The clinical respiratory journal
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Average volume-assured pressure support (AVAPS), a dual mode, delivers a set tidal volume (TV) per kg by adjusting the pressure between upper and lower inspiratory positive airway pressures (IPAP). Thus, ventilation is presumed to be happened effectively by sending a guaranteed TV. This study was aimed to evaluate the effectiveness of AVAPS mode in critically ill patients with acute hypercarbic respiratory failure (HRF) and compare the results with bilevel positive airway pressure-spontaneous/timed (BPAP-S/T) mode. ⋯ AVAPS mode had similar efficiency with BPAP-S/T mode regarding the NIMV treatment success in critically ill patients with acute HRF.
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During this long COVID-19 pandemic outbreak, continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) are being widely used to treat patients with moderate to severe acute respiratory failure (ARF). As for now, data on the efficacy of NIV in COVID-19 acute respiratory distress syndrome (ARDS) are lacking, and for this reason it is extremely important to accurately determine the outcomes of this strategy. This study aimed to evaluate clinical data and outcomes of NIV in patients with COVID-19 ARDS. ⋯ Previous studies conducted on patients undergoing invasive mechanical ventilation showed higher mortality rate than the present study. Our data showed that NIV can avoid intubation in almost half of the patients. Therefore, this data could reassure clinicians who would consider using NIV in COVID-19 ARDS-related treatment.
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Acute exacerbation (AE) is recognized as a life-threatening condition with acute respiratory worsening in idiopathic pulmonary fibrosis (IPF). AE also occurs in fibrotic interstitial lung disease (ILD) other than IPF, including other types of idiopathic interstitial pneumonias (IIPs), ILD associated with collagen vascular disease (CVD-ILD), and chronic hypersensitivity pneumonia (CHP). However, the clinical impact after AE in those patients is still unclear. ⋯ AE of ILD other than IPF might have a better prognosis than AE-IPF, but both are fatal conditions that cause chronic respiratory failure.
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COVID-19 has spread rapidly worldwide and has been declared a pandemic. ⋯ These findings provide insights for early detection and management of patients at risk of disease progression or even death, especially older patients and those with comorbidities.
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Sleep medicine is an under-recognised medical specialty in Pakistan and obstructive sleep apnoea (OSA) often goes unnoticed. Final year medical students and junior doctors are the primary medical contact to elicit patient history and physical examination. We aimed to measure the current knowledge of OSA amongst the final year medical students and junior doctors at four university teaching hospitals across three large Pakistani cities. ⋯ Final year medical students and junior doctors from a sample of four university teaching hospitals in three large cities of Pakistan have limited knowledge about the diagnosis and management of OSA. The observed limited knowledge of OSA may contribute towards under-diagnosis of this increasingly prevalent medical condition.