Passive Versus Active Circuit During Invasive Mechanical Ventilation in Subjects With Amyotrophic Lateral Sclerosis.
BACKGROUND: Until recently, it has been considered essential to maintain the use of a doublelimb circuit in patients with amyotrophic lateral sclerosis (ALS) to avoid rebreathing expired air during invasive mechanical ventilation. Currently, life-sustaining home ventilators can work with a single, l...
| Publicado en: | Respiratory Care Vol. 63; no. 9; pp. 1132 - 1139 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=131514641&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 131514641 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Sep2018 vid: 63 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 131514641 131514641 131514641 10.4187/respcare.05866 131514641 ppf: 1132 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Passive Versus Active Circuit During Invasive Mechanical Ventilation in Subjects With Amyotrophic Lateral Sclerosis. aug: au: De Mattia, Elisa Falcier, Elisa Lizio, Andrea Lunetta, Christian Sansone, Valeria A. Barbarito, Nicola Garabelli, Barbara Iatomasi, Marino Roma, Elisabetta Rao, Fabrizio Carlucci, Annalisa affil: NEuroMuscular Omnicentre, Fondazione Serena Onlus, Milan, Italy sug: subj: Amyotrophic Lateral Sclerosis Therapy Respiration, Artificial Methods Retrospective Design Blood Gas Analysis Oxygen Saturation Amyotrophic Lateral Sclerosis Mortality Hospitalization Respiration, Artificial Adverse Effects Academic Medical Centers Italy Italy Outpatients Descriptive Statistics Data Analysis Software T-Tests Chi Square Test Wilcoxon Rank Sum Test Kruskal-Wallis Test Fisher's Exact Test P-Value Cox Proportional Hazards Model Post Hoc Analysis Human Female Male Adult Middle Age Aged Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female Male ab: BACKGROUND: Until recently, it has been considered essential to maintain the use of a doublelimb circuit in patients with amyotrophic lateral sclerosis (ALS) to avoid rebreathing expired air during invasive mechanical ventilation. Currently, life-sustaining home ventilators can work with a single, lighter circuit that is easier to manage. Our aim was to evaluate the effectiveness and safety of a single-limb circuit with intentional leaks (passive circuit) in comparison with a circuit with an expiratory valve (active circuit), in subjects with ALS who use invasive home ventilation. METHODS: We conducted a retrospective single-center study. The enrolled subjects were divided into 2 groups according to the type of exhalation port. The aim of the study was to compare arterial blood gases; nocturnal oxygen saturation recordings; and the occurrence of adverse events, both clinical and technical events. In addition, we compared the rate of mortality and unplanned hospital admissions that occurred within a year after discharge from the hospital. RESULTS: Forty-three subjects were included in our study: 23 who used a passive circuit and 20 who used an active circuit. No significant difference in nocturnal and diurnal gas exchanges was detected. The incidence of adverse events was significantly higher in the active circuit group (85% in active circuit vs 30% in passive circuit, P < .001). However, by splitting the adverse events into 2 categories, clinical and technical, the technical events were significantly more frequent in the active circuit group. None of these events led to hospital admission or death. CONCLUSIONS: The passive circuit was shown to be as effective and safe as the active circuit during home invasive ventilation in the subjects with amyotrophic lateral sclerosis. A future randomized controlled study is necessary to confirm these results and to extend indications to other pathologies. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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