Zusammenfassung
Fragestellung
Überprüfung von Effizienz und Verträglichkeit eines neu entwickelten Helmes für die nicht-invasive Beatmung von Patienten mit akutem respiratorischem Versagen.
Patienten und Methoden
Zehn immunsupprimierte Patienten mit akutem respiratorischem Versagen wurden an unserer Intensivstation aufgenommen und in die Studie eingeschlossen. Bei allen Patienten wurde eine nichtinvasive Beatmung mit dem neuen Helm durchgeführt. Arterielle Sauerstoffsättigung und subjektive Verträglichkeit wurden während der ersten 24 Stunden evaluiert.
Ergebnisse
Alle Patienten tolerierten die Beatmung mit dem neuen Helm sehr gut, es kam zu einer deutlichen Verbesserung der arteriellen Blutgaswerte. Zwei Patienten mussten aufgrund eines septischen Schocks endotracheal intubiert werden, 8 Patienten konnten von der nichtinvasiven Beatmung entwöhnt werden.
Zusammenfassung
Die nicht-invasive Beatmung mit Hilfe des neuen Helmes könnte im Vergleich zur endotrachealen Intubation und der nicht-invasiven Beatmung mittels Standard-Maske eine effektive und besser verträgliche Methode sein.
Summary
Objectives
To assess efficacy and tolerability of a newly developed helmet for the delivery of non-invasive ventilation in patients with acute respiratory failure.
Patients and methods
Ten consecutive immunocompromised patients with acute respiratory failure admitted to our intensive care unit were included in the study. The patients were equipped with the helmet and non-invasive ventilation (NIV) was performed. Oxygenation and tolerability were assessed during the first 24 hours of NIV.
Results
All patients tolerated the helmet well and their oxygenation improved. Two patients developed septic shock and had to be endotracheally intubated during the study period, eight patients survived to be weaned from NIV.
Conclusions
NIV delivered via the helmet is effective and may serve as a better tolerated alternative to endotracheal intubation and to NIV via a standard face mask.
Article PDF
References
Estopa R, Torres-Marti A, Kastanos N, Rives A, Augusti-Vidal A, Rozman C (1984) Acute respiratory failure in severe hematologic disorders. Crit Care Med 12: 26–28
Blot F, Guigner M, Nitenberg G, Leclerq B, Gachot B, Escudier B (1997) Prognostic factors for neutropenic patients in an intensive care unit: respective roles of underlying malignancies and acute organ failures. Eur J Cancer 33: 1031–1037
Meduri GU (1996) Noninvasive positive-pressure ventilation in patients with acute respiratory failure. Clin Chest Med 17: 513–553
Antonelli M, Conti G, Rocco M, Bufi M, De Blasi RA, Vivino G, et al (1998) A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 339: 429–435
Antonelli M, Conti G, Bufi M, Costa MG, Lappa A, Rocco M, et al (2000) Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation. JAMA 283: 235–241
Antonelli M, Conti G, (2000) Noninvasive ventilation in intensive care unit patients. Curr Opin Crit Care 6: 11–16
Antonelli M, Conti G, Pelosi P, Gregoretti C, Pennisi MA, Costa R, et al (2002) Now treatment of acute hypoxemic respiratory failure: nononvasive pressure support ventilation delivered by helmet — a pilot controlled trial. Crit Care Med 30: 602–608
Villa F, Cereda M, Colombo E, et al (1999) Evaluation of four noninvasive CPAP systems. Intensive Care Med S 66: A246
Azoulay E, Alberti C, Barnstain C, Leleu G, Mareau D, Recher C, et al (2001) Imroved survival in cancer patients requiring mechanical ventilatory support: impact of noninvasive mechanical ventilatory support. Crit Care Med 29: 519–525
Hilbert G, Gruson D, Vargas F, Valentino R, Gbikpi-Benissan G, Dupon M, et al (2001) Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 344: 481–487
Pingleton S (1998) Complications of acute respiratory failure. Am Rev Respir Dis 137: 463–493
Stauffer JL (1994) Complications of translaryngeal intubation. In: Tobin MJ (ed) Principles and practice of mechanical ventilation. McGraw-Hill, New York, pp 711–747
Rubenfeld GD, Crawford SW (1996) Withdrawing life support from mechanically ventilated recipients of bone marrow transplants: a case for evidence based guidelines. Ann Intern Med 125: 625–633
Gruson D, Hilbert G, Portel L, Boiron JM, Bebear CM, Vargas F, et al (1999) Severe respiratory failure requiring ICU admission in bone marrow transplant recipients. Eur Respir J 13: 883–887
Rabitsch W, Staudinger T, Brugger SA, Reiter E, Keil F, Herold C, et al (1998) Successful management of adult respiratory distress syndrome (ARDS) after high-dose chemotherapy and peripheral blood progenitor cell rescue by non-invasive ventilatory support. Bone Marrow Transplant 21: 1067–1069
Sica S, Sora F, Chiusolo P, Pennisi M, Salutari P, Laurenti L, et al (1999) Non-invasive ventilatory support in the management of respiratory failure after autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 23: 527
Brochard L, Mancebo J, Wysocki J, Lofaso F, Conti G, Rauss A, et al (1995) Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 333: 817–822
Staudinger T, Stoiser B, Müllner M, Locker GJ, Laczika K, Knapp S, et al (2000) Outcome and prognostic factors in critically ill cancer patients admitted to the intensive care unit. Crit Care Med 28: 1322–1328
Vanpee D, Delaunois L, Gillet JB (2001) Non-invasive positive pressure ventilation for exacerbation of chronic obstructive pulmonary patients in the emergency department. Eur J Emerg Med 8: 21–25
Brochard L (2000) Non-invasive ventilation for acute exacerbations of COPD: a new standard care. Thorax 55: 817–818
Keenan SP, Kernerman PD, Cook DJ, Martin CM, McCormack D, Sibbald WJ (1997) The effect of non invasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: A meta-analysis. Crit Care Med 25: 1685–1692
Welte T (2003) Nicht-invasive Beatmung auf der Intensivstation — geht es noch ohne? Wien Klin Wochenchr 115: 89–98
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rabitsch, W., Schellongowski, P., Köstler, W.J. et al. Efficacy and tolerability of non-invasive ventilation delivered via a newly developed helmet in immunosuppressed patients with acute respiratory failure. Wien Klin Wochenschr 115, 590–594 (2003). https://doi.org/10.1007/BF03040454
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03040454