Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure
Introduction. Acute respiratory failure (ARF) remains one of the most relevant problems of modern medicine and intensive care, and respiratory support (RS) remains the indispensable method of temporary external respiratory function replacement. Despite of widespread use of non-invasive ventilation (...
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| Format: | Article |
| Language: | Russian |
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New Terra Publishing House
2024-10-01
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| Series: | Вестник анестезиологии и реаниматологии |
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| Online Access: | https://www.vair-journal.com/jour/article/view/1058 |
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| author | A. G. Koryakin A. V. Vlasenko E. P. Rodionov V. I. Makovey V. V. Erofeev S. A. Osipov E. A. Evdokimov |
| author_facet | A. G. Koryakin A. V. Vlasenko E. P. Rodionov V. I. Makovey V. V. Erofeev S. A. Osipov E. A. Evdokimov |
| author_sort | A. G. Koryakin |
| collection | DOAJ |
| description | Introduction. Acute respiratory failure (ARF) remains one of the most relevant problems of modern medicine and intensive care, and respiratory support (RS) remains the indispensable method of temporary external respiratory function replacement. Despite of widespread use of non-invasive ventilation (NIV) in clinical practice, at present systematic scientific data about possibilities for optimizing the use of these methods of RS in patients with hypoxemic ARF development is absent. It can be assumed that the combination of mask NIV and high-flow oxygen therapy (HFOT) at the stage of ARF development can improve results of treatment in this group of patients.The objective was to improve the results of treatment in patients with hypoxemic ARF through the combined use of mask NIV and HFOT.Materials and methods. The prospective cohort study included 77 patients aged 46.8 ± 11.8 years. Patients were randomized into three groups: in group A, RS was performed by using NIV and traditional low-flow oxygen therapy, in group B – by using HFOT, in group C – by sequential combination of NIV sessions and HFOT. The groups compared gas exchange rates, RS duration, intubation rate and nosocomial pneumonia (NP) incidence, length of treatment in the intensive care unit (ICU) and hospitalizations, overall mortality, and prognostic factors for tracheal intubation were also studied.Results. The combination of mask NIV and HFOT was found to be more clinically effective compared to their separate use. Combination of mask NIV and HFOT had the best effect on gas exchange rates in the long term period, reduced RS duration, intubation rate and pneumonia incidence, ICU treatment duration. Risk factors for tracheal intubation were revealed: RS duration more than 4.5 days, intra-abdominal pressure (IAP) more than 18 cm of water.Conclusions. The combination of mask NIV and HFOT increases the therapeutic potential of each of these RS methods and improves the results of treatment in patients with hypoxemic ARF development. |
| format | Article |
| id | doaj-art-8f6aa7ee119044ffa1e668b66d727a01 |
| institution | Matheson Library |
| issn | 2078-5658 2541-8653 |
| language | Russian |
| publishDate | 2024-10-01 |
| publisher | New Terra Publishing House |
| record_format | Article |
| series | Вестник анестезиологии и реаниматологии |
| spelling | doaj-art-8f6aa7ee119044ffa1e668b66d727a012025-08-04T10:20:49ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532024-10-01215284110.24884/2078-5658-2024-21-5-28-41708Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failureA. G. Koryakin0A. V. Vlasenko1E. P. Rodionov2V. I. Makovey3V. V. Erofeev4S. A. Osipov5E. A. Evdokimov6S. P. Botkin Moscow Multidisciplinary Scientific and Clinical CenterS. P. Botkin Moscow Multidisciplinary Scientific and Clinical Center; Russian Medical Academy for Continuing Professional EducationS. P. Botkin Moscow Multidisciplinary Scientific and Clinical Center; Russian Medical Academy for Continuing Professional EducationRussian Medical Academy for Continuing Professional EducationRussian Medical Academy for Continuing Professional EducationS. P. Botkin Moscow Multidisciplinary Scientific and Clinical Center; Russian Medical Academy for Continuing Professional EducationRussian Medical Academy for Continuing Professional EducationIntroduction. Acute respiratory failure (ARF) remains one of the most relevant problems of modern medicine and intensive care, and respiratory support (RS) remains the indispensable method of temporary external respiratory function replacement. Despite of widespread use of non-invasive ventilation (NIV) in clinical practice, at present systematic scientific data about possibilities for optimizing the use of these methods of RS in patients with hypoxemic ARF development is absent. It can be assumed that the combination of mask NIV and high-flow oxygen therapy (HFOT) at the stage of ARF development can improve results of treatment in this group of patients.The objective was to improve the results of treatment in patients with hypoxemic ARF through the combined use of mask NIV and HFOT.Materials and methods. The prospective cohort study included 77 patients aged 46.8 ± 11.8 years. Patients were randomized into three groups: in group A, RS was performed by using NIV and traditional low-flow oxygen therapy, in group B – by using HFOT, in group C – by sequential combination of NIV sessions and HFOT. The groups compared gas exchange rates, RS duration, intubation rate and nosocomial pneumonia (NP) incidence, length of treatment in the intensive care unit (ICU) and hospitalizations, overall mortality, and prognostic factors for tracheal intubation were also studied.Results. The combination of mask NIV and HFOT was found to be more clinically effective compared to their separate use. Combination of mask NIV and HFOT had the best effect on gas exchange rates in the long term period, reduced RS duration, intubation rate and pneumonia incidence, ICU treatment duration. Risk factors for tracheal intubation were revealed: RS duration more than 4.5 days, intra-abdominal pressure (IAP) more than 18 cm of water.Conclusions. The combination of mask NIV and HFOT increases the therapeutic potential of each of these RS methods and improves the results of treatment in patients with hypoxemic ARF development.https://www.vair-journal.com/jour/article/view/1058hypoxemic acute respiratory failurenoninvasive ventilationhigh-flow oxygen therapy |
| spellingShingle | A. G. Koryakin A. V. Vlasenko E. P. Rodionov V. I. Makovey V. V. Erofeev S. A. Osipov E. A. Evdokimov Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure Вестник анестезиологии и реаниматологии hypoxemic acute respiratory failure noninvasive ventilation high-flow oxygen therapy |
| title | Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure |
| title_full | Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure |
| title_fullStr | Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure |
| title_full_unstemmed | Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure |
| title_short | Options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure |
| title_sort | options for optimizing noninvasive respiratory support in the development of hypoxemic acute respiratory failure |
| topic | hypoxemic acute respiratory failure noninvasive ventilation high-flow oxygen therapy |
| url | https://www.vair-journal.com/jour/article/view/1058 |
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