need for endotracheal intubation, the length of the hospital stay, and the in-hos- pital mortality rate. (N Engl J Med 1995;333:817-22.)
Nicholas S. Hill - One of the best experts on this subject based on the ideXlab platform.
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Noninvasive Ventilation for acute respiratory failure.
Current opinion in critical care, 2005Co-Authors: Adnan Majid, Nicholas S. HillAbstract:PURPOSE OF REVIEW This review critically examines recent literature related to applications of Noninvasive Ventilation in the acute setting. RECENT FINDINGS Recent articles have strengthened the evidence supporting the use of Noninvasive Ventilation for patients with cardiogenic pulmonary edema and exacerbation of severe chronic pulmonary obstructive disease. In the former, however, it remains unclear whether Noninvasive Ventilation offers any significant advantages over continuous positive airway pressure. The rate of myocardial infarction seems to be no higher when patients with cardiogenic pulmonary edema are treated with Noninvasive Ventilation rather than continuous positive airway pressure, although caution is still advised in patients with acute coronary syndromes. Noninvasive Ventilation also does not seem to increase the risk of dissemination of severe acute respiratory syndrome to health care workers as long as strict isolation procedures are used. Noninvasive Ventilation facilitates weaning in patients with chronic obstructive pulmonary disease but should not be used routinely to treat extubation failure, and necessary intubation should not be delayed. Guidelines for the use of Noninvasive Ventilation can alter caregivers' behavior but have not been clearly shown to improve outcomes. Outcomes do seem to improve, however, as caregivers acquire experience with the technique. SUMMARY The recent literature has refined some of the current indications for Noninvasive Ventilation in the acute-care setting, including chronic pulmonary obstructive disease and cardiogenic pulmonary edema. Guidelines for use are now being developed, and outcomes seem to be improving, partly as a consequence of greater caregiver experience and possibly related to technologic advances.
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Noninvasive Ventilation in chronic obstructive pulmonary disease
Clinics in chest medicine, 2000Co-Authors: Nicholas S. HillAbstract:Noninvasive Ventilation, referring to the provision of mechanical ventilatory assistance without the need for an invasive airway, has been assuming increasing importance in the management of chronic obstructive pulmonary disease (COPD). Particularly in the acute arena, where a number of randomized, controlled trials have demonstrated the efficacy of Noninvasive positive-pressure Ventilation (NPPV) in averting the need for intubation, Noninvasive Ventilation is now seen as the first choice mode of Ventilation for the therapy of selected patients suffering from COPD exacerbations. Despite numerous studies spanning decades using different types of nonivasive ventilators and all manner of ventilator regimens, however, the use of Noninvasive Ventilation for patients with severe stable COPD remains controversial. The following discussion focuses on the use of Noninvasive Ventilation for patients with severe COPD in the subacute and stable settings, paying little attention to the acute setting. For more information on acute applications, the reader is referred elsewhere. 2,29 The following discussion includes the physiologic bases for the use of Noninvasive Ventilation in severe COPD, evidence for (or against) efficacy, possible indications and selection guidelines, newer possible uses, and practical application as it applies to patients with COPD.
Massimo Antonelli - One of the best experts on this subject based on the ideXlab platform.
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Noninvasive Ventilation: practical advice.
Current opinion in critical care, 2013Co-Authors: Giuseppe Bello, Gennaro De Pascale, Massimo AntonelliAbstract:Purpose of reviewThis critical review discusses the key points that would be of practical help for the clinician who applies Noninvasive Ventilation (NIV) for treatment of patients with acute respiratory failure (ARF).Recent findingsIn recent years, the growing role of NIV in the acute care setting
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Noninvasive Ventilation in intensive care unit patients
Current Opinion in Critical Care, 2000Co-Authors: Massimo Antonelli, Giorgio ContiAbstract:Current knowledge regarding Noninvasive Ventilation (NIV) and some technical aspects of the subject are discussed. In patients with chronic obstructive pulmonary disease, NIV can prevent endotracheal intubation and reduce mortality. A trial of NIV could be recommended in the early phases of acute exacerbation of chronic obstructive pulmonary disease, before eventual intubation. Some promising preliminary results propose Noninvasive Ventilation as a possible first line intervention for acute hypoxemic respiratory failure. However, the use of Noninvasive Ventilation in patients with acute respiratory failure still remains controversial. Large randomized multicenter studies are still needed before extensive clinical application of NIV is used in patients with acute hypoxemic respiratory failure.
Jose M. Panisello - One of the best experts on this subject based on the ideXlab platform.
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Noninvasive Ventilation in pediatric intensive care.
Current opinion in pediatrics, 2013Co-Authors: Kimberly Marohn, Jose M. PaniselloAbstract:Purpose of reviewThe use of Noninvasive Ventilation (NIV) has become increasingly popular in the pediatric intensive care unit (PICU) over the last decade. This review intends to assess our current knowledge on the utilization of Noninvasive support in children, especially focusing on its efficacy a
Antoni Torres - One of the best experts on this subject based on the ideXlab platform.
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Noninvasive Ventilation for acute respiratory failure.
Current opinion in critical care, 2015Co-Authors: Miquel Ferrer, Antoni TorresAbstract:Purpose of reviewThis article reviews the use of Noninvasive Ventilation (NIV) in patients with acute respiratory failure (ARF), with a critical review of the most recent literature in this setting.Recent findingsThe efficacy of NIV is variable depending on the cause of the episode of ARF. In commun
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early Noninvasive Ventilation averts extubation failure in patients at risk a randomized trial
American Journal of Respiratory and Critical Care Medicine, 2006Co-Authors: Miquel Ferrer, Mauricio Valencia, Josep M Nicolas, Oscar Bernadich, Joan Ramon Badia, Antoni TorresAbstract:Rationale: Respiratory failure after extubation and reintubation is associated with increased morbidity and mortality.Objectives: To assess the efficacy of Noninvasive Ventilation in averting respiratory failure after extubation in patients at increased risk.Methods: A prospective randomized controlled trial was conducted in 162 mechanically ventilated patients who tolerated a spontaneous breathing trial after recovery from the acute episode but had increased risk for respiratory failure after extubation. Patients were randomly allocated after extubation to receive Noninvasive Ventilation for 24 h (n = 79), or conventional management with oxygen therapy (control group, n = 83).Measurements and Main Results: The primary end-point variable was the decrease in respiratory failure after extubation. In the Noninvasive Ventilation group, respiratory failure after extubation was less frequent (13, 16 vs. 27, 33%; p = 0.029) and the intensive care unit mortality was lower (2, 3 versus 12, 14%; p = 0.015). However...
