Ventilación no invasiva en casa: ¿Qué necesita conocer el anestesiólogo?
Home noninvasive ventilation: what does the anesthesiologist need to know?
Brown KA, Bertolizio G, Leone M, Dain SL.
Division of Pediatric Anesthesia, Department of Pediatric Respiratory Therapy, McGill University Health Center Research Institute, Montreal Children's Hospital, Montreal, Quebec, Canada.roula.cacolyris@muhc.mcgill.ca
Anesthesiology. 2012 Sep;117(3):657-68.
Abstract
Treatment of chronic respiratory failure with noninvasive ventilation (NIV) is standard pediatric practice, and NIV systems are commonly used in the home setting. Although practice guidelines on the perioperative management of children supported with home NIV systems have yet to be published, increasingly these patients are referred for consultation regarding perioperative management. Just as knowledge of pharmacology underlies the safe prescription of medication, so too knowledge of biomedical design is necessary for the safe prescription of NIV therapy. The medical device design requirements developed by the Organization for International Standardization provide a framework to rationalize the safe prescription of NIV for hospitalized patients supported at home with NIV systems. This review article provides an overview of the indications for home NIV therapy, an overview of the medical devices currently available to deliver it, and a specific discussion of the management conundrums confronting anesthesiologists.
http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2012&issue=09000&article=00036&type=abstract
Ventilación no invasiva con presión positiva para falla respiratoria crónica estable...
Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis.
COPD Working Group.
Ont Health Technol Assess Ser. 2012;12(9):1-51. Epub 2012 Mar 1.
OBJECTIVE:
The objective of this health technology assessment was to determine the effectiveness and cost-effectiveness of noninvasive ventilation for stable chronic obstructive pulmonary disease (COPD). CLINICAL NEED: CONDITION AND TARGET POPULATION Noninvasive ventilation is used for COPD patients with chronic respiratory failure. Chronic respiratory failure in COPD patients may be due to the inability of the pulmonary system to coordinate ventilation, leading to adverse arterial levels of oxygen and carbon dioxide. Noninvasive ventilation in stable COPD patients has the potential to improve quality of life, prolong survival, and improve gas exchange and sleep quality in patients who are symptomatic after optimal therapy, have hypercapnia or nocturnal hypoventilation and mild hypercapnia, and are frequently hospitalized. TECHNOLOGY: Noninvasive positive pressure ventilation (NPPV) is any form of positive ventilatory support without the use of an endotracheal tube. For stable COPD, the standard of care when using noninvasive ventilation is bilevel positive airway pressure (BiPAP). Bilevel positive airway pressure involves both inspiratory and expiratory pressure, high during inspiration and lower during expiration. It acts as a pressure support to accentuate a patient's inspiratory efforts. The gradient between pressures maintains alveolar ventilation and helps to reduce carbon dioxide levels. Outpatients typically use BiPAP at night. Additional advantages of using BiPAP include resting of respiratory muscles, decreased work of breathing, and control of obstructive hypopnea.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384378/pdf/ohtas-12-51.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Home noninvasive ventilation: what does the anesthesiologist need to know?
Brown KA, Bertolizio G, Leone M, Dain SL.
Division of Pediatric Anesthesia, Department of Pediatric Respiratory Therapy, McGill University Health Center Research Institute, Montreal Children's Hospital, Montreal, Quebec, Canada.roula.cacolyris@muhc.mcgill.ca
Anesthesiology. 2012 Sep;117(3):657-68.
Abstract
Treatment of chronic respiratory failure with noninvasive ventilation (NIV) is standard pediatric practice, and NIV systems are commonly used in the home setting. Although practice guidelines on the perioperative management of children supported with home NIV systems have yet to be published, increasingly these patients are referred for consultation regarding perioperative management. Just as knowledge of pharmacology underlies the safe prescription of medication, so too knowledge of biomedical design is necessary for the safe prescription of NIV therapy. The medical device design requirements developed by the Organization for International Standardization provide a framework to rationalize the safe prescription of NIV for hospitalized patients supported at home with NIV systems. This review article provides an overview of the indications for home NIV therapy, an overview of the medical devices currently available to deliver it, and a specific discussion of the management conundrums confronting anesthesiologists.
http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2012&issue=09000&article=00036&type=abstract
Ventilación no invasiva con presión positiva para falla respiratoria crónica estable...
Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis.
COPD Working Group.
Ont Health Technol Assess Ser. 2012;12(9):1-51. Epub 2012 Mar 1.
OBJECTIVE:
The objective of this health technology assessment was to determine the effectiveness and cost-effectiveness of noninvasive ventilation for stable chronic obstructive pulmonary disease (COPD). CLINICAL NEED: CONDITION AND TARGET POPULATION Noninvasive ventilation is used for COPD patients with chronic respiratory failure. Chronic respiratory failure in COPD patients may be due to the inability of the pulmonary system to coordinate ventilation, leading to adverse arterial levels of oxygen and carbon dioxide. Noninvasive ventilation in stable COPD patients has the potential to improve quality of life, prolong survival, and improve gas exchange and sleep quality in patients who are symptomatic after optimal therapy, have hypercapnia or nocturnal hypoventilation and mild hypercapnia, and are frequently hospitalized. TECHNOLOGY: Noninvasive positive pressure ventilation (NPPV) is any form of positive ventilatory support without the use of an endotracheal tube. For stable COPD, the standard of care when using noninvasive ventilation is bilevel positive airway pressure (BiPAP). Bilevel positive airway pressure involves both inspiratory and expiratory pressure, high during inspiration and lower during expiration. It acts as a pressure support to accentuate a patient's inspiratory efforts. The gradient between pressures maintains alveolar ventilation and helps to reduce carbon dioxide levels. Outpatients typically use BiPAP at night. Additional advantages of using BiPAP include resting of respiratory muscles, decreased work of breathing, and control of obstructive hypopnea.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384378/pdf/ohtas-12-51.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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