Hyaline Membrane Disease(HMD)in newborns,also known as neonatal respiratory distress syndrome,is a common critical illness in premature infants,with an incidence inversely correlated with gestational age,posing a seri...Hyaline Membrane Disease(HMD)in newborns,also known as neonatal respiratory distress syndrome,is a common critical illness in premature infants,with an incidence inversely correlated with gestational age,posing a serious threat to the life and health of newborns.This paper systematically reviews the core pathogenesis of HMD,focusing on the abnormal metabolism of pulmonary surfactant(PS),genetic factors,immature lung development,and the synergistic effects of inflammatory oxidative stress.It highlights the advances in non-invasive ventilation(NIV)therapy for HMD,including the mechanisms of action,clinical application effects,and optimization strategies of mainstream modalities such as nasal continuous positive airway pressure ventilation(NCPAP),nasal intermittent positive pressure ventilation(NIPPV),and heated humidified high-flow nasal cannula ventilation(HHHFNC).The aim is to provide references for standardized clinical treatment.展开更多
Patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)often suffer from respiratory failure and require respiratory support therapy.High-flow nasal cannula oxygen therapy(HFNC)and non-invasive...Patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)often suffer from respiratory failure and require respiratory support therapy.High-flow nasal cannula oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)are commonly used non-invasive respiratory support methods.HFNC can provide precisely heated and humidified high-flow oxygen,reducing dead space and increasing alveolar ventilation.NIPPV can supply stable high-concentration oxygen and improve gas exchange.This article reviews the application of HFNC and NIPPV in the acute exacerbation stage of COPD,aiming to provide references for reasonable clinical selection.展开更多
Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional ...Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.展开更多
Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients...Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients required either non-invasive[oxygen≤10 L/min or>10 L/min through mask or nasal prongs,rebreather masks and bilevel positive airway pressure(BiPAP)]or invasive ventilation.For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen,Kaplan Meier and log rank analyses were used.In the end,independent predictors of survival were determined by Cox regression analysis.Results:Invasive ventilation was required by 15.1%patients while 84.9%patients needed non-invasive ventilation.Patients with evidence of thromboembolism,high inflammatory markers and hypoxemia mainly required invasive ventilation.The 30-day in hospital mortality was 72.7%for the invasive group and 12.9%for the non-invasive group(1.8%oxygen<10 L/min,0.9%oxygen>10 L/min,3.6%rebreather mask and 4.5%BiPAP).The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group(P<0.05).Age,presence of co-morbidities,number of days requiring oxygen,rebreather,BiPAP and invasive ventilation were independent predictors of outcome.Conclusions:Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury.Thus,protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.展开更多
Objective:To compare the survival and length of stay of invasive ventilation(IV)with those of non-invasive ventilation(NIV)in patients with COVID-19 acute respiratory distress syndrome in a single hospital from May 20...Objective:To compare the survival and length of stay of invasive ventilation(IV)with those of non-invasive ventilation(NIV)in patients with COVID-19 acute respiratory distress syndrome in a single hospital from May 2020 to March 2021.Methods:After obtaining approval from the Hospital Director,the data of COVID-19 patients including demographics,type of respiratory support(non-invasive ventilation or invasive ventilation),duration of ventilation,length of stay,discharge,and death were collected and analyzed.Results:Out of the 152 patients identified,134 patients were analyzed.The median intubation days were 10.0(Q1:3.5,Q3:13.5)in the IV group and 0.0(Q1:0.0,Q3:0.0)days in the NIV-only group.Out of the 101 patients who received NIV,43 patients were subsequently intubated due to failure of NIV.Of the 63 patients(47.01%)who died,22(66.66%)were from the IV group and 40(92.02%)were from the NIV-followed-by-intubation group,and 1(1.72%)were from the NIV-only group.Multivariate analysis showed that the presence of a respiratory comorbidity(OR=16.56,95%CI=1.56-175.48,P=0.02)was an independent predictor of survival.Conclusions:Respiratory co-morbidity is a significant adverse predictor of survival outcome.The decision on the type of respiratory support should be made on a patient-to-patient basis.展开更多
Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension unde...Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension undergoing surgical procedures such as hemiarthroplasty present a high risk of fatal complications. Nonetheless, there are no widely accepted protocols explaining their perioperative care in great detail. Case presentation: We present a case with an 89-years-old patient, with comorbidities such as GOLD 4D chronic obstructive pulmonary disease (COPD) and, as a consequence of this, severe pulmonary hypertension with signs of right ventricular dysfunction, thus requiring of pulmonary vasodilator, that has suffered a subcapital hip fracture requiring urgent surgery. Surgery is carried out successfully, under regional lumbar-sacral plexus block and sedation assisted by non-invasive ventilation. Conclusion: Multidisciplinary specialized treatment, preoperative optimization, as well as the careful selection of both the surgical and anesthetic techniques to be used, are among the strategies that improve the perioperative outcome in patients with pulmonary hypertension with right ventricle systolic dysfunction. Regional lumbar-sacral plexus block plus sedation is a technique that maintains hemodynamic stability;however, these patients require advance measures and postoperative monitoring under intensive care.展开更多
