Artificial respiration: Difference between revisions
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==Classification== | ==Classification== | ||
===Using intratracheal intubation=== | ===Using intratracheal intubation=== | ||
* PEEP | |||
===Noninvasive=== | ===Noninvasive=== | ||
The terminology for noninvasive respiratory support is inconsistently used in the medical literature. | The terminology for noninvasive respiratory support is inconsistently used in the medical literature. | ||
* Some authors interchange [[Intermittent positive-pressure breathing|IPPB]] with IPPV. ''B'' indicates the patient is spontaneously breathing while ''V'' indicates [[intratracheal intubation]] | * Some authors interchange [[Intermittent positive-pressure breathing|IPPB]] with IPPV. ''B'' indicates the patient is spontaneously breathing while ''V'' indicates [[intratracheal intubation]] | ||
* Some authors interchange [[Intermittent positive-pressure breathing|IPPB]] and IPPV with | * Some authors interchange [[Intermittent positive-pressure breathing|IPPB]] and IPPV with Bilevel PAP as done in a recent [[randomized controlled trial]].<ref name="pmid18614781">{{cite journal |author=Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J |title=Noninvasive ventilation in acute cardiogenic pulmonary edema |journal=N. Engl. J. Med. |volume=359 |issue=2 |pages=142–51 |year=2008 |month=July |pmid=18614781 |doi=10.1056/NEJMoa0707992 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18614781&promo=ONFLNS19 |issn=}}</ref> | ||
According to the U.S. [[National Library of Medicine]], the terms are: | According to the U.S. [[National Library of Medicine]], the terms are: | ||
*[[Continuous positive airway pressure]] (CPAP). CPAP may help [[respiratory insufficiency]] due to [[heart failure]].<ref name="pmid9792593">{{cite journal |author=Pang D, Keenan SP, Cook DJ, Sibbald WJ |title=The effect of positive pressure airway support on mortality and the need for intubation in cardiogenic pulmonary edema: a systematic review |journal=Chest |volume=114 |issue=4 |pages=1185–92 |year=1998 |month=October |pmid=9792593 |doi= |url=http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=9792593 |issn=}}</ref> | *[[Continuous positive airway pressure]] (CPAP). CPAP may help [[respiratory insufficiency]] due to [[heart failure]].<ref name="pmid9792593">{{cite journal |author=Pang D, Keenan SP, Cook DJ, Sibbald WJ |title=The effect of positive pressure airway support on mortality and the need for intubation in cardiogenic pulmonary edema: a systematic review |journal=Chest |volume=114 |issue=4 |pages=1185–92 |year=1998 |month=October |pmid=9792593 |doi= |url=http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=9792593 |issn=}}</ref> | ||
**Bilevel positive airway pressure (BiPAP) | **Bilevel positive airway pressure (''bilevel PAP'' - not to be confused with ''BiPAP'' which is a specific brand of a bilevel PAP ventilator) | ||
*[[Intermittent positive-pressure breathing]] (IPPB or NIPPB). IPPB may help [[respiratory insufficiency]] due to [[chronic obstructive pulmonary disease]]<ref name="pmid15222912">{{cite journal |author=Hess DR |title=The evidence for noninvasive positive-pressure ventilation in the care of patients in acute respiratory failure: a systematic review of the literature |journal=Respir Care |volume=49 |issue=7 |pages=810–29 |year=2004 |month=July |pmid=15222912 |doi= |url=http://www.rcjournal.com/contents/07.04/07.04.0810.pdf |issn=}}</ref>, especially if the exacerbations are severe<ref name="pmid12779296">{{cite journal |author=Keenan SP, Sinuff T, Cook DJ, Hill NS |title=Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature |journal=Ann. Intern. Med. |volume=138 |issue=11 |pages=861–70 |year=2003 |month=June |pmid=12779296 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=12779296 |issn=}}</ref>. | *[[Intermittent positive-pressure breathing]] (IPPB or NIPPB or called pressure support). IPPB may help [[respiratory insufficiency]] due to [[chronic obstructive pulmonary disease]]<ref name="pmid15222912">{{cite journal |author=Hess DR |title=The evidence for noninvasive positive-pressure ventilation in the care of patients in acute respiratory failure: a systematic review of the literature |journal=Respir Care |volume=49 |issue=7 |pages=810–29 |year=2004 |month=July |pmid=15222912 |doi= |url=http://www.rcjournal.com/contents/07.04/07.04.0810.pdf |issn=}}</ref>, especially if the exacerbations are severe<ref name="pmid12779296">{{cite journal |author=Keenan SP, Sinuff T, Cook DJ, Hill NS |title=Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature |journal=Ann. Intern. Med. |volume=138 |issue=11 |pages=861–70 |year=2003 |month=June |pmid=12779296 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=12779296 |issn=}}</ref>. | ||
