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  1. Article ; Online: Supporting patients with hypercapnia.

    Tregidgo, Laura / D'Cruz, Rebecca F

    Clinical medicine (London, England)

    2024  Volume 24, Issue 1, Page(s) 100007

    Abstract: Hypercapnia is commonly encountered by general and specialist respiratory clinicians. Patients at risk of developing hypercapnic respiratory failure include those with chronic obstructive pulmonary disease (COPD), obesity and neuromuscular disease. Such ... ...

    Abstract Hypercapnia is commonly encountered by general and specialist respiratory clinicians. Patients at risk of developing hypercapnic respiratory failure include those with chronic obstructive pulmonary disease (COPD), obesity and neuromuscular disease. Such patients may present to clinicians acutely unwell on the acute medical take or during an inpatient deterioration, or be identified in the stable outpatient setting. In this review, we provide a practical guide to develop clinicians' knowledge, skills and confidence in promptly recognising and managing hypercapnic respiratory failure, and to promote national ventilation quality standards to encourage consistent delivery of high-quality care and optimise outcomes for patients.
    MeSH term(s) Humans ; Hypercapnia/therapy ; Inpatients ; Obesity ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
    Language English
    Publishing date 2024-01-18
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.1016/j.clinme.2023.100007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5439: Show issues Location:
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  2. Article ; Online: A history of home mechanical ventilation: The past, present and future.

    D'Cruz, Rebecca F / Hart, Nicholas

    Chronic respiratory disease

    2024  Volume 21, Page(s) 14799731241240776

    Abstract: This state-of-the-art review provides an overview of the history of home mechanical ventilation (HMV), including early descriptions of mechanical ventilation from ancient and Renaissance perspectives and the mass development of ventilators designed for ... ...

    Abstract This state-of-the-art review provides an overview of the history of home mechanical ventilation (HMV), including early descriptions of mechanical ventilation from ancient and Renaissance perspectives and the mass development of ventilators designed for long-term use during the poliomyelitis epidemic. Seminal data from key clinical trials supports the application of HMV in certain patients with chronic obstructive pulmonary disease, neuromuscular disease and obesity-related respiratory failure. Innovative engineering coupled with refined physiological understanding now permits widespread delivery of home mechanical ventilation to a global population, using portable devices with advanced ventilatory modes and telemonitoring capabilities. Exponential growth in digital technology continues, and ongoing research is needed to understand how to harness clinical and physiological data to benefit patients and healthcare services in a clinically- and cost-effective manner.
    MeSH term(s) Humans ; Respiration, Artificial ; Obesity ; Pulmonary Disease, Chronic Obstructive/therapy
    Language English
    Publishing date 2024-03-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2211488-9
    ISSN 1479-9731 ; 1479-9723
    ISSN (online) 1479-9731
    ISSN 1479-9723
    DOI 10.1177/14799731241240776
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6215: Show issues Location:
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  3. Article ; Online: Quality of life in patients with chronic respiratory failure on home mechanical ventilation.

    D'Cruz, Rebecca F / Kaltsakas, Georgios / Suh, Eui-Sik / Hart, Nicholas

    European respiratory review : an official journal of the European Respiratory Society

    2023  Volume 32, Issue 168

    Abstract: Home mechanical ventilation (HMV) is a treatment for chronic respiratory failure that has shown clinical and cost effectiveness in patients with underlying COPD, obesity-related respiratory failure and neuromuscular disease (NMD). By treating chronic ... ...

    Abstract Home mechanical ventilation (HMV) is a treatment for chronic respiratory failure that has shown clinical and cost effectiveness in patients with underlying COPD, obesity-related respiratory failure and neuromuscular disease (NMD). By treating chronic respiratory failure with adequate adherence to HMV, improvement in patient-reported outcomes including health-related quality of life (HRQoL) have been evaluated using general and disease-specific quantitative, semi-qualitative and qualitative methods. However, the treatment response in terms of trajectory of change in HRQoL is not uniform across the restrictive and obstructive disease groups. In this review, the effect of HMV on HRQoL across the domains of symptom perception, physical wellbeing, mental wellbeing, anxiety, depression, self-efficacy and sleep quality in stable and post-acute COPD, rapidly progressive NMD (such as amyotrophic lateral sclerosis), inherited NMD (including Duchenne muscular dystrophy) and obesity-related respiratory failure will be discussed.
    MeSH term(s) Humans ; Respiration, Artificial/adverse effects ; Quality of Life ; Respiratory Insufficiency/diagnosis ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Neuromuscular Diseases/complications ; Neuromuscular Diseases/diagnosis ; Neuromuscular Diseases/therapy ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy ; Home Care Services
    Language English
    Publishing date 2023-05-03
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1077620-5
    ISSN 1600-0617 ; 0905-9180
    ISSN (online) 1600-0617
    ISSN 0905-9180
    DOI 10.1183/16000617.0237-2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3265: Show issues Location:
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  4. Article ; Online: Nutrition therapy during noninvasive ventilation: oral or enteral?