Objective:To analyze key factors associated with the failure of non-invasive ventilation(NIV)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by type II respiratory fail...Objective:To analyze key factors associated with the failure of non-invasive ventilation(NIV)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by type II respiratory failure.Methods:A total of 122 patients with AECOPD and type II respiratory failure admitted to Gaoyou People’s Hospital between January 2020 and June 2023 were selected for the study.Upon admission,all patients received ECG monitoring and NIV,along with comprehensive therapies such as anti-infective treatment,antispasmodics,bronchodilators,and expectorants.NIV was provided using the S/T mode,with ventilator parameters adjusted based on the patient’s respiratory status and blood gas analysis results.Clinical data were retrospectively analyzed from electronic medical records.Results:Out of the 122 patients,30 experienced NIV failure,accounting for 24.59%.Significant differences were observed in C-reactive protein(CRP),pH,and partial pressure of arterial carbon dioxide(PaCO_(2))between patients with successful and failed NIV outcomes(P<0.05).There were no statistically significant differences in gender,age,arterial oxygen partial pressure(PaO_(2)),neutrophil count(NEUT),procalcitonin(PCT),albumin(ALB),or tidal volume between the two groups(P>0.05).Logistic regression analysis confirmed that CRP,pH,and PaCO_(2)were significant risk factors for NIV failure(P<0.05).Conclusion:CRP,pH,and PaCO_(2)are independent risk factors influencing NIV failure.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become an immense public health burden,first in China and subsequently worldwide.Developing effective control measures for COVID-19,especially measures tha...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become an immense public health burden,first in China and subsequently worldwide.Developing effective control measures for COVID-19,especially measures that can halt the worsening of severe cases to a critical status is of urgent importance.CASE SUMMARY A 52-year-old woman presented with a high fever(38.8°C),chills,dizziness,and weakness.Epidemiologically,she had not been to Wuhan where COVID-19 emerged and did not have a family history of a disease cluster.A blood test yielded a white blood cell count of 4.41×109/L(60.6±2.67%neutrophils and 30.4±1.34%lymphocytes).Chest imaging revealed bilateral ground-glass lung changes.Based on a positive nasopharyngeal swab nucleic acid test result and clinical characteristics,the patient was diagnosed with COVID-19.Following treatment with early non-invasive ventilation and a bundle pharmacotherapy,she recovered with a good outcome.CONCLUSION Early non-invasive ventilation with a bundle pharmacotherapy may be an effective treatment regimen for the broader population of patients with COVID-19.展开更多
Objective: To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in respiratory support for severe pneumonia. Methods: Data were analyzed from 74 patients with severe pneumonia undergoing respi...Objective: To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in respiratory support for severe pneumonia. Methods: Data were analyzed from 74 patients with severe pneumonia undergoing respiratory support at our hospital between May 2024 and April 2025. Patients were randomly assigned using a random number table to two groups (n = 37 each): the experimental group received NIPPV, while the control group underwent conventional invasive mechanical ventilation. Intergroup differences were compared. Results: Compared with the control group, the experimental group demonstrated significantly higher PaO2 and oxygenation index, significantly lower PaCO2, significantly reduced levels of WBC, CRP, and PCT, significantly higher overall efficacy rate, and significantly lower incidence of adverse reactions after treatment (p < 0.05). Pre-treatment PaO2, oxygenation index, PaCO2, WBC, CRP, and PCT levels showed no significant differences between groups (p > 0.05). Conclusion: Non-invasive positive pressure ventilation demonstrates favorable outcomes in respiratory support for severe pneumonia.展开更多
Over the last 20 years, the application of non-invasive ventilation （NIV） in China has progressively increased both in the hospital and extrahospital setting. The history of the NIV and its increasing spread in the ...Over the last 20 years, the application of non-invasive ventilation （NIV） in China has progressively increased both in the hospital and extrahospital setting. The history of the NIV and its increasing spread in the clinical practice over China are one of the most important results of the cooperation between medicine and non-invasive mechanic technology.展开更多
Optimal initial non-invasive management of acute hypoxemic respiratory failure(AHRF),of both coronavirus disease 2019(COVID-19)and non-COVID-19 etiologies,has been the subject of significant discussion.Avoidance of en...Optimal initial non-invasive management of acute hypoxemic respiratory failure(AHRF),of both coronavirus disease 2019(COVID-19)and non-COVID-19 etiologies,has been the subject of significant discussion.Avoidance of endotracheal intubation reduces related complications,but maintenance of spontaneous breathing with intense respiratory effort may increase risks of patients’self-inflicted lung injury,leading to delayed intubation and worse clinical outcomes.High-flow nasal oxygen is currently recommended as the optimal strategy for AHRF management for its simplicity and beneficial physiological effects.Non-invasive ventilation(NIV),delivered as either pressure support or continuous positive airway pressure via interfaces like face masks and helmets,can improve oxygenation and may be associated with reduced endotracheal intubation rates.However,treatment failure is common and associated with poor outcomes.Expertise and knowledge of the specific features of each interface are necessary to fully exploit their potential benefits and minimize risks.Strict clinical and physiological monitoring is necessary during any treatment to avoid delays in endotracheal intubation and protective ventilation.In this narrative review,we analyze the physiological benefits and risks of spontaneous breathing in AHRF,and the characteristics of tools for delivering NIV.The goal herein is to provide a contemporary,evidence-based overview of this highly relevant topic.展开更多
