Indian Journal of Respiratory Care最新文献_第8页

Postextubation stridor in paediatric cardiac surgery patients 小儿心脏手术患者拔管后喘鸣

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02109

J. Sreedharan, S. Nair, Rakhi B, Rakhi K R, Joel D Vazhakat, Jomson John

{"title":"Postextubation stridor in paediatric cardiac surgery patients","authors":"J. Sreedharan, S. Nair, Rakhi B, Rakhi K R, Joel D Vazhakat, Jomson John","doi":"10.5005/jp-journals-11010-02109","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02109","url":null,"abstract":"Background: Paediatric patients undergoing cardiac surgery are likely to be prone to developing postextubation stridor (PES) due to their airway anatomy and several factors related to surgery, Aim: To examine the incidence and risk factors for PES in paediatric patients undergoing cardiac surgery. Methods: The study was prospectively conducted in the paediatric cardiac postsurgical ICU (PICU) at a tertiary referral hospital from November 2010 to January 2012. All paediatric patients presenting with immediate stridor or its developing within 24 hours after extubation were included. Only those patients who were ventilated for at least 6 hours after surgery, but not more than 7 days and deemed fit for elective extubation were considered. Results: Of the 1328 patients admitted to the PICU, 29 patients (2.18%) met the criteria for PES. Of these, 22 (75.6%) were < 1 year old. Ten patients (34%) did not respond to conservative approach or Noninvasive Ventilation (NIV) and had to be reintubated. Six patients were reintubated within an hour, three in < 6 hours and one after 12 hours of extubation. Conclusion: PES is common in paediatric postcardiac surgical patients. Infants are more prone to develop PES. Majority of them can be successfully managed with conservative measures and noninvasive ventilation. The onset of PES varies from immediately after extubation to 3 hours after extubation. Up to one-third of the patients with PES may require reintubation and is common in the first hour after extubation. Patients who develop PES need close observation in the first few hours after extubation.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47087067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome 成人急性呼吸窘迫综合征患者的高频振荡通气

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02103

B. Pawar, P. Rajhans, S. Jog, P. Akole, B. Bhurke, D. Patel, M. Kothari

{"title":"High frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome","authors":"B. Pawar, P. Rajhans, S. Jog, P. Akole, B. Bhurke, D. Patel, M. Kothari","doi":"10.5005/jp-journals-11010-02103","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02103","url":null,"abstract":"Clinical trials on the use of mechanical ventilation in Acute Respiratory Distress Syndrome (ARDS) showed that use of low tidal volumes reduces the mortality significantly. Another approach that proved beneficial was to open the lung and keep it open. Theoretically, this can be best achieved with High Frequency Oscillatory Ventilation (HFOV). HFOV provides oscillations at three to ten Hertz in adults. Both inspiration and expiration are active. Gas exchange occurs even though the tidal volume delivered during each oscillation is less than the anatomical dead space. Furthermore, the potential adverse effects of the conventional ventilation such as alveolar overdistension, and repeated opening and collapse of alveoli are reduced. Many investigators have studied the potential benefit of HFOV in neonatal and paediatric population but the evidence for its use in adult population is limited. A lot of work is being done and two large ongoing trials OSCAR and OSCILLATE should give better idea regarding its use in adults. This review article mainly focuses on the principles and practices of HFOV in adults and current evidence regarding its use in adults.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43859748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Noninvasive ventilation in preterm neonates - Nasal continuous positive airway pressure vS Nasal intermittent positive pressure ventilation – A randomised controlled trial 早产儿无创通气——鼻腔持续正压通气vS鼻腔间歇性正压通气——一项随机对照试验

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02107

Tisha Ann Skariah, L. Lewis, Arun Sasi

{"title":"Noninvasive ventilation in preterm neonates - Nasal continuous positive airway pressure vS Nasal intermittent positive pressure ventilation – A randomised controlled trial","authors":"Tisha Ann Skariah, L. Lewis, Arun Sasi","doi":"10.5005/jp-journals-11010-02107","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02107","url":null,"abstract":"Background: Noninvasive ventilation (NIV) has been used in preterm neonates in the past few decades, with the main objective of reducing the exposure to invasive ventilation. It proves to be safe and effective but the best option is yet to be determined. Objective: To determine, if nasal intermittent positive pressure ventilation (NIPPV) decreases the need for mechanical ventilation in the first 48 h when given as a respiratory support post-extubation in preterm neonates compared to nasal continuous positive airway pressure (NCPAP). It is a randomised controlled trial. Method: Preterm neonates (gestational age 28-36 weeks) with respiratory distress requiring invasive ventilation were randomly assigned to receive NIPPV or NCPAP as postextubation respiratory support. The primary outcome was the need for mechanical ventilation within the first 48 hours of life. Results: A total of 32 neonates in postextubation NIV group after stratification to gestational age of 28-32 weeks and 33-36 weeks. The need for invasive mechanical ventilation in the first 48 h was not different in both NIPPV (11.1%) and NCPAP (7.1%). The complications associated with these modes were also compared and analysed. There was no difference noted. Conclusions: NIPPV did not decrease the need for mechanical ventilation compared to NCPAP, overall, in the first 48 hours of support. It could be considered as safe and beneficial compared to NCPAP. However, further studies have to assess the potential benefits and complications associated with NIPPV in preterm neonates.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45816491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utility of rapid shallow breathing index in progressive weaning of adult patients from mechanical ventilation using pressure support ventilation 快速浅呼吸指数在使用压力支持通气的成人机械通气患者进行性脱机中的应用

