Trans-thoracic echo evaluation before and during noninvasive ventilation

L Vetrugno,M Rojatti,M Costa,G Della Rocca,N Langiano,C Centonze

doi:10.1186/cc10695

Abstract

Over the last decade noninvasive ventilation (NIV) gained the dignity of first-line intervention for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in the ICU. Its great interest is based on a lower complications rate compared with traditional invasive ventilation. However, the NIV application, although less invasive, cannot ignore its hemodynamic effect over the patient. This study evaluates the NIV effects on the left ventricle in terms of systolic and diastolic function through trans-thoracic echocardiography (TTE). We also try to obtain a preload value index equivalent of flow time corrected (FTc).

Highlights

Sepsis is primarily a disease of the aged and 60% of sepsis occurs in patients older than 65 years, 80% of deaths due to sepsis occur in this age group
The purpose of the study is to elucidate the immunological changes that occur in Klotho mice after sepsis in order to identify therapeutic targets for sepsis that occurs in aged individuals
Poor survival in Klotho-septic mice may be associated with impaired bacterial clearance with decreased recruitment of neutrophils/macrophages in peritoneal cavity, elevated cytokines in serum, and increased apoptosis in thymus and spleen, following to impaired innate and adaptive immunity

Summary

Introduction

Sepsis is primarily a disease of the aged and 60% of sepsis occurs in patients older than 65 years, 80% of deaths due to sepsis occur in this age group. The aim of this study was to determine the reasons behind out-of-hours discharges in our hospital and the effect this has on mortality This audit reviewed the discharge process of patients from an adult general ICU to the general wards before and after the introduction of a liaison nurse post over a 3-year, 3-month time period. The aim of this study was to establish and compare the quality and value of the summaries as judged by ICU doctors and GPs. The relationship between provider volume and patient outcome has been demonstrated for many medical and surgical services, including critical care. Methods In this single-centre observational study we aimed to quantify functional dependency at three different time points: discharge from ICU (DI), discharge from hospital (DH) and discharge from nursing home rehabilitation unit (DR) To this end we retrospectively assed Barthel scores (BS) for individual patients [1], with a duration of mechanical ventilation >48 hours.

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