Patients affected by monogenic diseases impose a substantial burden on both themselves and their families.The primary preventive measure,i.e.,invasive prenatal diagnosis,carries a risk of miscarriage and cannot be per...Patients affected by monogenic diseases impose a substantial burden on both themselves and their families.The primary preventive measure,i.e.,invasive prenatal diagnosis,carries a risk of miscarriage and cannot be performed early in pregnancy.Hence,there is a need for non-invasive prenatal testing(NIPT)for monogenic diseases.By utilizing enriched cell-free fetal DNA(cffDNA)from maternal plasma,we refine the NIPT method,which combines targeted region capture technology,haplotyping,and analysis of informative site frequency.We apply this method to 93 clinical families at genetic risk for thalassemia,encompassing various genetic variant types,to establish a workflow and evaluate its efficiency.Our approach requires only 3 ng of DNA input to generate 0.1 Gb informative target genomic data and leverages a minimum of 3%cffDNA.This method has a 98.16%success rate and 100%concordance with conventional invasive methods.Furthermore,we demonstrate the ability to analyze fetal genotypes as early as eight weeks of gestation.This study establishes an optimized NIPT method for the early detection of various thalassemia disorders during pregnancy.This technique demonstrates high accuracy and potential for clinical application in prenatal diagnosis.展开更多
The development of non-invasive brain-computer interfaces(BCIs)relies on multidisciplinary integration across neuroscience,artificial intelligence,flexible electronics,and systems engineering.Recent advances in deep l...The development of non-invasive brain-computer interfaces(BCIs)relies on multidisciplinary integration across neuroscience,artificial intelligence,flexible electronics,and systems engineering.Recent advances in deep learning have significantly improved the accuracy and robustness of neural signal decoding.Parallel progress in electrode design—particularly through the use of flexible and stretchable materials like nanostructured conductors and novel fabrication strategies—has enhanced wearability and operational stability.Nevertheless,key challenges persist,including individual variability,biocompatibility limitations,and susceptibility to interference in complex environments.Further validation and optimization are needed to address gaps in generalization capability,long-term reliability,and real-world operational robustness.This review systematically examines the representative progress in neural decoding algorithms and flexible bioelectronic platforms over the past decade,highlighting key design principles,material innovations,and integration strategies that are poised to advance non-invasive BCI capabilities.It also discusses the importance of multimodal data fusion,hardware-software co-optimization,and closed-loop control strategies.Furthermore,the review discusses the application potential and associated engineering challenges of this technology in clinical rehabilitation and industrial translation,aiming to provide a reference for advancing non-invasive BCIs toward practical and scalable deployment.展开更多
Objective:To investigate the application effect of intelligent empowerment standardized airway management process in patients receiving mechanical ventilation.Methods:A retrospective analysis was conducted on the clin...Objective:To investigate the application effect of intelligent empowerment standardized airway management process in patients receiving mechanical ventilation.Methods:A retrospective analysis was conducted on the clinical data of 79 EICU inpatients who underwent tracheal intubation and mechanical ventilation treatment at our hospital from January 2023 to May 2025.The patients were divided into a control group(conventional airway management process,n=40)and a study group(intelligent empowerment standardized airway management process,n=39)based on the intervention protocols they received.Oral health scores,dental plaque index,oral odor,serum inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)],clinical pulmonary infection score(CPIS),as well as the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were assessed before and after treatment.Results:The baseline values of all indicators were consistent between the two groups before intervention(p>0.05).After corresponding interventions,both groups showed significant improvements in Beck oral health scores,dental plaque index,and oral odor,with more pronounced improvements observed in the study group(p<0.05).After the intervention,the research group showed a significant decrease in serum CRP and PCT levels,as well as CPIS scores(p<0.05).In contrast,the control group experienced an increase in these three indicators to a certain extent(p<0.05).Moreover,the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were all lower in the research group compared to the control group,while the nurse’s compliance rate with the protocol was higher in the research group(p<0.05).Conclusion:The standardized airway management protocol empowered by intelligent technology can significantly improve nursing compliance,benefit oral health status,reduce the risk of pulmonary infection and systemic inflammation levels,and promote rapid patient recovery,demonstrating considerable potential for widespread adoption.展开更多