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-05 DOI: 10.5005/jp-journals-11010-02108

Gordon R Kharmalki, A. Shenoy, S. Johnson

{"title":"Utility of rapid shallow breathing index in progressive weaning of adult patients from mechanical ventilation using pressure support ventilation","authors":"Gordon R Kharmalki, A. Shenoy, S. Johnson","doi":"10.5005/jp-journals-11010-02108","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-02108","url":null,"abstract":"Introduction: Many weaning indices have been proposed to evaluate readiness of a patient to tolerate discontinuation of mechanical ventilation. Aim: This study evaluated the utility of these indices in progressive weaning from mechanical ventilation. Methods: All patients receiving mechanical ventilation and assessed to be ready to wean clinically were included in the study. They were initially placed on pressure support, positive end expiratory pressure (PEEP) of 5-8 cm H2O and FiO2 0.4. Tidal volume, respiratory frequency, minute ventilation and rapid shallow breathing index (RSBI) were measured at baseline, 5 min, 30 min and at 2 h. The patient was also monitored for clinical signs of respiratory distress. If the patient remained stable, the pressure support was reduced by 2 cm H2O and the weaning process repeated till PSV reached 5-8 cm H2O. Results: Respiratory rate (< 35/min) and tidal volume corrected to weight (> 5 mL/kg) had high sensitivity (100% and 98.5% respectively) but lacked specificity. Minute volume of < 10 L/min lacked both sensitivity (73.1%) and specificity (50%). The RSBI (< 105 b/min/L) had very high sensitivity (99.1%), reasonable specificity (83.3%) with a positive predictive value 98.4% and a negative predictive value 90.9%. RSBI corrected to weight (7 breaths/min/mL/kg) was not useful. RSBI rate of < 20% was found to be a good weaning index even for progressive decrease in ventilatory support. Conclusion: RSBI < 105 b/min/L and RSBI rate < 20% are reliable criteria to predict success of progressive weaning from mechanical ventilation using pressure support.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46349930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial oxygenation as early predictor of mortality in acute respiratory distress syndrome: a retrospective study 初始氧合作为急性呼吸窘迫综合征死亡率的早期预测因子:一项回顾性研究

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-02 DOI: 10.5005/jp-journals-11010-04105

H. Mahto, A. Shenoy, R. Unnikrishnan

{"title":"Initial oxygenation as early predictor of mortality in acute respiratory distress syndrome: a retrospective study","authors":"H. Mahto, A. Shenoy, R. Unnikrishnan","doi":"10.5005/jp-journals-11010-04105","DOIUrl":"https://doi.org/10.5005/jp-journals-11010-04105","url":null,"abstract":"Introduction: Acute respiratory distress syndrome (ARDS) is a major contributor to mortality and morbidity of adult patients admitted to intensive care units (ICU). Numerous scoring systems have been developed for critically ill patients with the goal of more accurately predicting clinical outcomes. However, the variability in these scores among individual patients, and consequently, their individual predictive ability is quite limited. Aim: To evaluate the role of initial oxygenation as an early predictor of mortality in ARDS patients. Methodology: One hundred and six mechanically ventilated adult patients with ARDS were enrolled retrospectively. Baseline parameters from the day of ICU admission were recorded. The details of ventilation, inspired oxygen fraction required, positive end-expiratory pressure and number of days on ventilation along with duration of hospital stay were recorded. Similarly, the status of oxygenation was assessed using PaO2/FiO2 (P/F) ratio. Survival of the patients was correlated with the baseline status of oxygenation. Results: Of the 106 patients, 65 were males and 41 female. The mean (± SD) age was 44 years (16.08). The difference in the P/F ratio between survivors and nonsurvivors was statistically significant. The ROC curve showed a cutoff value for P/F ratio of 108. Among survivors, the ICU stay was shorter in patients in pulmonary group compared to extrapulmonary group. Conclusion: Mortality is high if the baseline P/F ratio at admission is below 108. There is no difference in mortality due to lung injury caused by pulmonary or extrapulmonary aetiologies. ICU stay is longer among survivors if cause of ARDS is extrapulmonary.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48972675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuing education 继续教育

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-02 DOI: 10.5005/jp-journals-11010-04201

A. Shenoy, R. Unnikrishnan

引用次数: 0

Postextubation stridor in the ICU ICU中拔管后的刺耳声音

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-02 DOI: 10.5005/jp-journals-11010-06107

A. Shenoy

引用次数: 0

Monitoring an unconscious patient in the Intensive Care Unit 在加护病房监护一个失去意识的病人

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-02 DOI: 10.5005/jp-journals-11010-06104

N. S. L. Jacob, J. Paul

引用次数: 1

Electrical Impedance Tomography - Watch the lungs breathe! 电阻抗断层扫描-观察肺部呼吸！

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-02 DOI: 10.5005/jp-journals-11010-04104

Abdul Gafoor M Tharayi

引用次数: 0

Capnography: Principles and application in critical care medicine 脑电图：原理及其在重症医学中的应用

IF 0.3

Indian Journal of Respiratory Care Pub Date : 2022-12-02 DOI: 10.5005/jp-journals-11010-04208

L. Budania, K. Goyal

引用次数: 0