| Noninvasive positive pressure ventilation to prevent respiratory collapse after extubation: clinical case reports. | |
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MedLine Citation:
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PMID: 19917412 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Respiratory complications often develop in liver transplant recipients, and appropriate respiratory management is crucial to improve patient outcome. To evaluate the clinical usefulness of noninvasive positive pressure ventilation (NPPV) in liver transplant recipients, we established application criteria for NPPV in respiratory management in these patients, as follows: (1) arterial oxygen tension to fraction of inspired oxygen ratio less than 300 and arterial carbon dioxide tension greater than 45 mm Hg; (2) arterial oxygen tension to fraction of inspired oxygen ratio less than 200; (3) respiratory rate greater than 25/min; and (4) presence of severe atelectasis or pulmonary edema. A bilevel positive airway pressure ventilator was used with the pressure level adjusted to minimize patient discomfort. In patients who were not able to tolerate NPPV, it was discontinued. However, it was continued until patients no longer had dyspnea without NPPV or to resolution of the initial indication for NPPV such as hypoxemia, hypercapnia, or atelectasis. Of 36 patients who underwent liver transplantation between 2005 and 2007, NPPV was administered in 6 according to our criteria. After extubation, recipients demonstrated hypoxemia, hypercapnia, tachypnea, severe atelectasis, or pulmonary edema. After treatment, these conditions improved without apparent problems related to treatment with NPPV. In 1 patient, reintubation was required because of deterioration of respiratory function due to systemic infection. In conclusion, NPPV was useful in liver transplant recipients after extubation to prevent respiratory deterioration. For successful NPPV, settings must be individualized for each patient. |
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Authors:
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S Nagai; Y Fujimoto; H Kamei; T Nakamura; T Kiuchi |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 41 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 3919-22 Citation Subset: IM |
Affiliation:
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Department of Transplant Surgery, Nagoya University Hospital, Nagoya City, Aichi, Japan. snagai@med.nagoya-u.ac.jp |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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