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Journal of Intensive Medicine 2023年第1期3卷 20-26页

作者： Jean-Pierre Frat Laura Marchasson François Arrivé Rémi Coudroy Centre Hospitalier Universitaire de Poitiers Médecine Intensive RéanimationPoitiers 86021France Centre d'Investigation Clinique 1402 ALIVE INSERMUniversitéde PoitiersPoitiers 86021France

Although standard oxygen face masks are first-line therapy for patients with acute hypoxemic respiratory failure,high-flow nasal cannula oxygen therapy has gained major popularity in intensive care units.The physiological effects of high-flow oxygen counterbalance the physiological consequences of acute hypoxemic respiratory failure by lessening the deleterious effects of intense and prolonged inspiratory efforts generated by patients.Its simplicity of application for physicians and nurses and its comfort for patients are other arguments for its use in this setting.Although clinical studies have reported a decreased risk of intubation with high-flow oxygen compared with standard oxygen,its survival benefit is uncertain.A more precise definition of acute hypoxemic respiratory failure,including a classification of severity based on oxygenation levels,is needed to better compare the efficiencies of different non-invasive oxygenation support methods(standard oxygen,high-flow oxygen,and non-invasive ventilation).Additionally,the respective role of each non-invasive oxygenation support method needs to be established through further clinical trials in acute hypoxemic respiratory failure,especially in severe forms.

关键词： High-flow nasal oxygen Acute Respiratory Failure COVID-19 Oxygen support

Oxygenation strategy during Acute Respiratory Failure in immunocompromised patients

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Journal of Intensive Medicine 2021年第2期1卷 81-89页

作者： Virginie Lemiale Elise Yvin Achille Kouatchet Djamel Mokart Alexandre Demoule Guillaume Dumas Grrr-OH Research Group Service de Médecine Intensive et Réanimation APHP Hopital Saint Louis1 Avenue Claude VellefauxParis 75010France Service de Réanimation Médicale et Médecine Hyperbare Angers 49100France Institut Paoli-Calmettes Réanimation Medico-ChirurgicaleMarseille 13009France AP-HP Groupe Hospitalier Universitaire APHP-Sorbonne Universitésite Pitié-SalpêtrièreService de Médecine Intensive et Réanimation(Département R3S)and Sorbonne UniversitéINSERMUMRS1158 Neurophysiologie Respiratoire Expérimentale et CliniqueParis 75013France

Acute Respiratory Failure(ARF)in immunocompromised patients remains challenging to treat.A large number of case require admission to intensive care unit(ICU)where mortality remains high.Oxygenation without intubation is important in this setting.This review summarizes recent studies assessing oxygenation devices for immunocompromised patients.Previous studies showed that non-invasive ventilation(NIV)has been associated with lower intubation and mortality rates.Indeed,in recent years,the outcomes of immunocompromised patients admitted to the ICU have improved.In the most recent randomized controlled trials,including immunocompromised patients admitted to the ICU with ARF,neither NIV nor high-flow nasal oxygen(HFNO)could reduce the mortality rate.In this setting,other strategies need to be tested to decrease the mortality rate.Early admission strategy and avoiding late failure of oxygenation strategy have been assessed in retrospective studies.However,objective criteria are still lacking to clearly discriminate time to admission or time to intubation.Also,diagnosis strategy may have an impact on intubation or mortality rates.On the other hand,lack of diagnosis has been associated with a higher mortality rate.In conclusion,improving outcomes in immunocompromised patients with ARF may include strategies other than the oxygenation strategy alone.This review discusses other unresolved questions to decrease mortality after ICU admission in such patients.

关键词： Outcome Acute Respiratory Failure Invasive mechanical ventilation

Application of Venovenous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Failure： Situations, Issues, and Trends

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Chinese Medical Journal 2017年第5期130卷 505-507页

作者： Xu-Yan LI Bing Sun Department of respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China Beijing institute of respiratory Medicine Beijing 100020 China Beijing Key Laboratory of respiratory and Pulmonary Circulation Beijing 100020 China Beijing Engineering Research Center for Diagnosis and Treatment of respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital) Beijing 100020 China

Extracorporeal membrane oxygenation （ECMO） is a type of extracorporeal life support （ECLS）, and technological advances have expanded the use of this technique from the confines of the operating room by producing a... 详细信息