Phrenic nerve stimulation(PNS)may preserve diaphragm activation and mitigate multiorgan injury during mechanical ventilation(MV);however,a minimal invasive rat model integrating PNS with MV is lacking.We established a...Phrenic nerve stimulation(PNS)may preserve diaphragm activation and mitigate multiorgan injury during mechanical ventilation(MV);however,a minimal invasive rat model integrating PNS with MV is lacking.We established an omohyoid muscle-based PNS rat model combined with MV.Bilateral nerves were exposed within 20±2 min by transection at the intermediate tendon of omohyoid muscle,minimizing trauma and bleeding.Threshold stimulation(0.6±0.2 mA)correlated with body weight.Ventilator-synchronized stimulation increased compound muscle action potentials by~30%,whereas histology confirmed intact nerve.Physiological parameters remained stable throughout ventilation.This model provides a safe and scalable platform for mechanistic and preclinical studies on PNS-mediated protection against MV-induced organ injury.展开更多
Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is sig...Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is significant controversy regarding its concurrent use with ACS owing to concerns of increased risk of intra-abdominal pressure(IAP).[1]We present a case of successful PPV application without adverse eff ects.展开更多
Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe p...Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.展开更多
<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failur...<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Currently,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> there are no guidelines for the management of respiratory failure in pregnancy. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. </span><b><span style="font-family:Verdana;">Measurements</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 30</span><sup><span style="font-family:Verdana;">5/7</span></sup><span style="font-family:Verdana;"> ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">p</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">a/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.</span></span></span></span>展开更多
Introduction: During the application of non-invasive positive pressure ventilation (NPPV) therapy in home mechanical ventilation (HMV), leaks in the NPPV mask may occur owing to the position of the mask due to conditi...Introduction: During the application of non-invasive positive pressure ventilation (NPPV) therapy in home mechanical ventilation (HMV), leaks in the NPPV mask may occur owing to the position of the mask due to conditions such as skin disorders. Methods: To investigate whether such a leak affects FiO2 supplied to the alveoli, we simulated a patient with chronic obstructive pulmonary disorder during NPPV in HMV. In addition, FiO2 was measured in the portion assumed to be the mouth and lungs while setting the flow of the oxygen concentrator and leak amount based on a previous study. Results: FiO2 supplied to the lungs increased statistically significantly upon increasing the amount of leak (P Conclusions: We observed that FiO2 supplied to alveoli can be reduced by a leak in the NPPV mask. Because our results differ from those previously reported, we believe that further studies should reassess the selection of respirators and oxygen concentrators.展开更多
Background and purpose: Patients with severely impaired pulmonary function have an increased operative risk for major lung resection. The clinical benefits of pre- and perioperative, non-invasive pressure support vent...Background and purpose: Patients with severely impaired pulmonary function have an increased operative risk for major lung resection. The clinical benefits of pre- and perioperative, non-invasive pressure support ventilation (NIPSV) have up to now not been extensively evaluated. Patients with severely reduced pulmonary function were investigated in this prospective and randomised single centre clinical trial. Methods: Standard pulmonary evaluation was performed in all patients before major lung resection. To predict postoperative pulmonary function, a lung perfusion-ventilation scan was carried out. All patients enrolled in the study were instructed preoperatively on how to use a NIPSV respirator. Af-ter lung resection patients were randomised either for continuation of NIPSV or for standard treatment. Results: Of the 52 patients assessed, 21 patients met the inclusion criteria for the study protocol. Predicted mean postoperative FEV1 was 1.10 L (range 0.92 - 1.27 L). Lobectomy was performed in 14 patients, pneumonectomy in 6 patients and a segmentectomy in 1 patient. No inhospital deaths occurred. Pulmonary complications (reintubation, pneumonia) were more frequent in the NIPSV group than in the control group (3 patients versus 1 patient), without statistical significance (p = 0.31). Conclusions: We observed no mortality and a low morbidity in this high risk group. Postoperative continuation of NIPSV had no beneficial effect on the clinical outcome. Preoperative conditioning with NIPSV, however, seems to be a suitable tool for patients with severely impaired pulmonary function. This study may serve therefore as basis for further investigations for the potential clinical benefits of prophylactic NIPSV in major lung surgery.展开更多
文摘Hyaline Membrane Disease(HMD)in newborns,also known as neonatal respiratory distress syndrome,is a common critical illness in premature infants,with an incidence inversely correlated with gestational age,posing a serious threat to the life and health of newborns.This paper systematically reviews the core pathogenesis of HMD,focusing on the abnormal metabolism of pulmonary surfactant(PS),genetic factors,immature lung development,and the synergistic effects of inflammatory oxidative stress.It highlights the advances in non-invasive ventilation(NIV)therapy for HMD,including the mechanisms of action,clinical application effects,and optimization strategies of mainstream modalities such as nasal continuous positive airway pressure ventilation(NCPAP),nasal intermittent positive pressure ventilation(NIPPV),and heated humidified high-flow nasal cannula ventilation(HHHFNC).The aim is to provide references for standardized clinical treatment.
