Respiratory medicine
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Respiratory medicine · Oct 2017
Review Meta AnalysisDoes high-flow nasal cannula oxygen improve outcome in acute hypoxemic respiratory failure? A systematic review and meta-analysis.
To evaluate the efficacy of high-flow nasal cannula (HFNC) in the rate of intubation and mortality for patients with acute hypoxemic respiratory failure. ⋯ The use of HFNC showed a trend toward reduction in the intubation rate, which did not meet statistical significance, in patients with acute respiratory failure compared with conventional oxygen therapy (COT) and noninvasive ventilation (NIV). Moreover no difference in mortality. So, Large, well-designed, randomized, multi-center trials are needed to confirm the effects of HFNC in acute hypoxemic respiratory failure patients.
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Respiratory medicine · Oct 2017
Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients.
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing lung disease of unknown etiology. Inter-society consensus guidelines on IPF diagnosis and management outline radiologic patterns including definite usual interstitial pneumonia (UIP), possible UIP, and inconsistent with UIP. We evaluate these diagnostic categories as prognostic markers among patients with IPF. ⋯ Radiologic diagnosis categories outlined by inter-society consensus guidelines is a widely-reported and potentially useful prognostic marker in IPF patients, with possible UIP pattern on HRCT associated with a favorable prognosis compared to definite UIP pattern, after adjusting for relevant covariates.
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Respiratory medicine · Oct 2017
Blood eosinophilia as a marker of early and late treatment failure in severe acute exacerbations of COPD.
Blood eosinophilia is frequently encountered in patients with AECOPD. However the impact of blood eosinophilia at admission in patients with AECOPD on outcome on the short and long term has not been extensively studied which was the objective of the present study. ⋯ NCT01232140.
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Respiratory medicine · Oct 2017
Global Lung Function Initiative 2012 reference values for spirometry in South Italian children.
Despite the widespread use of the Global Lung Function Initiative (GLI) 2012 reference values, there is still the need of testing their applicability in local areas. ⋯ GLI 2012 references underestimate FEV1/FVC predicted values in a sample of normal South Italian children. Physicians interpreting spirometry should be aware to test reference values prior to their use in a local area.
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Respiratory medicine · Oct 2017
The use of high-flow nasal cannula (HFNC) as respiratory support in neonatal and pediatric intensive care units in Germany - A nationwide survey.
High-flow nasal cannula (HFNC)1 is a technique of oxygen supply, initially being used as a potentially less-invasive alternative to nasal continuous positive airway pressure (nCPAP)2 for premature infants/neonates, which nowadays crosses the border of neonatal care. HFNC builds up a positive end-expiratory pressure (PEEP)3 but lacks the opportunity for continuous monitoring. Therefore, pressure-depending complications are a risk. Our goal was to evaluate the current use of HFNC in Germany regarding indications, techniques of application and complications experienced. ⋯ We reported for the first time a nationwide overview about the expanded use of HFNC in pediatric clinics. Our results emphasize the fact that, even though HFNC is widely accepted as a non-invasive procedure there is still a potential of severe side effects. Therefore the use of HFNC should be monitored continuously and closely within an intensive or intermediate care unit.