关键词： acute respiratory Distress Syndrome Acute Respiratory Failure Extracorporeal Membrane Oxygenation

Efficacy and safety of noninvasive positive pressure ventilation in the treatment of Acute Respiratory Failure after cardiac surgery

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Chinese Medical Journal 2013年第23期126卷 4463-4469页

作者： ZHU Guang-fa WANG Di-jia LIU Shuang JIA Ming JIA Shi-jie Department of Repiratory and Critical Care Medicine Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China Department of Surgical Intensive Care Unit Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China Intensive Care Unit Beijing Tongren Hospital Capital Medical University Beijing 100730 China

Background Although noninvasive positive pressure ventilation （NPPV） has been successfully used for various kinds of Acute Respiratory Failure,the data are limited regarding its application in postoperative respiratory failure after cardiac surgery.Therefore,we conducted a prospective randomized control study in a university surgical intensive care unit to evaluate the efficacy and safety of NPPV in the treatment of Acute Respiratory Failure after cardiac surgery,and explore the predicting factors of NPPV failure.Methods From September 2011 to November 2012 patients with Acute Respiratory Failure after cardiac surgery who had indication for the use of NPPV were randomly divided into a NPPV treatment group （NPPV group） and the conventional treatment group （control group）.The between-group differences in the patients＇ baseline characteristics,re-intubation rate,tracheotomy rate,ventilator associated pneumonia （VAP） incidence,in-hospital mortality,mechanical ventilation time after enrollment （MV time）,intensive care unit （ICU） and postoperative hospital stays were compared.The factors that predict NPPV failure were analyzed.Results During the study period,a total of 139 patients who had Acute Respiratory Failure after cardiac surgery were recorded,and 95 of them met the inclusion criteria,which included 59 males and 36 females with a mean age of （61.5±11.2） years.Forty-three patients underwent coronary artery bypass grafting （CABG）,23 underwent valve surgery,13 underwent CABG＋valve surgery,13 underwent major vascular surgery,and three underwent other surgeries.The NPPV group had 48 patients and the control group had 47 patients.In the NPPV group,the re-intubation rate was 18.8％,tracheotomy rate was 12.5％,VAP incidence was 0,and the in-hospital mortality was 18.8％,significantly lower than in the control group 80.9％,29.8％,17.0％ and 38.3％ respectively,P ＜0.05 or P ＜0.01.The MV time and ICU stay （expressed as the median （P25,P75）） were 18.0 （9.2,35.0） hours and 4.0 （2.0,5.0） days,which were significantly shorter than in

关键词： noninvasive positive pressure ventilation Acute Respiratory Failure cardiac surgery intensive care medicine

Association between Acute Respiratory Failure and traumatic intraventricular or subarachnoid hemorrhage in severe traumatic brain injury patients

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Association between acute respiratory failure and traumatic ...

Pulmonary infection control window as a switching point for consequential ventilation: an encouraging finding in treatment of Acute Respiratory Failure of chronic obstructive pulmonary disease

第十六届中国医师协会神经外科医师年会

作者： Min Li Ying Wu Shi Guo Dong Gao Yan Qu Department of Neurosurgery Tangdu HospitalFourth Military Medical University

Aim:The aim of the study was to demonstrate the neuroimaging features of moderate to severe traumatic brain injury(TBI) patients with or without Acute Respiratory Failure(ARF) and analyze the relationship between the neuroimaging features and ARF.Method:Clinical and neuroimaging data from moderate to severe TBI(GCS 3-12) in adults from 2013 to 2019 were retrospectively collected and analyzed.Multivariable regression was used to analyze the association between the ARF and neuroimaging features(midline shift,grade of basal cisterns compressed,grade of traumatic subarachnoid hemorrhage,and traumatic intraventricular hemorrhage).Result:During the study period,695 patients who met the criteria of this study were included,and 239 had an event of ARF.Compared with the patients without ARF,the patients with ARF had significantly lower Glasgow Coma Scale(GCS),and a higher proportion of multiple injuries,midline shift(MLS),effacement of the basal cisterns(BC scale 2),traumatic intraventricular hemorrhage(tIVH),and traumatic high-grade subarachnoid hemorrhage(tSAH scale 3-4).BC scale of 2,tIVH and tSAH scale of 3-4 were associated with ARF by multivariate analysis after adjusted for age,gender,GCS,smoking history,multiple injuries,and comorbidities in severe TBI(STBI) patients(P0.05).For the STBI patients,tIVH and tSAH scale of 4 were associated with ARF in isolated STBI or multiple injuries patients with STBI(P<0.01).Conclusion:The study demonstrated that the tIVH or severe t SAH was associated with ARF within 48 hours of admission in the STBI patients.Early airway management should be prepared for STBI patients with risk factors.

