Articles: postoperative.
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Non-invasive positive pressure ventilation or non-invasive ventilation (NIV) has emerged as a simpler and safer alternative to invasive mechanical ventilation in patients developing acute postoperative respiratory failure. The benefits of NIV as compared to intubation and mechanical ventilation include lower complications, shorter duration of hospital stay, reduced morbidity, lesser cost of treatment and even reduced mortality rates. However, its use may not be uniformly applicable in all patient groups. ⋯ The author searched PubMed and Ovid MEDLINE, without date restrictions. Search terms included Non-invasive ventilation, postoperative and respiratory failure. Foreign literature was included, though only articles with English translation were used.
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Pediatr Crit Care Me · Jul 2011
CommentA critical appraisal of Vlasselaers D, Milants I, Desmet L, et al: intensive insulin therapy for patients in paediatric intensive care: a prospective, randomised controlled study. Lancet 2009; 373:547-556.
To review findings and discuss implications of strict glycemic control in children. ⋯ This was a well-designed single-center trial that serves as proof of concept. The effects of intensive insulin therapy on mortality require further investigation, and its practice may need refinement to reduce the risk of hypoglycemia. In the meantime, targeting age-adjusted fasting glucose ranges cannot be routinely recommended in critically ill children.
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In the immediate postoperative period, obese patients are more likely to exhibit hypoxaemia due to atelectasis and impaired respiratory mechanics, changes which can be attenuated by non-invasive ventilation (NIV). The aim of the study was to evaluate the duration of any effects of early initiation of short term pressure support NIV vs. traditional oxygen delivery via venturi mask in obese patients during their stay in the PACU. ⋯ Early initiation of short term NIV during in the PACU promotes more rapid recovery of postoperative lung function and oxygenation in the obese. The effect lasted 24 hours after discontinuation of NIV. Patient selection is necessary in order to establish clinically relevant improvements. TRIAL REGISTRATION#: DRKS00000751; http://www.germanctr.de.