Noninvasive positive-pressure ventilation with different interfaces in patients with respiratory failure after abdominal surgery: a matched-control study.

Background: Acute respiratory failure (ARF) is a relatively common complication after abdominal surgery.

Methods: We compared the efficacy of noninvasive positive-pressure ventilation (NPPV) delivered via helmet versus via face mask in patients with ARF after abdominal surgery in 2 intensive care units (31 beds) in the hospital affiliated with the Catholic University of Rome. Twenty-five patients with ARF after abdominal surgery were treated with NPPV via helmet, and the data from those patients were matched with 25 controls chosen from a historical group of 151 patients treated with face mask during the previous 2 years for respiratory complications after abdominal surgery.

Analgesia in PACU: intravenous opioids.

Critically ill patients, particularly those under mechanical ventilation, require analgo-sedation to control noxious stimuli and enhance comfort. Despite their harmful side effects, such as respiratory depression, physical dependence and difficult arousal, opioids are effective in providing a good level of analgesia and comfort. Traditional opioids (morphine and fentanyl) have been shown effective in providing analgesia; however, the respiratory adverse effects and their pharmacokinetics, with an high risk of accumulation, limits their use, especially for a long-term sedation.

Physiologic evaluation of different levels of assistance during noninvasive ventilation delivered through a helmet.

Objective: To evaluate the effects of various levels of pressure support (PS) during noninvasive ventilation delivered through a helmet on breathing pattern, inspiratory effort, CO2 rebreathing, and comfort.

Design: Physiologic study.

Setting: University-affiliated hospital.