tailieunhanh - Báo cáo y học: "Noninvasive mechanical ventilation during the weaning process: facilitative, curative, or preventive"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Noninvasive mechanical ventilation during the weaning process: facilitative, curative, or preventive? | Available online http content 12 2 136 Commentary Noninvasive mechanical ventilation during the weaning process facilitative curative or preventive Massimo Antonelli and Giuseppe Bello Policlinico Universitario A. Gemelli Università Cattolica del Sacro Cuore Largo A. Gemelli 8 00168 Rome Italy Corresponding author Massimo Antonelli Published 21 April 2008 This article is online at http content 12 2 136 2008 BioMed Central Ltd Critical Care 2008 12 136 doi cc6853 See related research by Trevisan et al. http content 12 2 R51 Abstract To avoid the complications associated with endotracheal intubation noninvasive positive-pressure ventilation NPPV has been proposed in the management of ventilator weaning in patients with acute respiratory failure ARF of various etiologies. Several studies have been performed to assess the benefit of NPPV in various weaning strategies including permitting early extubation in patients who fail to meet standard extubation criteria facilitation use avoiding reintubation in patients who fail extubation curative use and preventing extubation failure in nonselected and selected patients preventive use . NPPV has been successfully used in facilitating early extubation particularly in patients with chronic obstructive pulmonary disease. In contrast applying curative NPPV to treat postextubation ARF in nonselected populations may not be effective and could even be deleterious. Early use of NPPV was successful in preventing ARF after extubation and decreased the need for reintubation in selected patients at risk of developing postextubation ARF. It is important that caregivers clearly differentiate among these application modalities of NPPV. The skills and expertise of both medical and nonmedical personnel are crucial predictive factors for the success of NPPV in the ventilator weaning process. In the present issue of Critical Care the use of noninvasive positive-pressure .

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