关键词： Acute Respiratory Failure traumatic intraventricular hemorrhage Traumatic subarachnoid hemorrhage Neuroimaging features Traumatic Brain Injury

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Chinese Medical Journal 2005年第19期118卷 1587-1588页

作者： ZHANG Xi-long Department of respiratory Medicine First Affiliated Hospital ofNanjing Medical University Nanjing 210029 China

I read with great interest the article by Collaborating Research Group for NoninvasiveMechanical Ventilation of Chinese respiratory Society. 1 Based on the concept mentioned in this paper, I have found that it is really an encouraging new finding in the field of clinical application of mechanical ventilation and treatment of Acute Respiratory Failure （ARF） of chronic obstructive pulmonary disease （COPD）.

关键词： FINDINGS Mechanical Ventilation Acute Respiratory Failure switching point Infectious Lung Disorder Chronic Obstructive Airway Disease

Noninvasive Positive Pressure Ventilation Treatment for Acute Respiratory Failure in SARS

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Noninvasive Positive Pressure Ventilation Treatment for Acut...

Non-invasive versus invasive mechanical ventilation for respiratory failure in severe acute respiratory syndrome

2006年中国睡眠研究会第四届学术年会

作者： Fang Han, M.D., YuY. Jiang, M.D., Jian H. Zheng, M.D., Zhan C. Gao, M.D., and QuanY. He, M.D. Sleep and Breatbing, volume 8, number 2,2004. Address for correspondence and reprint requests: Fang Han, M.D., Department of Pulmonary Medicine, the People''s Hospital, Beijing University, 11#, Xi Zhi Men Na Da Jie, Xi ChenQu, Beijing, 100044, China. Department of Pulmonary Medicine, the People''s Hospital, Beijing University, Beijing, China Beijing DiTan Hospital, Beijing, China Beijing DianLi Hospital, Beijing, China. Copyright

＜正＞This study describes the blood gases features and short-term outcomes with noninvasive positive pressure ventilation （NPPV） treatment in the management of Acute Respiratory Failure （ARF） during a severe acute respiratory syndrome （SARS） epidemic. Between April 22 and May 1, 2003, 120 patients meeting clinical criteria for SARS were admitted to a hospital for infectious diseases in Beijing, China. At 6 weeks after onset, 25% of patients （30/120） had experienced ARF. Of interest, 16 of these patients （53%） exhibited hypercapnia （PaCO2＞45 mm Hg）, and 10 hypercapnic events occurred within 1 week of admission. The occurence of hypercapnia or CO2 retention and was accompanied by myalgias. NPPV was instituted in 28 patients;one was intolerant of NPPV. In the remaining 27 patients, NPPV was initiated 1.2 ?1.6 days after ARF onset. An hour of NPPV therapy led to significant increases in PaO2 and PaO2/FiO2 and a decrease in respiratory rate （p＜0.01）. Endotracheal intubation was required in one third of the patients （9 of 27） who initially had a favorable response to NPPV. Remarkable pulmonary barotrauma was noticed in 7 of all 120 patients （5.8%） and in 6 of those （22%） on NPPV. The overall fatality rate at 13 weeks was 6.7% （8/120）;it was higher （26.7%） in those needing NPPV. No caregiver contracted SARS. We conclude that NPPV is a feasible and appropriate treatment for ARF occurring as a result of a SARS infection.

关键词： Noninvasive positive pressure ventilation Acute Respiratory Failure acute respiratory distress syndrome

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Chinese Medical Journal 2005年第17期118卷 1413-1421页

作者： Loretta YC Yam Alfred YF Chan Thomas MT Cheung Eva LH Tsui Jane CK Chan Vivian CW Wong Division of respiratory and Critical Care Medicine Department ofMedicine Pamela Youde Nethersole Eastern Hospital Hong KongChina Division of Respiratory and Critical Care Medicine Department ofMedicine Pamela Youde Nethersole Eastern Hospital Hong KongChina Division of Respiratory and Critical Care Medicine Department ofMedicine Pamela Youde Nethersole Eastern Hospital Hong KongChina Hong Kong Hospital Authority Head Office Hong Kong ChinaHong Kong Hospital Authority Head Office Hong Kong ChinaHong Kong Hospital Authority Head Office Hong Kong China