==Effectiveness== | |||
===Chronic obstructive pulmonary disease=== | |||
===Health failure=== | |||
In a [[randomized controlled trial]] of [[respiratory insufficiency]] due to [[heart failure]], neither CPAP or BiPAP reduced mortality as compared to standard oxygen therapy; however, both of the noninvasive methods provided similar symptomatic and metabolic improvement.<ref name="pmid18614781">{{cite journal |author=Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J |title=Noninvasive ventilation in acute cardiogenic pulmonary edema |journal=N. Engl. J. Med. |volume=359 |issue=2 |pages=142–51 |year=2008 |month=July |pmid=18614781 |doi=10.1056/NEJMoa0707992 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18614781&promo=ONFLNS19 |issn=}}</ref> In this trial CPAP was started at 5 cm of water and<sup> </sup>increased as needed to 15 cm of water. BiPAP was started<sup> </sup>at an inspiratory positive airway pressure of 8 cm of water<sup> </sup>and an expiratory positive airway pressure of 4 cm of water<sup> </sup>and was increased as needed to an inspiratory pressure of 20 cm<sup> </sup>of water and expiratory pressure of 10 cm of water.<ref name="pmid18614781"/> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 12:29, 14 July 2008
In medicine, artificial respiration is "Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have respiratory insufficiency to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2)."[1]
Classification
Using intratracheal intubation
- PEEP
Noninvasive
The terminology for noninvasive respiratory support is inconsistently used in the medical literature.
- Some authors interchange IPPB with IPPV. B indicates the patient is spontaneously breathing while V indicates intratracheal intubation
- Some authors interchange IPPB and IPPV with Bilevel PAP as done in a recent randomized controlled trial.[2]
According to the U.S. National Library of Medicine, the terms are:
- Continuous positive airway pressure (CPAP). CPAP may help respiratory insufficiency due to heart failure.[3]
- Bilevel positive airway pressure (bilevel PAP - not to be confused with BiPAP which is a specific brand of a bilevel PAP ventilator)
- Intermittent positive-pressure breathing (IPPB or NIPPB or called pressure support). IPPB may help respiratory insufficiency due to chronic obstructive pulmonary disease[4], especially if the exacerbations are severe[5].
Effectiveness
Chronic obstructive pulmonary disease
Health failure
In a randomized controlled trial of respiratory insufficiency due to heart failure, neither CPAP or BiPAP reduced mortality as compared to standard oxygen therapy; however, both of the noninvasive methods provided similar symptomatic and metabolic improvement.[2] In this trial CPAP was started at 5 cm of water and increased as needed to 15 cm of water. BiPAP was started at an inspiratory positive airway pressure of 8 cm of water and an expiratory positive airway pressure of 4 cm of water and was increased as needed to an inspiratory pressure of 20 cm of water and expiratory pressure of 10 cm of water.[2]
References
- ↑ Anonymous (2024), Artificial respiration (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 2.2 Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J (July 2008). "Noninvasive ventilation in acute cardiogenic pulmonary edema". N. Engl. J. Med. 359 (2): 142–51. DOI:10.1056/NEJMoa0707992. PMID 18614781. Research Blogging.
- ↑ Pang D, Keenan SP, Cook DJ, Sibbald WJ (October 1998). "The effect of positive pressure airway support on mortality and the need for intubation in cardiogenic pulmonary edema: a systematic review". Chest 114 (4): 1185–92. PMID 9792593. [e]
- ↑ Hess DR (July 2004). "The evidence for noninvasive positive-pressure ventilation in the care of patients in acute respiratory failure: a systematic review of the literature". Respir Care 49 (7): 810–29. PMID 15222912. [e]
- ↑ Keenan SP, Sinuff T, Cook DJ, Hill NS (June 2003). "Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature". Ann. Intern. Med. 138 (11): 861–70. PMID 12779296. [e]