Contact Information:
Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society



Kredyty mieszkaniowe Kredyty mieszkaniowe

Sprawdź aktualny ranking najlepszych kredytów mieszkaniowych w Polsce - atrakcyjne kredytowanie nieruchomości.

PRESS-NEWS.org - Press Release Distribution
FREE PRESS RELEASES DISTRIBUTION
RSS - Press News Release
Add Press Release

Non-invasive ventilation as a weaning or rescue technique may cut risks in some patients


2011-06-11
(Press-News.org) Noninvasive ventilation (NIV) used as a weaning technique for mechanically ventilated patients can shorten intubation time and may reduce the risk of post-extubation acute respiratory failure (ARF), according to French researchers. They also found that NIV used as a post-intubation rescue therapy could significantly reduce the risk of reintubation and death.

"While NIV used as a weaning technique did not reduce the risk of reintubation as compared with conventional weaning and standard oxygen therapy, we do think the reduced risk of reintubation or death with NIV used as rescue therapy bears further investigation," said lead investigator Christophe Girault, MD.

The study was published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

Researchers consecutively recruited patients with chronic hypercapnic respiratory failure (CHRF) from 13 French and Tunisian ICUs between January 2002 and March 2006. Eligible patients had to have been intubated for at least 48 hours and failed a spontaneous breathing trial (SBT). Nearly one-third of 388 ventilated patients passed the SBT and were able to breathe on their own. Of the remaining patients, 208 failed the spontaneous breathing trial and were randomized to one of three ventilation-weaning strategies: "conventional weaning," where patients remained intubated and underwent one or more daily SBT with T-piece or pressure support ventilation (PSV) with or without positive end expiratory pressure (PEEP), and a progressive decrease in PSV level (until  7 cmH2O); extubation followed by standard oxygen therapy—administered via a nasal cannula or venturi mask; or extubation followed by NIV administered through a facial mask. This was the first randomized, controlled study of its sort in CHRF patients.

The primary endpoint evaluated was the need for reintubation within seven days of extubation. The secondary endpoints were secondary occurrence of ARF or death from all causes within seven days of extubation. The researchers also evaluated time to rescue post-extubation NIV and the probability of reintubation or death within seven days following its initiation; ICU and hospital length of stay and survival; and respiratory condition on hospital discharge.

They found that the probability of reintubation was not significantly different between the three weaning strategies, and that the causes of reintubation were similar between groups. However, post-intubation ARF in the NIV group was significantly lower than in others.

"Our results suggest that rescue NIV might be useful to avoid reintubation when post-extubation ARF occurs in these patients," said Dr. Girault.

These results are consistent with previously published results, including those of the VENISE trial, which involved a large cohort of CHRF patients considered to be potentially difficult-to-wean.

"NIV allowed to decrease the intubation duration as compared to invasive weaning, without increasing the risk of weaning failure in terms of reintubation," he continued. "NIV might, in fact, allow earlier extubation but not necessarily more rapidly 'de-ventilation' in difficult-to-wean CHRF patients."

Importantly, the study also points to a possible benefit of NIV as a rescue therapy to avoid reintubation. "Indeed, it was applied frequently in the two non-NIV groups and reduced the risk of reintubation or death by 45 percent in patients assigned to invasive weaning and 58 percent in those assigned to the oxygen therapy group," said Dr. Girault.

"Rescue NIV is currently not recommended for non-selected medical patients because until now there has been no proven benefit and even potential harmful outcome," he continued. "However, this study suggests that the standard should perhaps be re-evaluated in light of this, and further research, if the result proves consistent."

Further research should be done, he continued. For next steps, Dr. Girault would like to see a randomized, controlled trial with NIV as a weaning technique but with post-extubation ARF occurrence as the primary endpoint, and another randomized, controlled trial to confirm the potential benefit of NIV used as rescue therapy in this specific population.

### END

ELSE PRESS RELEASES FROM THIS DATE:

Quitlines help smokers quit regardless of recruitment method

2011-06-11
Proactive telephone counseling helps smokers quit regardless of how they are recruited to a telephone quitline, according to a study published online June 10th in the Journal of the National Cancer Institute. Smokers who use telephone counseling quitlines may do so in response to active recruitment methods, such as physician referral or direct mail or phone calls, or passive methods, such as posters or television ads. Whether quitlines are equally effective for actively recruited smokers and passively recruited smokers has been a key question. In this study, Flora ...

Venice to suffer fewer storm surges

2011-06-11
Venice – the City of Dreams – may have one less nightmare to deal with following a finding that the frequency of extreme storm surge events generated by Adriatic Sea tempests could fall by about 30 per cent by 2100. A team of international scientists led by CSIRO's Dr Alberto Troccoli studied atmospheric circulation in the Mediterranean region to assess climate impacts through changes in storm surge frequency in Venice – a World Heritage-listed city built on 117 small islands and considered vulnerable to high sea levels (locally known as Acqua Alta). Dr Troccoli said ...

Gender differences in risk pathways for adolescent substance abuse and early adult alcoholism

2011-06-11
Clinically ascertained reports suggest that boys and girls with attention deficit hyperactivity disorder (ADHD) may differ from each other in their vulnerability to substance use problems, say the researchers of the University of Helsinki and University of Jyväskylä, Finland. A total of 1545 Finnish adolescents were assessed for DSM-IV-based ADHD symptoms by their parents and classroom teachers using standardized rating scales at age 11-12 years. At age 14, substance use disorders and psychiatric co-morbidity were assessed with the Semi-Structured Assessment for the ...

