Risk prediction models for non-invasive ventilation failure in patients with chronic obstructive pulmonary disease: A systematic review.

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition with high morbidity and mortality. Noninvasive mechanical ventilation (NIV) is often used to manage acute COPD exacerbations, but failure can lead to worse outcomes. This systematic review aimed to evaluate risk prediction models for NIV failure in patients with COPD.

Noninvasive Mechanical Ventilation Is a Promising Way to Improve Lung Cancer Radiation Therapy.

Purpose: Accurate radiation therapy (RT) for lung cancer is challenging because of the respiratory motion of the tumor and surrounding organs at risk. Recently, non-invasive mechanical ventilation (NIMV) has been investigated as a novel respiratory motion management strategy. Using NIMV, respiratory motion can be minimized, while a larger lung volume yields less overall lung dose.

Prevalence, management, health-care burden, and 90-day outcomes of prolonged mechanical ventilation in the paediatric intensive care unit (LongVentKids): an international, prospective, cross-sectional cohort study.

Background: The number of children requiring prolonged mechanical ventilation (PMV) has increased with the advancement of medical care. We aimed to estimate the prevalence of PMV worldwide, document demographic and clinical characteristics of children requiring PMV in paediatric intensive care units (PICUs), and to understand variation in clinical practice and health-care burden.

Methods: This international, multicentre, cross-sectional cohort study screened participating PICUs in 28 countries for children aged >37 postgestational weeks to 17 years who had been receiving mechanical ventilation (MV; invasive or non-invasive) for at least 14 consecutive days.

Managing Intracranial Pressure Crisis.

Purpose Of Review: The objective of this review is to provide a comprehensive management protocol for the treatment of intracranial pressure (ICP) crises based on the latest evidence.

Recent Findings: The review discusses updated information on various aspects of critical care management in patients experiencing ICP crises, including mechanical ventilation, fluid therapy, hemoglobin targets, and hypertonic saline infusion, the advantages of ICP monitoring, the critical ICP threshold, and bedside neuromonitoring. All aspects of critical care treatment, including hemodynamic and respiratory support and adjustment of ICP reduction therapy, may impact patient outcomes.

Planning a Phased Guideline Implementation Strategy Across the Multicenter Ventilation Liberation for Kids (VentLib4Kids) Collaborative.

Objectives: To evaluate contextual factors relevant to implementing pediatric ventilator liberation guidelines and to develop an implementation strategy for a multicenter collaborative.

Design: Cross-sectional qualitative analysis of a 2023/2024 survey.

Setting: International, multicenter Ventilation Liberation for Kids (VentLib4Kids) collaborative.

Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?

Purpose Of Review: This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive pulmonary disease (COPD). As emerging evidence continues to show substantial benefits in reducing mortality and hospitalizations, it's crucial to identify which patients will benefit most and to provide clear guidance on implementing homeNIV effectively.

Recent Findings: Recent research supports the use of high intensity homeNIV for CHRF secondary to COPD, showing marked reductions in hospitalizations and mortality.

A worldwide assessment of the mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Analysis of the VENTILAGROUP over time. A retrospective, multicenter study.

Background: The trend over time and across different geographical areas of outcomes and management with noninvasive ventilation or invasive mechanical ventilation in patients admitted for acute exacerbations of chronic obstructive pulmonary disease and treated with ventilatory support is unknown. The purpose of this study was to describe outcomes and identify variables associated with survival for patients admitted to an intensive care unit (ICU) with acute exacerbation of chronic obstructive pulmonary disease [aeCOPD] who received noninvasive or invasive mechanical ventilation worldwide.

Methods: Retrospective, multi-national, and multicenter studies, including four observational cohort studies, were carried out in 1998, 2004, 2010, and 2016 for the VENTILAGROUP following the same methodology.

Burden of viral respiratory infections in the pediatric intensive care unit: age, virus distribution, and the impact of the COVID-19 pandemic.

Unlabelled: Though usually self-limiting, viral respiratory infections can escalate to severe cases requiring admission to a pediatric intensive care unit (PICU). This study aims to examine the proportional incidence, affected age ranges, viral pathogens involved, associated severity measures, and the impact of the COVID-19 pandemic on their incidence and virus distribution. This retrospective cohort study conducted in a tertiary care center (2011-2021) reviewed all pediatric patients admitted to PICU with laboratory-confirmed viral respiratory infection.

Outcomes Associated With Airway Management of Adult Trauma Patients Admitted to Surgical Intensive Care.

Introduction: Advanced airway management and ventilation of trauma patients are often needed during acute stabilization and resuscitation and later, in those admitted. In addition to endotracheal intubation for advanced airway management, tracheostomy is commonly used in critically ill patients when prolonged mechanical ventilation is required. However, the outcomes associated with airway management approaches and the timing of a tracheostomy in critically ill patients are mixed.

Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report.

