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Context: In patients with hypoxemic acute respiratory failure (ARF), randomized studies have shown noninvasive positive pressure ventilation (NPPV) to be associated with lower rates of endotracheal intubation. In these patients, predictors of NPPV failure are not well characterized. Objective: To investigate variables predictive of NPPV failure in patients(More)
OBJECTIVE In randomized studies of heterogeneous patients with hypoxemic acute respiratory failure, noninvasive positive pressure ventilation (NPPV) was associated with a significant reduction in endotracheal intubation. The role of NPPV in patients with acute respiratory distress syndrome (ARDS) is still unclear. The objective was to investigate the(More)
OBJECTIVE To assess the efficacy of noninvasive pressure support ventilation (NPSV) using a new special helmet as first-line intervention to treat patients with hypoxemic acute respiratory failure (ARF), in comparison to NPSV using standard facial mask. DESIGN AND SETTING Prospective clinical pilot investigation with matched control group in three(More)
Abstract Objective. We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met(More)
The helmet is a new interface with the potential of increasing the success rate of non-invasive ventilation by improving tolerance. To perform a physiological comparison between the helmet and the conventional facial mask in delivering non-invasive ventilation in hypercapnic patients with chronic obstructive pulmonary disease. Prospective, controlled,(More)
OBJECTIVE To compare the outcomes and the short- and long-term complications of percutaneous translaryngeal tracheostomy (TLT) and surgical tracheostomy (ST). DESIGN Prospective, randomized clinical trial with 1-yr double-blind follow-up. SETTING A general intensive care unit of a university hospital. PATIENTS A total of 139 consecutive critically ill(More)
Positive end-expiratory pressure (PEEP) is one of the most frequently discussed topics in critical care medicine. However, alveolar pressure can remain positive throughout expiration without PEEP set by the ventilator whenever the time available to breathe out is shorter than the time required to decompress the lungs to the elastic equilibrium volume of the(More)
BACKGROUND Noninvasive positive pressure ventilation (NPPV) with a facemask (FM) is effective in patients with acute exacerbation of their chronic obstructive pulmonary disease. Whether it is feasible to treat these patients with NPPV delivered by a helmet is not known. METHODS Over a 4-month period, the authors studied 33 chronic obstructive pulmonary(More)
This bench and human study compared large and small helmets with face mask (FM) for delivery of noninvasive positive pressure ventilation. A lung simulator was employed, and the human study involved six healthy subjects. We evaluated a continuous high-flow (CPAPHF), low flow (CPAPLF), ventilator (CPAPVENT) CPAP, and pressure support ventilation (PSV 10 and(More)
The activity of ethyl alcohol and acetaldehyde on mitotic chromosome segregation and conidial germination in Aspergillus nidulans was studied. Ethanol effectively induced malsegregation in a narrow range of concentrations (4.5-5.5%, v/v) and was inactive at doses which arrested conidial germination (above 6%). The same bell-shaped dose-response curve was(More)