    Viner Smith, Elizabeth / D'Cruz, Rebecca F / Chapple, Lee-Anne

    Current opinion in critical care

    2023  Volume 29, Issue 4, Page(s) 346–353

    Abstract: Purpose of review: Critical care nutrition guidelines primarily focus on patients receiving invasive mechanical ventilation, yet noninvasive ventilation (NIV) is an increasingly common intervention. The optimal route of nutrition delivery in patients ... ...

    Abstract Purpose of review: Critical care nutrition guidelines primarily focus on patients receiving invasive mechanical ventilation, yet noninvasive ventilation (NIV) is an increasingly common intervention. The optimal route of nutrition delivery in patients receiving NIV has not been established. This review aims to describe the implications of NIV on the route of feeding prescribed.
    Recent findings: Five small, mostly observational, studies have quantified energy or protein intake in patients receiving NIV in critical care, which demonstrate intake to be poor. No study has assessed the impact of feeding route on outcomes. The predominant route of feeding observed is oral intake, yet nutrition intake via this route is lower than that from enteral or parenteral nutrition. Barriers to oral intake include fasting for intubation, the inability to remove NIV apparatus to eat, breathlessness, fatigue and poor appetite, while barriers to enteral nutrition include the impact of the naso-enteric tube on the mask seal and potential aspiration.
    Summary: Until evidence to support the optimal route of feeding is developed, patient safety should be the key driver of route selection, followed by the ability to achieve nutrition targets, perhaps utilizing a combination of routes to overcome barriers to nutrition delivery.
    MeSH term(s) Humans ; Respiration, Artificial ; Noninvasive Ventilation ; Nutritional Support ; Enteral Nutrition ; Parenteral Nutrition ; Critical Illness/therapy
    Language English
    Publishing date 2023-06-09
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000001053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4999: Show issues Location:
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  5. Article ; Online: Does impaired respiratory function lead to sudden cardiac death?

    D'Cruz, Rebecca F / Kaltsakas, Georgios

    Thorax

    2022  Volume 77, Issue 7, Page(s) 641–642

    MeSH term(s) Death, Sudden, Cardiac/etiology ; Humans ; Pulmonary Disease, Chronic Obstructive
    Language English
    Publishing date 2022-01-07
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 204353-1
    ISSN 1468-3296 ; 0040-6376
    ISSN (online) 1468-3296
    ISSN 0040-6376
    DOI 10.1136/thoraxjnl-2021-218296
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    Ui III Zs.83: Show issues Location:
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  6. Article: High-flow therapy: physiological effects and clinical applications.

    D'Cruz, Rebecca F / Hart, Nicholas / Kaltsakas, Georgios

    Breathe (Sheffield, England)

    2021  Volume 16, Issue 4, Page(s) 200224

    Abstract: Humidified high-flow therapy (HFT) is a noninvasive respiratory therapy, typically delivered through a nasal cannula interface, which delivers a stable fraction of inspired oxygen (: Educational aims: Provide a practical guide to HFT setup and ... ...

    Abstract Humidified high-flow therapy (HFT) is a noninvasive respiratory therapy, typically delivered through a nasal cannula interface, which delivers a stable fraction of inspired oxygen (
    Educational aims: Provide a practical guide to HFT setup and delivery.Outline the physiological effects of HFT on the respiratory system.Describe clinical applications of HFT in adult respiratory and critical care medicine and evaluate the supporting evidence.Discuss application of HFT in COVID-19 and aerosolisation of respiratory droplets.
    Language English
    Publishing date 2021-02-16
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2562899-9
    ISSN 2073-4735 ; 1810-6838
    ISSN (online) 2073-4735
    ISSN 1810-6838
    DOI 10.1183/20734735.0224-2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Sleep disordered breathing and chronic obstructive pulmonary disease: a narrative review on classification, pathophysiology and clinical outcomes.

