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Related Concept Videos

Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

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The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
113
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

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Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
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Respiratory Assessment: Purpose and Indications01:19

Respiratory Assessment: Purpose and Indications

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Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
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Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

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Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
147
Administering Oxygen by Mask01:30

Administering Oxygen by Mask

186
Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
186
Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

297
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
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Lessons Learned From Awake ECMO Approach in Covid-19-Related Acute Respiratory Distress Syndrome - a Scoping Review.

Peter Sklienka1,2,3, Filip Burša1,2,3, Michal Frelich1,2

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Therapeutics and Clinical Risk Management
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Summary

Full-awake venovenous extracorporeal membrane oxygenation (V-V ECMO) offers a safe alternative for COVID-19 patients with acute respiratory distress syndrome, showing lower mortality than traditional V-V ECMO.

Keywords:
COVID-19-related acute respiratory distress syndromeawake venovenous extracorporeal membrane oxygenationbarotraumableedingrefusal of intubation

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Area of Science:

  • Critical Care Medicine
  • Respiratory Medicine
  • Cardiovascular Engineering

Background:

  • The COVID-19 pandemic spurred interest in awake venovenous extracorporeal membrane oxygenation (V-V ECMO) for non-intubated patients.
  • This approach is utilized in specific COVID-19-related acute respiratory distress syndrome (CARDS) conditions.

Purpose of the Study:

  • To conduct a scoping review of awake V-V ECMO in CARDS patients.
  • To describe its application, outcomes, and safety profile.

Main Methods:

  • Searched PubMed, Web of Science, and Scopus for studies on "awake ECMO" or "spontaneous breathing AND ECMO" combined with COVID-19 terms.
  • Included 14 articles (7 cohort studies, 7 case reports) with 95 CARDS patients published between November 2019 and December 2024.

Main Results:

  • Awake V-V ECMO was preferred over mechanical ventilation due to barotrauma or patient refusal of intubation.
  • Success rate (no intubation, hospital discharge) was 36.4% in cohort studies.
  • Low incidence of severe adverse events; mortality was 33.0% in cohort studies, lower than the ELSO registry (48%).

Conclusions:

  • Awake V-V ECMO is a safe strategy for CARDS patients, associated with reduced mortality compared to conventional V-V ECMO.
  • Intubation during awake V-V ECMO correlated with significantly higher mortality.
  • Heterogeneity in reporting necessitates standardized definitions for future research.