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Respiratory Support for Critically Ill Patients

Call for Papers

Intensive care medicine as medical discipline was born with mechanical ventilation and, in the public opinion, ventilation probably represents the form of organ support that firstly comes to mind. After decades from the polio epidemic, the H1N1 2009 pandemic influenza influenced the way we considered respiratory support for severely hypoxic patients until that moment, opening the way to a reappraisal of extracorporeal life support. Technological advantages, indeed, allowed considering extracorporeal life support among the armamentarium of therapies for these patients, highlighting the need for expertise and training for its successful implementation. However, also invasive mechanical ventilation has been associated with risks. Endotracheal intubation of hypoxic patients is a risky procedure and up to 30% of critically ill patients develop a severe intubation-related complication of which severe hypoxemia is the most common. Strategies to optimize preoxygenation have been recently investigated. Jaber et al. proposed a new method consisting of the association of noninvasive ventilation (NIV) with high flow nasal cannula therapy in the attempt to combine the benefits of positive pressure with those of apneic oxygenation. This was a proof of concept study and large randomized studies should shed light on the best method to increase the safety of endotracheal intubation. NIV has been also studied as a method to avoid intubation. This use is well recognized in hypercapnic respiratory failure, whereas its application for de novo hypoxemic respiratory failure is a matter of debate, even in patients traditionally considered to benefit most from invasive ventilation avoidance (i.e., immunodepressed patients). The detrimental effects of mechanical ventilation have been recognized almost from the origin of its widespread adoption. However, a growing body of data highlights the potential of injury also for spontaneously breathing patients, even during noninvasive ventilation if the respiratory demand is high, and the new expression patient “self-inflicted lung injury” has been introduced to describe this potential harm. Respiratory support continues to represent, therefore, a burning topic and a field of interest for both clinicians and researchers. The balance of risks and benefits of a given respiratory support method (noninvasive ventilation versus invasive ventilation versus extracorporeal support) is going to dynamically change in the near future for different patient categories. In this fascinating and stimulating scenario, we call for papers investigating the burning topic of respiratory support from methods used to avoid invasive ventilation to those used to optimize preoxygenation but also extracorporeal support techniques. We believe that these topics may be of interest not only for healthcare workers in the field of intensive care but also to the whole healthcare community, given the high social and economic burden of respiratory failure and the long term consequences in its survivors.

Potential topics include but are not limited to the following:

  • Preoxygenation techniques for critically ill patients requiring intubation
  • Noninvasive ventilation and high-flow nasal oxygen therapy for treatment of acute respiratory failure in the critical care setting
  • Sedation during noninvasive ventilation
  • Perioperative ventilation of the critically ill patients
  • Bench studies on respiratory failure and ARDS pathophysiology
  • Ventilation-induced lung injury and patient self-inflicted lung injury
  • Monitoring during respiratory support (e.g., diaphragm ultrasound and electrical impedance tomography)
  • Extracorporeal life support for patients with either hypoxic or hypercapnic respiratory failure

Authors can submit their manuscripts through the Manuscript Tracking System at https://mts.hindawi.com/submit/journals/bmri/critical.care/resuc/.

Submission DeadlineFriday, 15 June 2018
Publication DateNovember 2018

Papers are published upon acceptance, regardless of the Special Issue publication date.

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