OBJECTIVE To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation. METHODS Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retro...

Patients with chronic airflow obstruction and difficult weaning from mechanical ventilation are at increased risk for intubation-associated complications and mortality because of prolonged invasive mechanical ventilation. Non-invasive positive-pressure ventilation (NPPV) may revert most of the pathophysiologic mechanisms associated with weaning failure in these patients. Several randomised cont...

BACKGROUND There are data to suggest that anemia is associated with increased mortality in patients with chronic obstructive pulmonary disease (COPD). In contrast, critically ill patients with low hemoglobin levels (4.3-5.5 mmol/L, 7.0-9.0 g/dL) in general do not appear to have a worsened clinical outcome. The effects of anemia in critically ill patients with COPD remain to be clarified. We exa...

It is often unclear when and how to wean patients from mechanical ventilation. We have devised an evidence-based protocol in which patients undergo a 30-minute trial of spontaneous breathing with a T tube or pressure support of 7 cm H2O. Those who can tolerate the trial are extubated, while those who cannot are reconnected to mechanical ventilation but undergo another trial every day until they...

Normocapnia is recommended in intensive care management of patients after out-of-hospital cardiac arrest. While normocapnia is usually achievable, it may be therapeutically challenging, particularly in patients with airflow obstruction. Conventional mechanical ventilation may not be adequate to provide optimal ventilation in such patients. One of the recent advances in critical care management ...

Noninvasive ventilation (NIV) has emerged over the last 2 decades to become the clear choice in the management of patients presenting with respiratory distress secondary to cardiogenic pulmonary edema1 and exacerbations of COPD.2 For these patient groups NIV clearly improves symptoms and, for the latter group at least, NIV is associated with less need for invasive mechanical ventilation and les...

Background: Nasal intermittent positive pressure ventilation (NIPPV) is a non-invasive ventilatory mode, which delivers mechanical ventilation via nasal tubes or prongs. The present study was conducted to compare the efficacy of NIPPV and nasal continuous positive airway pressure ventilation (NCPAP) in reducing the need for intubation in preterm infants with respiratory distress syndrome (RDS)....