Medicina (B Aires)
August 2025
Acute respiratory distress syndrome (ARDS) presents a challenge for clinicians due to its high morbidity and mortality. Prone position (PP) has been used as a therapeutic strategy in ARDS patients, demonstrating benefits in respiratory mechanics and gas exchange. In SARSCoV-2-related ARDS (C-ARDS), 80% of patients require PP to alleviate refractory hypoxemia.
View Article and Find Full Text PDFFront Med (Lausanne)
June 2025
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently present with acute hypercapnic respiratory failure (AHRF). While non-invasive ventilation (NIV) remains the fist-line therapy, high-flow nasal cannula (HFNC) offers a potential alternative.
Methods: This retrospective cohort study compared the clinical effectiveness and safety of HFNC versus NIV as initial respiratory support in 100 consecutive patients with AECOPD and AHRF (PaCO2 > 45 mmHg, pH 7.
Lung ultrasound (LUS) has emerged as a valuable bedside decision-making tool, particularly since the COVID-19 pandemic, with applications in diagnosing pneumonia, managing fluid, and monitoring interstitial lung diseases (ILDs) and acute respiratory distress syndrome (ARDS), ultimately improving patient outcomes. Its repeatability, environmental safety, and reduced radiation exposure make it ideal for vulnerable populations and resource-limited settings. However, challenges such as inadequate documentation and a lack of standardized reporting formats limit its widespread adoption.
View Article and Find Full Text PDFHealthcare (Basel)
March 2025
The diaphragm is the primary muscle involved in the ventilatory pump, making it a vital component in mechanical ventilation. Various factors in patients who require mechanical ventilation can lead to the deterioration of the diaphragm, which is associated with increased mortality. This deterioration can arise from either excessive or insufficient support due to improper adjustment of ventilation programming variables.
View Article and Find Full Text PDFBackground: Asthma is a common chronic respiratory disease affecting 1-29% of the population in different countries. Exacerbations represent a change in symptoms and lung function from the patient's usual condition that requires emergency department (ED) admission. Recently, the use of a High-Flow Nasal Cannula (HFNC) plus an in-line vibrating mesh nebulizer (VMN) for aerosol drug delivery has been advocated in clinical practice.
View Article and Find Full Text PDFBackground: Lung ultrasound has demonstrated its usefulness in several respiratory diseases management. One derived score, the Lung Ultrasound (LUS) score, is considered a good outcome predictor in patients with Acute Respiratory Failure (ARF). Nevertheless, it has not been tested in patients undergoing non-invasive respiratory support (NIRS).
View Article and Find Full Text PDFBackground: Bronchodilator delivery via a high-flow nasal cannula (HFNC) has generated interest in recent years. The efficacy of in-line vibrating mesh nebulizers with an HFNC during COPD exacerbation is limited. The aim of this study was to evaluate the clinical response of subjects with COPD exacerbation who require bronchodilator therapy (anticholinergic and β-agonist) by using a vibrating mesh nebulizer in line with an HFNC.
View Article and Find Full Text PDFBackground: The roles of high-flow nasal cannula (HFNC) and CPAP in coronavirus disease 2019 (COVID-19) are controversial. The objective of the study was to evaluate the impact of the application of a noninvasive respiratory support algorithm on clinical outcomes in subjects with COVID-19 and with acute respiratory failure.
Methods: We performed a single-center prospective observational study of subjects with respiratory failure from COVID-19 managed with HFNC and with CPAP plus HFNC (combined therapy).
Unlabelled: High flow nasal cannula (HFNC) is used to treat acute hypoxemic respiratory failure (AHRF) even outside the ICU and the ROX index (pulse oximetry/fraction of inspired oxygen/respiratory rate) may predict HFNC failure.
Objective: The purpose of this investigation was therefore to verify whether the ROX index is an accurate predictor of HFNC failure for COVID-19 patients treated outside the intensive care unit (ICU) and to evaluate the validity of the previously suggested threshold.
Design: Multicenter study.