Severe acute respiratory syndrome is frequently complicated by respiratory failure requiring ventilatory support. We aimed to compare the efficacy of non-invasive ventilation against invasive mechanical ventilation tr... 详细信息

关键词： Acute Respiratory Failure infection control invasive mechanical ventilation non-invasive ventilation severe acute respiratory syndrome

Performance of Multiple Risk Assessment Tools to Predict Mortality for Adult respiratory Distress Syndrome with Extracorporeal Membrane Oxygenation Therapy： An External Validation Study Based on Chinese Single-center Data

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Chinese Medical Journal 2016年第14期129卷 1688-1695页

作者： Lei Huang Tong Li Lei Xu Xiao-Min Hu Da-Wei Duan Zhi-Bo Li Xin-Jing Gao Jun Li Peng Wu Ying-Wu Liu Song Wang Yu-Heng Lang Department of Heart Center Tianiin Third Central Hospital TianLin 300170 China Depariment of Intensive Care Unit l:ianjin Third Central Hospital Tianjin 300170 China

Background： There has been no external validation of survival prediction models for severe adult respiratory distress syndrome （ARDS） with extracorporeal membrane oxygenation （ECMO） therapy in China. The aim of study was to compare the performance of multiple models recently developed for patients with ARDS undergoing ECMO based on Chinese single-center data. Methods： A retrospective case study was performed, including twenty-three severe ARDS patients who received ECMO from January 2009 to July 2015. The PRESERVE （Predicting death for severe ARDS on VV-ECMO）, ECMOnet, respiratory Extracorporeal Membrane Oxygenation Survival Prediction （RESP） score, a center-specific model developed lbr inter-hospital transfers receiving ECMO, and the classical risk-prediction scores of acute Physiology and Chronic Health Evaluation （APACHE） II and Sequential Organ failure Assessment （SOFA） were calculated. In-hospital and six-month mortality were regarded as the endpoints and model performance was evaluated by comparing the area under the receiver operating characteristic curve （AUC）. Results： The RESP and APACHE II scores showed excellent discriminate performance in predicting survival with AUC of 0.835 （95% confidence interval [CI], 0.659-1 .010, P = 0.007） and 0.762 （95% CI, 0.558-0.965, P = 0.035）, respectively. The optimal cutoff values were risk class 3.5 for RESP and 35.5 for APACHE II score, and both showed 70.0% sensitivity and 84.6% specificity. The excellent performance of these models was also evident for the pneumonia etiological subgroup, for which the SOFA score was also shown to be predictive, with an AUC of 0.790 （95% CI, 0.571-1.009, P = 0.038）. However, the ECMOnet and the score developed for externally retrieved ECMO patients failed to demonstrate significant discriminate power for the overall cohort. The PRESERVE model was unable to be evaluated fully since Conclusions： The RESP, APCHAE 11, and SOFA scorings only one patient died six months postdischarge. systems show good predictive value for intra-hospital

关键词： acute respiratory Distress Syndrome Acute Respiratory Failure Extracorporeal Membrane Oxygenation PredictiveModel Survival Outcome

Lung ultrasound for the early diagnosis of acute lung injury:A case report

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World Journal of Clinical Cases 2023年第32期11卷 7900-7904页

作者： Xin Zheng Na Liu Department of Anesthesiology The Second Hospital of Dalian Medical UniversityDalian 116027Liaoning ProvinceChina

BACKGROUND The extensive availability of ultrasound(US)technology has increased its use for point-of-care applications in many health care settings.During anaesthesia and surgery,Acute Respiratory Failure or pulmonary oedema are common lifethreatening events that,if not recognized and treated appropriately,result in a high mortality rate.CASE SUMMARY We report a patient under anaesthesia whose lung US examination showed multiple vertical artefacts(B-lines)in the lung tissue,indicating pulmonary oedema.The respiratory state improved with the resolution of the pulmonary oedema after our treatment.CONCLUSION We believe that US of the lungs may be a useful tool for dynamic respiratory monitoring at the bedside during anaesthesia.

关键词： Lung ultrasound Acute Respiratory Failure Ultrasound Lung Case report