(Press-News.org) New clinical guidelines for use of noninvasive ventilation in critical care settings are published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj100071.pdf.
The use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure by mask has increased significantly among acutely ill patients. A growing body of literature and variations in practice in recent years have necessitated the development of new clinical practical guidelines to help manage patients with acute respiratory distress or failure.
The guidelines were created by the Canadian Critical Care Trials Group/Canadian Critical Care Society Noninvasive Ventilation Guidelines Group. They address the use of noninvasive ventilation in the postoperative setting, in immunocompromised patients, in patients being weaned from conventional mechanical ventilation and in patients at high risk of respiratory failure after removal of breathing tube.
Noninvasive positive pressure ventilation should be the first choice in patients with chronic obstructive pulmonary disease (COPD) or cardiogenic pulmonary edema. It can be used postoperatively or in people with compromised immune systems.
"Implementation of these guidelines may require clinician education, additional health care personnel, organizational change or additional resources (equipment or beds with cardiopulmonary monitoring) to ensure safe and appropriate application of noninvasive positive-pressure ventilation and continuous positive airway pressure," writes Dr. Sean Keenan, Royal Columbian Hospital, with coauthors.
"Strategies for the implementation of these guidelines should be developed for each relevant clinician group (physicians in different clinical areas and with different levels of training and expertise, respiratory therapists and nurses)," they conclude.
In a related commentary (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj110122.pdf, Dr. Andrew Bersten from Flinders Medical Centre in Adelaide, Australia, writes "many factors appear to influence the effective implementation of noninvasive ventilation. These factors include an experienced team of health care staff able to provide 24-hour service and detailed attention to mask interface and leaks, choice of equipment, ventilator settings, inspired oxygen levels, glottic function and clearance of secretions."
"For these guidelines to change clinical practice, they have to be supported by appropriate education, implementation and review. Helping clinicians know when and when not to use noninvasive ventilation is perhaps the most important role for these guidelines," he concludes.
### END
New clinical practice guidelines for noninvasive ventilation
2011-02-15
ELSE PRESS RELEASES FROM THIS DATE:
Tuberculosis in Nunavut: a century of failure
2011-02-15
A recent outbreak of tuberculosis in Nunavut, with a population infection rate 62 times the Canadian average, points to a need to rebuild trust in public health to combat the disease, states an editorial published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj110160.pdf.
Nunavut is Canada's third territory in the eastern Arctic, created in 1999. Its population is about 30,000 people, and almost 80% are Inuit, spread over an area of more than 2 million square kilometers.
At least 100 new active cases of tuberculosis ...
Abnormal control of hand movements may hint at ADHD severity in children
2011-02-15
ST. PAUL, Minn. – Measurements of hand movement control may help determine the severity of attention deficit hyperactivity disorder (ADHD) in children, according to joint studies published in the February 15, 2011, print issue of Neurology®, the medical journal of the American Academy of Neurology. ADHD is a brain disorder characterized by impulsiveness, hyperactivity, such as not being able to sit still, and inattention or difficulty staying focused.
The studies were led by Stewart H. Mostofsky, MD, with the Kennedy Krieger Institute in Baltimore and Donald L. Gilbert, ...
Not so fast: Differences in the first embryonic cell lineage decision of mammals
2011-02-15
New research shows that all not mammals are created equal. In fact, this work shows that the animals most commonly used by scientists to study mammalian genetics -- mice -- develop unusually quickly and may not always be representative of embryonic development in other mammals. The study, published by Cell Press in the February 14 issue of the journal Developmental Cell, identifies significant differences in the timing of cell fate commitment during mouse and cattle embryonic development and raises important strategic implications for the generation of embryonic stem cells.
The ...
Military/civilian medical experts turning attention to 'army' of injured civilians supporting wars
2011-02-15
After analyzing data on 2,155 private contractors, diplomats and other civilians supporting war efforts in Iraq and Afghanistan who were medically evacuated out of combat zones, researchers have found they are more likely to be evacuated for noncombat-related injuries, but more likely to return to work in-country after treatment for these conditions.
Still, the findings of the Johns Hopkins-led research team, published online in CMAJ, the journal of the Canadian Medical Association, note that 75 percent of the nonmilitary group medically evacuated from the war zones to ...
People at risk of diabetes offer clues toward novel drugs
2011-02-15
BOSTON – February 14, 2011 – Once people develop type 2 diabetes, high blood glucose levels alter their metabolism so much that it becomes difficult to sift through all the clues to find what might enable the disease. "To identify factors that play a primary role in disease susceptibility, we want to investigate people before they get to that point," says Mary-Elizabeth Patti, M.D. of Joslin Diabetes Center. By examining people across the spectrum of diabetes—from healthy to the full-blown disease—scientists in her lab have found a molecular pathway that offers novel targets ...
New anti-clotting drug added to recommendations for treating irregular heartbeat
2011-02-15
The newly approved drug dabigatran is an alternative to warfarin to help prevent dangerous blood clots in patients with atrial fibrillation, according to updated guidelines from the American College of Cardiology, American Heart Association and the Heart Rhythm Society.
The "Focused Update" — published in Circulation: Journal of the American Heart Association, Journal of the American College of Cardiology and HeartRhythm Journal — specifically updates the section on emerging antithrombotic agents in atrial fibrillation treatment guidelines released by the three organizations ...
A hunk of a target for treating breast cancer
2011-02-15
Among women with breast cancer, approximately 25% have a subtype that is characterized by high levels of expression of the protein HER2. HER2-positive breast cancer tends to be more aggressive than other breast cancer subtypes. Increased molecular understanding of why HER2-positive breast cancer is so aggressive could aid in the development of new therapeutics. By studying mouse models, a team of researchers, led by Lewis Chodosh, at the University of Pennsylvania School of Medicine, Philadelphia, has now identified a key role for the protein Hunk in the formation of tumors ...
New combination therapy for solid tumors?
2011-02-15
Most, if not all, solid tumors contain regions that are not well oxygenated. Tumor cells in these regions, which are known as hypoxic regions, are usually resistant to the death-inducing effects of chemotherapeutics. But now, Caroline Dive and colleagues, at Manchester University, United Kingdom, have identified a compound (ABT-737) that induces human cancer cells exposed to hypoxic conditions in vitro to undergo a form of cell death known as apoptosis. In addition, cells in hypoxic regions of human tumors xenografted in mice were susceptible to ABT-737–induced apoptotic ...
JCI online early table of contents: Feb. 14, 2011
2011-02-15
EDITOR'S PICK: A hunk of a target for treating breast cancer
Among women with breast cancer, approximately 25% have a subtype that is characterized by high levels of expression of the protein HER2. HER2-positive breast cancer tends to be more aggressive than other breast cancer subtypes. Increased molecular understanding of why HER2-positive breast cancer is so aggressive could aid in the development of new therapeutics. By studying mouse models, a team of researchers, led by Lewis Chodosh, at the University of Pennsylvania School of Medicine, Philadelphia, has now identified ...
X-rays show why van Gogh paintings lose their shine
2011-02-15
This release is available in French.
VIDEO:
A microsample is taken from the van Gogh painting "Bank of river Seine " on display at the van Gogh Museum in Amsterdam (Netherlands), and then analyzed at the X-rays microscope...
Click here for more information.
Scientists have identified a complex chemical reaction responsible for the degradation of two paintings by Vincent ...