OBJECTIVE To analyze chronic obstructive lung disease (COPD) subjects in acute hypercapnic failure who were treated with non-invasive mechanical ventilation in a general respiratory ward. METHODS This was a two-year prospective study of 35 patients with acute exacerbation of COPD and mean FEV1/FVC relation in stable condition of 55.3 +/- 14.8% of predicted that were treated with positive pres...

We describe a patient who ingested 5 g of atenolol with ethanol. After awakening, with repeat toxicology screen only showing atenolol, and in spite of normal voluntary breathing mechanics, he had marked suppression of his spontaneous respirations as measured by minute ventilation and by occlusion pressure with no incremental response to hypercapnic challenge. Subsequently, he recovered. Althoug...

BACKGROUND The impact of humidification devices on ventilatory and arterial blood gases parameters during noninvasive ventilation (NIV) remains controversial. The aim of the study was to compare the short-term impact of heat and moisture exchangers (HMEs) and heated humidifiers (HHs) during NIV for either hypercapnic or hypoxemic acute respiratory failure. METHODS Consecutive subjects receiv...

BACKGROUND In recent years non-invasive ventilatory techniques have been used successfully in the treatment of acute on chronic respiratory failure (ACRF), but careful selection of patients is essential and a comatose state may represent an exclusion criterion. The aim of this retrospective and uncontrolled study was to evaluate whether a non-invasive ventilatory technique such as the iron lung...

PURPOSE Acute respiratory failure (ARF) is a common life-threatening complication in morbidly obese patients with obesity hypoventilation syndrome (OHS). We aimed to identify the determinants of noninvasive ventilation (NIV) success or failure for this indication. METHODS We prospectively included 76 consecutive patients with BMI>40 kg/m2 diagnosed with OHS and treated by NIV for ARF in a 15-...

Exacerbations of chronic obstructive pulmonary disease (COPD) are a common cause of acute respiratory failure,1 leading to over 700,000 hospitalizations annually in the United States.2 Approximately 50% of patients suffering hypercapnic respiratory failure from exacerbations of COPD require some form of ventilatory support.3 The ventilatory strategy employed in such patients has evolved during ...

The optimal management of acute ventilatory failure lies in a multidisciplinary approach focusing on doing simple things correctly, close liaison between healthcare professionals and adequate communication with patients and carers. The use of NIV support is increasing in a variety of conditions, both inside and outside the ICU.

Background: Nocturnal non-invasive ventilation (NIV) is an effective treatment for hypercapnic respiratory failure in patients with restrictive thoracic disease. We hypothesised that NIV may reverse respiratory failure by increasing the ventilatory response to carbon dioxide, reducing inspiratory muscle fatigue, or enhancing pulmonary mechanics. Methods: Twenty patients with restrictive disease...