Respiratory care
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Noninvasive respiratory support refers to strategies aimed at providing oxygenation and/or ventilation without the use of an artificial airway. These strategies include the use of standard oxygen delivery devices (face masks, low-flow nasal cannulas), noninvasive ventilation, and high-flow nasal cannula. Considerable interest has been generated recently as to which therapy provides the optimum noninvasive support. This review examined the important literature related to noninvasive respiratory support published in 2018.
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Editorial Observational Study
Outcome of Frail Do-Not-Intubate Subjects With End-Stage Chronic Respiratory Failure and Their Opinion of Noninvasive Ventilation to Reverse Hypercapnic Coma.
The use of noninvasive ventilation (NIV) in the emergency setting to reverse hypercapnic coma in frail patients with end-stage chronic respiratory failure and do-not-intubate orders remains a questionable issue given the poor outcome of this vulnerable population. We aimed to answer this issue by assessing not only subjects' outcome with NIV but also subjects' point of view regarding NIV for this indication. ⋯ In the frailest subjects with supposed end-stage chronic respiratory failure that justifies treatment limitation decisions, it is worth trying NIV when acute hypercapnic respiratory failure occurs, even in the case of extreme respiratory acidosis with hypercapnic coma at admission.
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Amyotrophic lateral sclerosis (ALS) is considered a multisystem degenerative disease due to its autonomic dysfunction effects. Autonomic cardiac control disorders can be seen in ALS and influence the quality of life and the life expectancy of affected individuals. We evaluated heart rate variability in subjects with ALS and with variable lung capacity. ⋯ The subjects with ALS and with decreased pulmonary capacity had reduced heart rate variability.
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Editorial Comment
Preventing Colonization by Lung Isolation: Primum Non Nocere.