在门诊家庭环境中使用RAM插管的无创鼻通气。

Q3 Medicine

Open Respiratory Medicine Journal Pub Date : 2017-07-21 eCollection Date: 2017-01-01 DOI:10.2174/1874306401711010041

Wilfredo De Jesus Rojas, Cheryl L Samuels, Traci R Gonzales, Katrina E McBeth, Aravind Yadav, James M Stark, Cindy Jon, Ricardo A Mosquera

{"title":"在门诊家庭环境中使用RAM插管的无创鼻通气。","authors":"Wilfredo De Jesus Rojas, Cheryl L Samuels, Traci R Gonzales, Katrina E McBeth, Aravind Yadav, James M Stark, Cindy Jon, Ricardo A Mosquera","doi":"10.2174/1874306401711010041","DOIUrl":null,"url":null,"abstract":"Background: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings.Objective: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure.Methods: We performed a retrospective case series of 18 children (4 months to 19 years old) using the Nasal NIV/RAM Cannula in the Pediatric Pulmonary Clinic at the McGovern Medical School, UTHealth (2014-16). Consideration for Nasal NIV/RAM Cannula utilization included: inability to wean-off in-patient respiratory support, comfort for dyspnea, intolerability of conventional mask interfaces and tracheostomy avoidance.Results: Average age was 7 years. 50% were Caucasian, 38% African-American and 11% Hispanics. Pulmonary disorders included: chest wall weakness (38%), central control abnormalities (33%), obstructive lung disease (16%) and restrictive lung disease (11%). Indications for Nasal NIV/RAM Cannula initiation included: CPAP/BPAP masks intolerability (11%), dyspnea secondary to chest wall weakness (38%) and tracheostomy avoidance (50%). Average length of use of Nasal NIV/RAM Cannula was 8.4 months. Successful implementation of Nasal NIV/Ram Cannula was 94%. One patient required a tracheostomy following the use of Nasal NIV/RAM Cannula. Significant decrease in arterial PaCO2 pre and post Nasal NIV/RAM cannula initiation was notable (p=0.001).Conclusion: Outpatient use of Nasal NIV/RAM Cannula may prove to be a feasible and save treatment alternative for children with chronic respiratory failure, chest wall weakness, dyspnea and traditional nasal/face mask intolerance to avoid tracheostomy.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"11 ","pages":"41-46"},"PeriodicalIF":0.0000,"publicationDate":"2017-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401711010041","citationCount":"8","resultStr":"{\"title\":\"Use of Nasal Non-Invasive Ventilation with a RAM Cannula in the Outpatient Home Setting.\",\"authors\":\"Wilfredo De Jesus Rojas, Cheryl L Samuels, Traci R Gonzales, Katrina E McBeth, Aravind Yadav, James M Stark, Cindy Jon, Ricardo A Mosquera\",\"doi\":\"10.2174/1874306401711010041\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings.Objective: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure.Methods: We performed a retrospective case series of 18 children (4 months to 19 years old) using the Nasal NIV/RAM Cannula in the Pediatric Pulmonary Clinic at the McGovern Medical School, UTHealth (2014-16). Consideration for Nasal NIV/RAM Cannula utilization included: inability to wean-off in-patient respiratory support, comfort for dyspnea, intolerability of conventional mask interfaces and tracheostomy avoidance.Results: Average age was 7 years. 50% were Caucasian, 38% African-American and 11% Hispanics. Pulmonary disorders included: chest wall weakness (38%), central control abnormalities (33%), obstructive lung disease (16%) and restrictive lung disease (11%). Indications for Nasal NIV/RAM Cannula initiation included: CPAP/BPAP masks intolerability (11%), dyspnea secondary to chest wall weakness (38%) and tracheostomy avoidance (50%). Average length of use of Nasal NIV/RAM Cannula was 8.4 months. Successful implementation of Nasal NIV/Ram Cannula was 94%. One patient required a tracheostomy following the use of Nasal NIV/RAM Cannula. Significant decrease in arterial PaCO2 pre and post Nasal NIV/RAM cannula initiation was notable (p=0.001).Conclusion: Outpatient use of Nasal NIV/RAM Cannula may prove to be a feasible and save treatment alternative for children with chronic respiratory failure, chest wall weakness, dyspnea and traditional nasal/face mask intolerance to avoid tracheostomy.\",\"PeriodicalId\":39127,\"journal\":{\"name\":\"Open Respiratory Medicine Journal\",\"volume\":\"11 \",\"pages\":\"41-46\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.2174/1874306401711010041\",\"citationCount\":\"8\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Respiratory Medicine Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/1874306401711010041\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Respiratory Medicine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874306401711010041","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 8