基金2022 Inner Mongolia Autonomous Region Health and Wellness Science and Technology Program Project(Project No.:202201533)。
文摘Patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)often suffer from respiratory failure and require respiratory support therapy.High-flow nasal cannula oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)are commonly used non-invasive respiratory support methods.HFNC can provide precisely heated and humidified high-flow oxygen,reducing dead space and increasing alveolar ventilation.NIPPV can supply stable high-concentration oxygen and improve gas exchange.This article reviews the application of HFNC and NIPPV in the acute exacerbation stage of COPD,aiming to provide references for reasonable clinical selection.
文摘Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.
文摘Objective:To evaluate the in-hospital outcome of moderate to severe COVID-19 patients admitted in High Dependency Unit(HDU)in relation to invasive vs.non-invasive mode of ventilation.Methods:In this study,the patients required either non-invasive[oxygen≤10 L/min or>10 L/min through mask or nasal prongs,rebreather masks and bilevel positive airway pressure(BiPAP)]or invasive ventilation.For analysis of 30-day in hospital mortality in relation to use of different modes of oxygen,Kaplan Meier and log rank analyses were used.In the end,independent predictors of survival were determined by Cox regression analysis.Results:Invasive ventilation was required by 15.1%patients while 84.9%patients needed non-invasive ventilation.Patients with evidence of thromboembolism,high inflammatory markers and hypoxemia mainly required invasive ventilation.The 30-day in hospital mortality was 72.7%for the invasive group and 12.9%for the non-invasive group(1.8%oxygen<10 L/min,0.9%oxygen>10 L/min,3.6%rebreather mask and 4.5%BiPAP).The median time from hospital admission to outcome was 7 days for the invasive group and 18 days for the non-invasive group(P<0.05).Age,presence of co-morbidities,number of days requiring oxygen,rebreather,BiPAP and invasive ventilation were independent predictors of outcome.Conclusions:Invasive mechanical ventilation is associated with adverse outcomes possibly due to ventilator associated lung injury.Thus,protective non-invasive ventilation remains the necessary and safe treatment for severely hypoxic COVID-19 patients.
文摘Objective:To compare the survival and length of stay of invasive ventilation(IV)with those of non-invasive ventilation(NIV)in patients with COVID-19 acute respiratory distress syndrome in a single hospital from May 2020 to March 2021.Methods:After obtaining approval from the Hospital Director,the data of COVID-19 patients including demographics,type of respiratory support(non-invasive ventilation or invasive ventilation),duration of ventilation,length of stay,discharge,and death were collected and analyzed.Results:Out of the 152 patients identified,134 patients were analyzed.The median intubation days were 10.0(Q1:3.5,Q3:13.5)in the IV group and 0.0(Q1:0.0,Q3:0.0)days in the NIV-only group.Out of the 101 patients who received NIV,43 patients were subsequently intubated due to failure of NIV.Of the 63 patients(47.01%)who died,22(66.66%)were from the IV group and 40(92.02%)were from the NIV-followed-by-intubation group,and 1(1.72%)were from the NIV-only group.Multivariate analysis showed that the presence of a respiratory comorbidity(OR=16.56,95%CI=1.56-175.48,P=0.02)was an independent predictor of survival.Conclusions:Respiratory co-morbidity is a significant adverse predictor of survival outcome.The decision on the type of respiratory support should be made on a patient-to-patient basis.
文摘Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension undergoing surgical procedures such as hemiarthroplasty present a high risk of fatal complications. Nonetheless, there are no widely accepted protocols explaining their perioperative care in great detail. Case presentation: We present a case with an 89-years-old patient, with comorbidities such as GOLD 4D chronic obstructive pulmonary disease (COPD) and, as a consequence of this, severe pulmonary hypertension with signs of right ventricular dysfunction, thus requiring of pulmonary vasodilator, that has suffered a subcapital hip fracture requiring urgent surgery. Surgery is carried out successfully, under regional lumbar-sacral plexus block and sedation assisted by non-invasive ventilation. Conclusion: Multidisciplinary specialized treatment, preoperative optimization, as well as the careful selection of both the surgical and anesthetic techniques to be used, are among the strategies that improve the perioperative outcome in patients with pulmonary hypertension with right ventricle systolic dysfunction. Regional lumbar-sacral plexus block plus sedation is a technique that maintains hemodynamic stability;however, these patients require advance measures and postoperative monitoring under intensive care.
