OBJECTIVES To investigate clinical outcomes according to ventilatory support indication in subjects with chronic obstructive pulmonary disease exacerbation in a "real-life" Emergency Department and to analyze potential predictors of successful noninvasive positive pressure ventilation. METHODS Retrospective cohort performed over an 18-month period, comparing the following patient groups with ...

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease in which most patients die of respiratory failure. Although volume-targeted non-invasive bilevel positive airway pressure (BPAP) ventilation has been studied in patients with chronic respiratory failure of various etiologies, its use in ALS has not been reported. We present the case of a 66-year-old woman with ALS an...

Mechanical ventilation is used for patients with a variety of lung diseases. Traditionally, ventilators have been designed to monotonously deliver equal sized breaths. While it may seem intuitive that lungs may benefit from unvarying and stable ventilation pressure strategy, recently it has been reported that variable lung ventilation is advantageous. In this study, we analyze the mean tidal vo...

Acute respiratory distress syndrome (ARDS) is an acute hypoxemic respiratory failure with lung oedema of non cardiac origin. Its primary treatment is mechanical ventilation. ARDS is under the spotlights with influenza A pandemic flu. An operating definition has been set out by an experts-consensus conference in order to include patients in clinical trials. However, this definition lacks diagnos...

The occurrence of postoperative pulmonary complications is strongly associated with increased hospital mortality and prolonged postoperative hospital stays. Although protective lung ventilation is commonly used in the intensive care unit, low tidal volume ventilation in the operating room is not a routine strategy. Low tidal volume ventilation, moderate positive end-expiratory pressure, and rep...

BACKGROUND Inspiratory rise time and cycling criteria are important settings in pressure support ventilation. The purpose of this study was to investigate the impact of minimum and maximum rise time and inspiratory cycling criteria settings on 6 new generation ventilators. Our hypothesis was there would be a difference in the exhaled tidal volume, inspiratory time, and peak flow among 6 differe...

This prospective study compared two weaning modalities in COPD patients requiring mechanical ventilation (MV) for acute respiratory failure. Nineteen patients with COPD were studied when their precipitating illness was controlled. Although they satisfied the conventional bedside weaning criteria, they could not tolerate any reduction in the respirator rate below 10 cycles/min. At this time, pat...

BACKGROUND Non-invasive mechanical ventilation (NIV) in patients with acute respiratory failure has been traditionally determined based on clinical assessment and changes in blood gases, with NIV support pressures manually adjusted by an operator. Bilevel positive airway pressure-spontaneous/timed (BiPAP S/T) with average volume assured pressure support (AVAPS) uses a fixed tidal volume that au...

BACKGROUND Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation techniques is poorly understood. METHODS A prospective randomised clinical trial was undertaken in January 2004 in 70 candidates randomly assigned to training in mouth-to-mouth, mouth-to-mask or mouth-to-face shield ventilation. Each candidate was trained for 10 min, after which tidal volume, respirator...