Oral manifestations of disseminated histoplasmosis are rare but can present in immunocompromised individuals. We report a case of disseminated Histoplasmosis presenting with presumed oral involvement and pneumonia in a seropositive HIV individual. A 32-year-old male with HIV presented to the emergency department for a two-week history of abdominal pain and a tongue ulcer in the setting of significant weight loss, blood-tinged sputum, and non-adherence with antiretroviral therapy for three years.

Nasal High-Flow Therapy Versus Low-Flow Oxygen Therapy Post-Discharge in Infants With Bronchopulmonary Dysplasia: A Retrospective Observational Study.

Introduction: Low-flow oxygen therapy (LFOT) has been the only option for infants with bronchopulmonary dysplasia (BPD) requiring supplemental oxygen after discharge for years. Nasal high-flow therapy (NHFT) has more recently become available as a home device. We compared the impact of NHFT and LFOT on respiratory morbidity and lung function over the first 4 years in infants with BPD requiring respiratory support post-discharge.

High-frequency percussive ventilation in acute respiratory failure.

Introduction: High-frequency percussive ventilation (HFPV) is a ventilation mode characterised by high-frequency breaths. This study investigated the impact of HFPV on gas exchange and clinical outcomes in acute respiratory failure (ARF) patients during spontaneous breathing, noninvasive ventilation (NIV) and invasive mechanical ventilation (iMV).

Methods: This systematic review included randomised and nonrandomised studies up to August 2023.

Perioperative Lung Ultrasound Findings in Elective Intra-Abdominal Surgery: Associations with Postoperative Pulmonary Complications.

For patients undergoing abdominal surgery, postoperative pulmonary complications (PPCs) are a major source of morbidity and mortality. The use of point-of-care ultrasonography (POCUS), and specifically POCUS of the lungs, has seen many advancements in recent years. We hypothesize that perioperative lung ultrasonography can be used as a predictor for PPCs.

A Technique for Monitoring Mechanically Ventilated Patient Lung Conditions.

Background: Mechanical ventilation is a critical but resource-intensive treatment. Automated tools are common in screening diagnostics, whereas real-time, continuous trend analysis in mechanical ventilation remains rare. Current techniques for monitoring lung conditions are often invasive, lack accuracy, and fail to isolate respiratory resistance-making them impractical for continuous monitoring and diagnosis.

Caffeine therapy for apnea of prematurity: single center study on dosing practices and perceived effectiveness.

Introduction: Caffeine is the registered pharmacologic treatment for apnea of prematurity and is extensively used in the neonatal intensive care units (NICUs) based on evidence from randomized controlled trials. This study aimed to describe the clinical use of caffeine based on real-world data, hypothesizing a divergence from the registered dosing regimen.

Methods: A retrospective analysis included infants born before 30 weeks of gestation, admitted to the NICU of the Erasmus MC Rotterdam from 2018 to 2021.

A Retrospective Data Audit of Outcome of Moderate and Severe Covid-19 Patients Who Had Received MP and Dex: A Single Center Study.

Purpose: To evaluate the necessity of the application of glucocorticoid (GC) in moderate COVID-19 patients, and which is the optimal choice between methylprednisolone (MP) and dexamethasone (DEX) in the clinical use of GC in different types of COVID-19 patients.

Patients And Methods: The study included patients with COVID-19 in Shanxi, China, from December 18, 2022, to March 1, 2023. The main clinical outcomes were 30-day mortality, disease exacerbations, and hospitalization days.

Fatal Tracheal and Bronchial Destruction Due to Pulmonary Mucormycosis in a 20-Year-Old with Diabetic Ketoacidosis.

Pulmonary mucormycosis is a rare and aggressive invasive fungal infection that predominantly affects immunocompromised individuals, such as those with diabetes mellitus or those undergoing immunosuppressive therapy. This case describes a severe instance of pulmonary mucormycosis resulting in progressive tracheal wall destruction in a young, previously healthy male. A 20-year-old male with a denied history of diabetes mellitus was admitted to a local hospital with abdominal pain for 9 days and diagnosed with acute pancreatitis and diabetic ketoacidosis (DKA).

High-velocity nasal insufflation versus noninvasive positive pressure ventilation for moderate acute exacerbation of chronic obstructive pulmonary disease in the emergency department: A randomized clinical trial.

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department (ED) involve dyspnea, cough, and chest discomfort; frequent exacerbations are associated with increased mortality and reduced quality of life. Noninvasive positive pressure ventilation (NiPPV) is commonly used to help relieve symptoms but is limited due to patient intolerance. We aimed to determine whether high-velocity nasal insufflation (HVNI) is noninferior to NiPPV in relieving dyspnea within 4 h in ED patients with acute hypercapnic respiratory failure.

Prolonged weaning from mechanical ventilation: who, what, when and how?

Weaning from invasive mechanical ventilation is an important part of the management of respiratory failure patients. Patients can be classified into those who wean on the first attempt (simple weaning), those who require up to three attempts (difficult weaning) and those who require more than three attempts (prolonged weaning). The process of weaning includes adequately treating the underlying cause of respiratory failure, assessing the readiness to wean, evaluating the response to a reduction in ventilatory support, and eventually liberation from mechanical ventilation and extubation or decannulation.