摘要

背景:鼻无创通气(Nasal non-invasive-ventilation, NIV)是一种通过鼻接口为患者提供正压的通气支持模式。RAM套管是一种供氧装置，可作为输送正压的替代方法。它们已成功地用于新生儿住院环境中提供呼吸支持。目的:描述门诊使用鼻NIV/RAM套管作为慢性呼吸衰竭儿童家庭呼吸支持的可行替代方案。方法:我们对2014- 2016年在UTHealth McGovern医学院儿科肺科使用鼻NIV/RAM插管的18名儿童(4个月至19岁)进行回顾性病例分析。使用鼻用NIV/RAM套管的考虑因素包括:无法切断住院患者的呼吸支持，呼吸困难的舒适性，传统面罩界面的不耐受性和气管切开术的避免。结果:平均年龄7岁。白人占50%，非裔美国人占38%，西班牙裔美国人占11%。肺部疾病包括:胸壁无力(38%)、中枢控制异常(33%)、阻塞性肺疾病(16%)和限制性肺疾病(11%)。鼻用NIV/RAM插管的适应症包括:CPAP/BPAP面罩难以耐受(11%)，胸壁无力继发呼吸困难(38%)和避免气管造口术(50%)。鼻用NIV/RAM插管平均使用时间8.4个月。鼻部NIV/Ram插管成功率为94%。1例患者在使用鼻腔NIV/RAM套管后需要气管切开术。鼻部NIV/RAM插管前后动脉血PaCO2显著降低(p=0.001)。结论:对于慢性呼吸衰竭、胸壁无力、呼吸困难、传统鼻/面罩不耐受、避免气管切开术的患儿，门诊使用鼻用NIV/RAM插管可能是一种可行且节省的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Use of Nasal Non-Invasive Ventilation with a RAM Cannula in the Outpatient Home Setting.

Background: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings.

Objective: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure.

Methods: We performed a retrospective case series of 18 children (4 months to 19 years old) using the Nasal NIV/RAM Cannula in the Pediatric Pulmonary Clinic at the McGovern Medical School, UTHealth (2014-16). Consideration for Nasal NIV/RAM Cannula utilization included: inability to wean-off in-patient respiratory support, comfort for dyspnea, intolerability of conventional mask interfaces and tracheostomy avoidance.

Results: Average age was 7 years. 50% were Caucasian, 38% African-American and 11% Hispanics. Pulmonary disorders included: chest wall weakness (38%), central control abnormalities (33%), obstructive lung disease (16%) and restrictive lung disease (11%). Indications for Nasal NIV/RAM Cannula initiation included: CPAP/BPAP masks intolerability (11%), dyspnea secondary to chest wall weakness (38%) and tracheostomy avoidance (50%). Average length of use of Nasal NIV/RAM Cannula was 8.4 months. Successful implementation of Nasal NIV/Ram Cannula was 94%. One patient required a tracheostomy following the use of Nasal NIV/RAM Cannula. Significant decrease in arterial PaCO₂ pre and post Nasal NIV/RAM cannula initiation was notable (p=0.001).

Conclusion: Outpatient use of Nasal NIV/RAM Cannula may prove to be a feasible and save treatment alternative for children with chronic respiratory failure, chest wall weakness, dyspnea and traditional nasal/face mask intolerance to avoid tracheostomy.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Open Respiratory Medicine Journal Medicine-Pulmonary and Respiratory Medicine

CiteScore

1.70

自引率

0.00%

发文量

期刊介绍： The Open Respiratory Medicine Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, letters and guest edited single topic issues in all important areas of experimental and clinical research in respiratory medicine. Topics covered include: -COPD- Occupational disorders, and the role of allergens and pollutants- Asthma- Allergy- Non-invasive ventilation- Therapeutic intervention- Lung cancer- Lung infections respiratory diseases- Therapeutic interventions- Adult and paediatric medicine- Cell biology. The Open Respiratory Medicine Journal, a peer reviewed journal, is an important and reliable source of current information on important recent developments in the field. The emphasis will be on publishing quality articles rapidly and making them freely available worldwide.