International Report Faults U.S. Immigration Detention Centers

2011-06-11
A report issued by the Inter-American Commission on Human Rights (IACHR) examines the use of detention centers for immigration cases. The report criticized the operation of system that is overly penal in nature, resorting to prison-like conditions for administrative detentions. The IACHR was prompted to investigate the detention systems by complaints human rights advocates, according to a New York Times story. Findings of the Report The Inter-American Commission found that: - In many if not the majority of cases, detention is a disproportionate measure and the ...

Earth from space: A gush of volcanic gas

Earth from space: A gush of volcanic gas
2011-06-11
This image shows the huge plume of sulphur dioxide that spewed from Chile's Puyehue-Cordón Caulle Volcanic Complex, which lies in the Andes about 600 km south of Santiago. After lying dormant for more than 50 years, a series of rumbling earthquakes signalled the beginnings of this major volcanic eruption. On 4 June, a fissure opened, sending a towering plume of volcanic ash and gas over 10 km high. Several thousand people were evacuated as a thick layer of ash and pumice fell and blanketed a wide area. Airports in Chile and Argentina were closed as a result. The ...

Side-Impact Car Accidents in California: Crash Stats and Victims' Rights

2011-06-11
Side-impact crashes account for 13 percent of all car accidents and 18 percent of all fatal car accidents, according to a 2009 study conducted by the University of Michigan. These types of crashes, also known as T-bone accidents, can result in serious injuries to drivers and passengers, who may be able to file personal-injury lawsuits following side-impact car accidents in California. Automotive Experts Test Side-Impact Safety While front-impact collisions have been the focus of automotive safety improvements for decades, researchers and auto engineers are turning ...

Voters have up to 5 times more influence in early primaries

2011-06-11
PROVIDENCE, R.I. [Brown University] — Voters in states with early primary races such as Iowa and New Hampshire have up to five times the influence of voters in later states in selecting presidential candidates, according to research by Brown University economist Brian Knight. The paper, the first to quantify the effects of early victories in the race for the presidential nomination, is co-authored by Nathan Schiff and published in The Journal of Political Economy. Knight and Schiff developed a statistical model that examines how daily polling data responds to returns ...

Strength training for grandma and grandpa

2011-06-11
People lose 30% of their muscle strength between the ages of 50 and 70 years. However, maintaining muscle strength in old age is enormously important in order to maintain mobility and to be able to lead an independent life and manage everyday tasks independently. In the current issue of Deutsches Ärzteblatt International, Frank Mayer and colleagues from the University of Potsdam conclude that progressive strength (resistance) training counteracts muscular atrophy in old age (Dtsch Arztebl Int 2011; 108(21): 359-64). The authors investigated the extent of the effects that ...

Supreme Court to Decide if Strip Searches Violated Civil Rights

2011-06-11
The U.S. Supreme Court has heard several cases regarding acceptable behavior by law enforcement, and this term is no exception. One of the cases involves Albert Florence, a New Jersey resident who alleged that his civil rights were violated after being subject to strip searches when being booked into two local jails. Florence was stopped in 2005 while riding in his vehicle with his wife and daughter. The police ran a search for the vehicle's registration, and discovered that it belonged to Florence, who had an outstanding warrant for an unpaid fine from a 2003 non-indictable ...

Chasing EHEC with the computer

Chasing EHEC with the computer
2011-06-11
Just a few genes make enterohaemorrhagic E. coli (EHEC) extremely dangerous to humans. If it were not for these genes, EHEC would hardly differ from harmless enteric bacteria. Bioinformatics scientists from the Saarbrücken Cluster of Excellence want to exploit this similarity to find starting points for effective drugs against the EHEC pathogen. In a very short time, the scientists have constructed EhecRegNet, a database and analysis platform that incorporates all known interactions between enteric E. coli genes. Using integrated simulations, genetic switches for the dangerous ...

LAST 30 PRESS RELEASES:

How your brain decides blame and punishment -- and how it can be changed

Uniquely human brain region enables punishment decisions

Pinpointing punishment

Chapman University publishes research on attractiveness and mating

E-cigarettes: Special issue from Nicotine & Tobacco Research

Placental problems in early pregnancy associated with 5-fold increased risk of OB & fetal disorders

UT study: Invasive brood parasites a threat to native bird species

Criminals acquire guns through social connections

Restoring ocean health

Report: Cancer remains leading cause of death in US Hispanics

Twin study suggests genetic factors contribute to insomnia in adults

To be fragrant or not: Why do some male hairstreak butterflies lack scent organs?

International team discovers natural defense against HIV

Bolivian biodiversity observatory takes its first steps

Choice of college major influences lifetime earnings more than simply getting a degree

Dominant strain of drug-resistant MRSA decreases in hospitals, but persists in community

Synthetic biology needs robust safety mechanisms before real world application

US defense agencies increase investment in federal synthetic biology research

Robots help to map England's only deep-water Marine Conservation Zone

Mayo researchers identify protein -- may predict who will respond to PD-1 immunotherapy for melanoma

How much water do US fracking operations really use?

New approach to mammograms could improve reliability

The influence of citizen science grows despite some resistance

Unlocking secrets of how fossils form

What happens on the molecular level when smog gets into the lungs?

Using ultrasound to clean medical instruments

Platinum and iron oxide working together get the job done

Tiny silica particles could be used to repair damaged teeth, research shows

A quantum lab for everyone

No way? Charity's logo may influence perception of food in package

[Press-News.org] Non-invasive ventilation as a weaning or rescue technique may cut risks in some patients
Press-News.org is a service of DragonFly Company. All Rights Reserved.
Issuers of news releases are solely responsible for the accuracy of their content.