文摘Objective:To analyze key factors associated with the failure of non-invasive ventilation(NIV)in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by type II respiratory failure.Methods:A total of 122 patients with AECOPD and type II respiratory failure admitted to Gaoyou People’s Hospital between January 2020 and June 2023 were selected for the study.Upon admission,all patients received ECG monitoring and NIV,along with comprehensive therapies such as anti-infective treatment,antispasmodics,bronchodilators,and expectorants.NIV was provided using the S/T mode,with ventilator parameters adjusted based on the patient’s respiratory status and blood gas analysis results.Clinical data were retrospectively analyzed from electronic medical records.Results:Out of the 122 patients,30 experienced NIV failure,accounting for 24.59%.Significant differences were observed in C-reactive protein(CRP),pH,and partial pressure of arterial carbon dioxide(PaCO_(2))between patients with successful and failed NIV outcomes(P<0.05).There were no statistically significant differences in gender,age,arterial oxygen partial pressure(PaO_(2)),neutrophil count(NEUT),procalcitonin(PCT),albumin(ALB),or tidal volume between the two groups(P>0.05).Logistic regression analysis confirmed that CRP,pH,and PaCO_(2)were significant risk factors for NIV failure(P<0.05).Conclusion:CRP,pH,and PaCO_(2)are independent risk factors influencing NIV failure.
基金We acknowledge the writing guidance provided by Prof.Kun-Mei Ji and the training camp for medical research held by Shenzhen Medical Association and Huada.We are grateful to the physicians and nurses at the Third People’s Hospital of Shenzhen who participated in clinical examinations and sample collection.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become an immense public health burden,first in China and subsequently worldwide.Developing effective control measures for COVID-19,especially measures that can halt the worsening of severe cases to a critical status is of urgent importance.CASE SUMMARY A 52-year-old woman presented with a high fever(38.8°C),chills,dizziness,and weakness.Epidemiologically,she had not been to Wuhan where COVID-19 emerged and did not have a family history of a disease cluster.A blood test yielded a white blood cell count of 4.41×109/L(60.6±2.67%neutrophils and 30.4±1.34%lymphocytes).Chest imaging revealed bilateral ground-glass lung changes.Based on a positive nasopharyngeal swab nucleic acid test result and clinical characteristics,the patient was diagnosed with COVID-19.Following treatment with early non-invasive ventilation and a bundle pharmacotherapy,she recovered with a good outcome.CONCLUSION Early non-invasive ventilation with a bundle pharmacotherapy may be an effective treatment regimen for the broader population of patients with COVID-19.
文摘Objective: To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in respiratory support for severe pneumonia. Methods: Data were analyzed from 74 patients with severe pneumonia undergoing respiratory support at our hospital between May 2024 and April 2025. Patients were randomly assigned using a random number table to two groups (n = 37 each): the experimental group received NIPPV, while the control group underwent conventional invasive mechanical ventilation. Intergroup differences were compared. Results: Compared with the control group, the experimental group demonstrated significantly higher PaO2 and oxygenation index, significantly lower PaCO2, significantly reduced levels of WBC, CRP, and PCT, significantly higher overall efficacy rate, and significantly lower incidence of adverse reactions after treatment (p < 0.05). Pre-treatment PaO2, oxygenation index, PaCO2, WBC, CRP, and PCT levels showed no significant differences between groups (p > 0.05). Conclusion: Non-invasive positive pressure ventilation demonstrates favorable outcomes in respiratory support for severe pneumonia.
文摘Over the last 20 years, the application of non-invasive ventilation （NIV） in China has progressively increased both in the hospital and extrahospital setting. The history of the NIV and its increasing spread in the clinical practice over China are one of the most important results of the cooperation between medicine and non-invasive mechanic technology.