    D'Cruz, Rebecca F / Murphy, Patrick B / Kaltsakas, Georgios

    Journal of thoracic disease

    2020  Volume 12, Issue Suppl 2, Page(s) S202–S216

    Abstract: Chronic obstructive pulmonary disease (COPD) causes load-capacity-drive imbalance in both wakefulness and sleep, principally driven by expiratory flow limitation and hyperinflation. Sleep imposes additional burdens to the respiratory muscle pump, driven ... ...

    Abstract Chronic obstructive pulmonary disease (COPD) causes load-capacity-drive imbalance in both wakefulness and sleep, principally driven by expiratory flow limitation and hyperinflation. Sleep imposes additional burdens to the respiratory muscle pump, driven by changes in respiratory muscle tone, neural respiratory drive and consequences of the supine position. COPD patients are therefore at higher risk of decompensation during sleep, which may manifest as altered sleep architecture, isolated nocturnal desaturation, sleep hypoventilation and restless legs. Each form of sleep disordered breathing in COPD is associated with adverse clinical and patient-reported outcomes, including increased risk of exacerbations, hospitalisation, cardiovascular events, reduced survival and poorer quality of life. COPD-obstructive sleep apnoea (OSA) overlap syndrome represents a distinct clinical diagnosis, in which clinical outcomes are significantly worse than in either disease alone, including increased mortality, risk of cardiovascular events, hospitalisation and exacerbation frequency. Sleep disordered breathing is under-recognised by COPD patients and their clinicians, however early diagnosis and management is crucial to reduce the risk of adverse clinical outcomes. In this narrative review, we describe the pathophysiology of COPD and physiological changes that occur during sleep, manifestations and diagnosis of sleep disordered breathing in COPD and associated clinical outcomes.
    Language English
    Publishing date 2020-11-19
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd-cus-2020-006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Response.

    Shah, Neeraj M / Apps, Chloe / Kaltsakas, Georgios / Madden-Scott, Sophie / Suh, Eui-Sik / D'Cruz, Rebecca F / Arbane, Gill / Patout, Maxime / Lhuillier, Elodie / Hart, Nicholas / Murphy, Patrick B

    Chest

    2024  Volume 165, Issue 4, Page(s) e130–e131

    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Letter
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2023.12.027
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  9. Article: Novel modes of non-invasive ventilation in chronic respiratory failure: a narrative review.

    Shah, Neeraj Mukesh / D'Cruz, Rebecca F / Murphy, Patrick B

    Journal of thoracic disease

    2020  Volume 12, Issue Suppl 2, Page(s) S217–S224

    Abstract: Home non-invasive ventilation (NIV) is central in the management of chronic hypercapnic respiratory failure and is associated with improvements in clinically relevant outcomes. Home NIV typically involves delivery of fixed positive inspiratory and ... ...

    Abstract Home non-invasive ventilation (NIV) is central in the management of chronic hypercapnic respiratory failure and is associated with improvements in clinically relevant outcomes. Home NIV typically involves delivery of fixed positive inspiratory and expiratory airway pressures. These pressures do not reflect physiological changes to respiratory mechanics and airway calibre during sleep, which may impact on physiological efficacy, subsequent clinical outcomes, and therapy adherence. Novel ventilator modes have been designed in an attempt to address these issues. Volume-assured pressure support modes aim to automatically adjust inspiratory pressure to achieve a pre-set target tidal volume. The addition of auto-titrating expiratory pressure to maintain upper airway calibre is designed for patients at risk of upper airway collapse, such as obese patients and those with obstructive sleep apnoea complicating their hypercapnic failure. Heterogeneity in setup protocols, patient selection and trial design limit firm conclusions to be drawn on the clinical efficacy of these modes. However, there are data to suggest that compared to fixed-pressure NIV, volume-assured modes may improve nocturnal carbon dioxide, sleep quality and ventilator adherence in select patients. The use of the forced oscillation technique to identify expiratory flow limitation and adjust expiratory pressure to eliminate it is the most recent addition to these advanced modes and is yet to be assessed in formal clinical trials.
    Language English
    Publishing date 2020-11-19
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd-cus-2020-013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Provision of holistic care after severe COVID-19 pneumonia - Authors' reply.

    D'Cruz, Rebecca F / Perrin, Felicity / Jolley, Caroline J / Waller, Michael D

    The Lancet. Respiratory medicine

    2021  Volume 9, Issue 3, Page(s) e25

    MeSH term(s) COVID-19 ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2021-02-05
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(21)00014-X
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