Internal medicine journal
-
Internal medicine journal · Nov 2020
Preventive use of non-invasive ventilation is associated with reduced risk of extubation failure in patients on mechanical ventilation for more than 7 days: a propensity-matched cohort study.
Extubation failure (EF) is high in patients on mechanical ventilation for more than 7 days. However, strategies to prevent EF in this population are lacking. ⋯ In patients on mechanical ventilation for more than 7 days, preventive use of NIV is associated with a reduction in EF.
-
Internal medicine journal · Nov 2020
Midland non-invasive ventilation score: a tool to predict non-invasive ventilation failure in people with acute hypercapnic respiratory failure.
Use of non-invasive ventilation (NIV) in patients with hypercapnic respiratory failure has clear benefits over invasive ventilation. Existing risk prediction models are complex and difficult to apply in the acute setting. ⋯ Individuals with Midland NIV score of ≤11 (average 13% NIV failure) may be suitable for general ward care, compared to intensive care for those with Midland NIV score ≥12 (average 66% NIV failure rate). Prospective external validation is required.
-
Internal medicine journal · Nov 2020
An audit of ventilation and perfusion SPECT reporting for the diagnosis of pulmonary embolism in a tertiary cardiothoracic centre.
The aim of the study was to identify reporting patterns of ventilation and perfusion single-photon emission computed tomography (V/Q SPECT) scans done in our department over 3 months in 2016. Factors impacting on reporting and patient groups that would most benefit from the addition of low-dose computed tomography (CT) to V/Q SPECT were analysed. Among 178 patients, 173 (97.2%) had a definitive (positive/negative) report and 2.8% had an equivocal report. As the majority of the equivocal reports were seen in patients aged ≥70 years, we believe that addition of low-dose CT with V/Q SPECT to this patient group will reduce the non-diagnostic rate.