文摘Optimal initial non-invasive management of acute hypoxemic respiratory failure(AHRF),of both coronavirus disease 2019(COVID-19)and non-COVID-19 etiologies,has been the subject of significant discussion.Avoidance of endotracheal intubation reduces related complications,but maintenance of spontaneous breathing with intense respiratory effort may increase risks of patients’self-inflicted lung injury,leading to delayed intubation and worse clinical outcomes.High-flow nasal oxygen is currently recommended as the optimal strategy for AHRF management for its simplicity and beneficial physiological effects.Non-invasive ventilation(NIV),delivered as either pressure support or continuous positive airway pressure via interfaces like face masks and helmets,can improve oxygenation and may be associated with reduced endotracheal intubation rates.However,treatment failure is common and associated with poor outcomes.Expertise and knowledge of the specific features of each interface are necessary to fully exploit their potential benefits and minimize risks.Strict clinical and physiological monitoring is necessary during any treatment to avoid delays in endotracheal intubation and protective ventilation.In this narrative review,we analyze the physiological benefits and risks of spontaneous breathing in AHRF,and the characteristics of tools for delivering NIV.The goal herein is to provide a contemporary,evidence-based overview of this highly relevant topic.
基金supported by the National Key R&D Program of China(2024YFA1802300)the Major Science and Technology Program of Hainan Province(ZDKJ2021037)+4 种基金the Regional Innovation and Development Joint Fund of the National Natural Science Foundation of China(U24A20677)Hainan Province Science and Technology Special Fund(ZDYF2020117,ZDY2024SHFZ143)Hainan Province Science and TechnologyProject(LCXY202102,LCYX202203,LCYX202301,LCYx202502)Innovative research project for postgraduate students in Hainan Medical University(HYYB2021A05)the Hainan Province Clinical Medical Center,and the specific research fund of The Innovation Platform for Academicians of Hainan Province(YSPTZX202310).
文摘Patients affected by monogenic diseases impose a substantial burden on both themselves and their families.The primary preventive measure,i.e.,invasive prenatal diagnosis,carries a risk of miscarriage and cannot be performed early in pregnancy.Hence,there is a need for non-invasive prenatal testing(NIPT)for monogenic diseases.By utilizing enriched cell-free fetal DNA(cffDNA)from maternal plasma,we refine the NIPT method,which combines targeted region capture technology,haplotyping,and analysis of informative site frequency.We apply this method to 93 clinical families at genetic risk for thalassemia,encompassing various genetic variant types,to establish a workflow and evaluate its efficiency.Our approach requires only 3 ng of DNA input to generate 0.1 Gb informative target genomic data and leverages a minimum of 3%cffDNA.This method has a 98.16%success rate and 100%concordance with conventional invasive methods.Furthermore,we demonstrate the ability to analyze fetal genotypes as early as eight weeks of gestation.This study establishes an optimized NIPT method for the early detection of various thalassemia disorders during pregnancy.This technique demonstrates high accuracy and potential for clinical application in prenatal diagnosis.
基金the National Natural Science Foundation of China for Distinguished Young Scholars(62325403)the National Natural Science Foundation of China(62504103 and 82002454)+4 种基金the Basic Research Program of Jiangsu(BK20251214)the Natural Science Foundation of Jiangsu Province(BK20230498)the China Postdoctoral Science Foundation under Grant Number 2025T180143 and 2025M770547the Medical Scientific Research Project of Jiangsu Health Commission(ZD2021011)the Jiangsu Funding Program for Excellent Postdoctoral Talent(2024ZB427)。
文摘The development of non-invasive brain-computer interfaces(BCIs)relies on multidisciplinary integration across neuroscience,artificial intelligence,flexible electronics,and systems engineering.Recent advances in deep learning have significantly improved the accuracy and robustness of neural signal decoding.Parallel progress in electrode design—particularly through the use of flexible and stretchable materials like nanostructured conductors and novel fabrication strategies—has enhanced wearability and operational stability.Nevertheless,key challenges persist,including individual variability,biocompatibility limitations,and susceptibility to interference in complex environments.Further validation and optimization are needed to address gaps in generalization capability,long-term reliability,and real-world operational robustness.This review systematically examines the representative progress in neural decoding algorithms and flexible bioelectronic platforms over the past decade,highlighting key design principles,material innovations,and integration strategies that are poised to advance non-invasive BCI capabilities.It also discusses the importance of multimodal data fusion,hardware-software co-optimization,and closed-loop control strategies.Furthermore,the review discusses the application potential and associated engineering challenges of this technology in clinical rehabilitation and industrial translation,aiming to provide a reference for advancing non-invasive BCIs toward practical and scalable deployment.
