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  1. Article ; Online: Monitoring Systems in Home Ventilation

    Jean-Michel Arnal / Mathilde Oranger / Jésus Gonzalez-Bermejo

    Journal of Clinical Medicine, Vol 12, Iss 2163, p

    2023  Volume 2163

    Abstract: Non-invasive ventilation (NIV) is commonly used at home for patient with nocturnal hypoventilation caused by a chronic respiratory failure. Monitoring NIV is required to optimize the ventilator settings when the lung condition changes over time, and to ... ...

    Abstract Non-invasive ventilation (NIV) is commonly used at home for patient with nocturnal hypoventilation caused by a chronic respiratory failure. Monitoring NIV is required to optimize the ventilator settings when the lung condition changes over time, and to detect common problems such as unintentional leaks, upper airway obstructions, and patient–ventilator asynchronies. This review describes the accuracy and limitations of the data recorded by the ventilator. To efficiently interpret this huge amount of data, clinician assess the daily use and regularity of NIV utilization, the unintentional leaks and their repartition along the NIV session, the apnea–hypopnea index and the flow waveform, and the patient–ventilator synchrony. Nocturnal recordings of gas exchanges are also required to detect nocturnal alveolar hypoventilation. This review describes the indication, validity criteria, and interpretation of nocturnal oximetry and transcutaneous capnography. Polygraphy and polysomnography are indicated in specific cases to characterize upper airway obstruction. Telemonitoring of the ventilator is a useful tool that should be integrated in the monitoring strategy. The technical solution, information, and limitations are discussed. In conclusion, a basic monitoring package is recommended for all patients complemented by advanced monitoring for specific cases.
    Keywords noninvasive ventilation ; chronic respiratory failure ; monitoring ; telemonitoring ; Medicine ; R
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Association between Previous CPAP and Comorbidities at Diagnosis of Obesity-Hypoventilation Syndrome Associated with Obstructive Sleep Apnea

    Moustapha Agossou / Berenice Awanou / Jocelyn Inamo / Marion Dufeal / Jean-Michel Arnal / Moustapha Dramé

    Journal of Clinical Medicine, Vol 12, Iss 2448, p

    A Comparative Retrospective Observational Study

    2023  Volume 2448

    Abstract: Obesity-hypoventilation syndrome (OHS) is associated with many comorbidities. The aim of this study was to evaluate the association between previous continuous positive airway pressure (CPAP) and the prevalence of comorbidities in OHS associated with ... ...

    Abstract Obesity-hypoventilation syndrome (OHS) is associated with many comorbidities. The aim of this study was to evaluate the association between previous continuous positive airway pressure (CPAP) and the prevalence of comorbidities in OHS associated with obstructive sleep apnea (OSA). We performed a retrospective, single-center study at the University Hospital of Martinique, the referral hospital for the island of Martinique. A total of 97 patients with OHS associated with severe OSA on non-invasive ventilation (NIV) were included; 54 patients (56%) had previous treatment of OSA with a positive airway pressure (PAP) device before shifting to NIV (PAP group) and 43 (44%) had no previous treatment of OSA with a PAP device before initiating NIV PAP (no PAP group). Sociodemographic characteristics were similar between groups; there were 40 women (74%) in the PAP group versus 34 (79%) in the no PAP group, mean age at OHS diagnosis was 66 ± 15 versus 67 ± 16 years, respectively, and the mean age at inclusion 72 ± 14 versus 71 ± 15 years, respectively. The average number of comorbidities was 4 ± 1 in the PAP group versus 4 ± 2 in the no PAP group; the mean Charlson index was 5 ± 2 in both groups. The mean BMI was 42 ± 8 kg/m 2 in both groups. The mean follow-up duration was 5.8 ± 4.4 years in the PAP group versus 4.7 ± 3.5 years in the no PAP group. Chronic heart failure was less common in patients who had a previous PAP 30% versus 53% ( p = 0.02). It is also noted that these patients were diagnosed less often in the context of acute respiratory failure in patients with previous PAP: 56% versus 93% ( p < 0.0001). In contrast, asthma patients were more frequent in patients with previous treatment of OSA with a PAP device at the time of OHS diagnosis but not significantly: 37% versus 19% ( p = 0.07). Early treatment of severe OSA with a PAP device prior to diagnosis of OHS seems to be associated with a reduced prevalence of cardiac diseases, notably chronic heart failure, in patients diagnosed with OHS associated with ...
    Keywords obesity-hypoventilation syndrome ; obstructive sleep apnea ; CPAP ; comorbidities ; cardiovascular diseases ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: How to implement NIV in the ICU?

    Jean-Michel Arnal

    Acta Medica Lituanica, Vol 19, Iss

    2012  Volume 3

    Abstract: NIV is widely used in the ICU for different types of respiratory failure. However, there is no recommendation on the method to implement successfully the NIV program in the ICU. The three keys are equipment, caregiver’s education and training, and ... ...

    Abstract NIV is widely used in the ICU for different types of respiratory failure. However, there is no recommendation on the method to implement successfully the NIV program in the ICU. The three keys are equipment, caregiver’s education and training, and organisation. Equipment should be considered purchasing the appropriate ventilators according to the number of patients and the type of patients admitted. Interface selection is very important and should not be neglected. Humidification devices should also be appropriate. Physician, nurses and respiratory therapist have to get education, practical training and a continuous training program. Organisation of NIV in the ICU is improved if there is a local developed protocol with precise indication criteria, initiation method, mask selection, ventilator settings, NIV session duration and monitoring.
    Keywords non-invasive ventilation ; acute respiratory failure ; mechanical ventilation ; Medicine ; R
    Language English
    Publishing date 2012-10-01T00:00:00Z
    Publisher Vilnius University Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Lung recruitment in ARDS patients

    Jean-Michel Arnal / Aude Garnero

    Acta Medica Lituanica, Vol 19, Iss

    2012  Volume 3

    Abstract: Lung recruitment is used to improve oxygenation and decrease the risk of ventilator induced lung injuries. Assessing the potential of recruitability is a pre-requisite for a rational recruitment strategy and setting of PEEP. Using a low flow pressure- ... ...

    Abstract Lung recruitment is used to improve oxygenation and decrease the risk of ventilator induced lung injuries. Assessing the potential of recruitability is a pre-requisite for a rational recruitment strategy and setting of PEEP. Using a low flow pressure-volume loop is helpful to assess the potential of recruitability at the bedside. For patients with a high potential of recruitability, recruitment maneuvers are efficient with an appropriate setting of PEEP to maintain the lung recruited. Recruitment maneuvers use pressures from 40 to 60 cmH2O for a short period of time, either with the sustained inflation or the staircase method. PEEP setting after the maneuver is important; a decreasing PEEP trial is a useful practical method.
    Keywords lung recruitment ; acute respiratory distress syndrome ; mechanical ventilation ; Medicine ; R
    Language English
    Publishing date 2012-10-01T00:00:00Z
    Publisher Vilnius University Press
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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