文摘Objective:To investigate the application effect of intelligent empowerment standardized airway management process in patients receiving mechanical ventilation.Methods:A retrospective analysis was conducted on the clinical data of 79 EICU inpatients who underwent tracheal intubation and mechanical ventilation treatment at our hospital from January 2023 to May 2025.The patients were divided into a control group(conventional airway management process,n=40)and a study group(intelligent empowerment standardized airway management process,n=39)based on the intervention protocols they received.Oral health scores,dental plaque index,oral odor,serum inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)],clinical pulmonary infection score(CPIS),as well as the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were assessed before and after treatment.Results:The baseline values of all indicators were consistent between the two groups before intervention(p>0.05).After corresponding interventions,both groups showed significant improvements in Beck oral health scores,dental plaque index,and oral odor,with more pronounced improvements observed in the study group(p<0.05).After the intervention,the research group showed a significant decrease in serum CRP and PCT levels,as well as CPIS scores(p<0.05).In contrast,the control group experienced an increase in these three indicators to a certain extent(p<0.05).Moreover,the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were all lower in the research group compared to the control group,while the nurse’s compliance rate with the protocol was higher in the research group(p<0.05).Conclusion:The standardized airway management protocol empowered by intelligent technology can significantly improve nursing compliance,benefit oral health status,reduce the risk of pulmonary infection and systemic inflammation levels,and promote rapid patient recovery,demonstrating considerable potential for widespread adoption.
基金Outstanding Young Investigator Program of Capital Medical University,Grant/Award Number:A2308。
文摘Phrenic nerve stimulation(PNS)may preserve diaphragm activation and mitigate multiorgan injury during mechanical ventilation(MV);however,a minimal invasive rat model integrating PNS with MV is lacking.We established an omohyoid muscle-based PNS rat model combined with MV.Bilateral nerves were exposed within 20±2 min by transection at the intermediate tendon of omohyoid muscle,minimizing trauma and bleeding.Threshold stimulation(0.6±0.2 mA)correlated with body weight.Ventilator-synchronized stimulation increased compound muscle action potentials by~30%,whereas histology confirmed intact nerve.Physiological parameters remained stable throughout ventilation.This model provides a safe and scalable platform for mechanistic and preclinical studies on PNS-mediated protection against MV-induced organ injury.
文摘Severe acute pancreatitis(SAP)can induce acute respiratory distress syndrome(ARDS)and abdominal compartment syndrome(ACS).Although prone position ventilation(PPV)can improve outcomes in patients with ARDS,there is significant controversy regarding its concurrent use with ACS owing to concerns of increased risk of intra-abdominal pressure(IAP).[1]We present a case of successful PPV application without adverse eff ects.
文摘Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.
文摘<strong>Rationale: </strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Currently,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> there are no guidelines for the management of respiratory failure in pregnancy. </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:Verdana;">To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. </span><b><span style="font-family:Verdana;">Measurements</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 30</span><sup><span style="font-family:Verdana;">5/7</span></sup><span style="font-family:Verdana;"> ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pa</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">O</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;">/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">p</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">a/FiO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.</span></span></span></span>
文摘Introduction: During the application of non-invasive positive pressure ventilation (NPPV) therapy in home mechanical ventilation (HMV), leaks in the NPPV mask may occur owing to the position of the mask due to conditions such as skin disorders. Methods: To investigate whether such a leak affects FiO2 supplied to the alveoli, we simulated a patient with chronic obstructive pulmonary disorder during NPPV in HMV. In addition, FiO2 was measured in the portion assumed to be the mouth and lungs while setting the flow of the oxygen concentrator and leak amount based on a previous study. Results: FiO2 supplied to the lungs increased statistically significantly upon increasing the amount of leak (P Conclusions: We observed that FiO2 supplied to alveoli can be reduced by a leak in the NPPV mask. Because our results differ from those previously reported, we believe that further studies should reassess the selection of respirators and oxygen concentrators.
文摘Background and purpose: Patients with severely impaired pulmonary function have an increased operative risk for major lung resection. The clinical benefits of pre- and perioperative, non-invasive pressure support ventilation (NIPSV) have up to now not been extensively evaluated. Patients with severely reduced pulmonary function were investigated in this prospective and randomised single centre clinical trial. Methods: Standard pulmonary evaluation was performed in all patients before major lung resection. To predict postoperative pulmonary function, a lung perfusion-ventilation scan was carried out. All patients enrolled in the study were instructed preoperatively on how to use a NIPSV respirator. Af-ter lung resection patients were randomised either for continuation of NIPSV or for standard treatment. Results: Of the 52 patients assessed, 21 patients met the inclusion criteria for the study protocol. Predicted mean postoperative FEV1 was 1.10 L (range 0.92 - 1.27 L). Lobectomy was performed in 14 patients, pneumonectomy in 6 patients and a segmentectomy in 1 patient. No inhospital deaths occurred. Pulmonary complications (reintubation, pneumonia) were more frequent in the NIPSV group than in the control group (3 patients versus 1 patient), without statistical significance (p = 0.31). Conclusions: We observed no mortality and a low morbidity in this high risk group. Postoperative continuation of NIPSV had no beneficial effect on the clinical outcome. Preoperative conditioning with NIPSV, however, seems to be a suitable tool for patients with severely impaired pulmonary function. This study may serve therefore as basis for further investigations for the potential clinical benefits of prophylactic NIPSV in major lung surgery.
