Peter Papadakos | University of Rochester (original) (raw)

Papers by Peter Papadakos

Neurocritical Care, Jun 2, 2021

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2012

Türk anestezi ve reanimasyon dergisi, Jun 1, 2018

There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytr... more There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring. In the presence of these criteria, NIMV is worth attempting, but only if endotracheal intubation is promptly available because non-responders to NIMV are burdened by an increased mortality when intubation is delayed.

As more and more individuals from the connected generation brought up interacting with their pers... more As more and more individuals from the connected generation brought up interacting with their personal electronic devices (PEDs) enter medicine, we must bring to their attention the issues of electronic distraction and proper technology interfacing. We must educate them in appropriate human interaction with patients in this wired world. Real patients need to be at the core of health care, not the i-Patients that exist in the electronic medical record. Institutions and professional schools must develop curricula to address the important subject of electronic etiquette. This chapter should be a springboard for the development of such programs.

European journal of anaesthesiology, Apr 1, 2017

Encyclopedia of Trauma Care, 2015

Journal of cardiothoracic and vascular anesthesia, 1995

Critical Care, 2013

Th e standard treatment for acute respiratory failure in critically ill patients has been based o... more Th e standard treatment for acute respiratory failure in critically ill patients has been based on oxygen therapy and invasive mechanical ventilation with endotracheal intubation. In addition, non-invasive mechanical ventilation (NIV) has proved an excellent technique, avoiding the need for intubation and improving outcome in selected patients with acute cardiogenic pulmonary edema, exacerbation of chronic obstructive pulmonary disease (COPD), and acute hypoxemic respiratory failure . Conversely to invasive mechanical ventilation, NIV can also be used outside the intensive care unit . However, NIV can fail because of either the patient's underlying conditions or multiple technical causes. Despite improvements in the oro-nasal mask's characteristics, intolerance to the device represents a frequent cause of failure ; thus, the interface is fundamental in the care of patients. One possible alternative to the face mask could be the helmet, especially for long-term use (Figure ). Although the facial mask is still the most commonly used interface in up to 60% of cases, in some European countries (such as Italy), the helmet is widely employed for patients with acute hypo xemic respiratory failure and acute cardiogenic pulmo nary edema . Th e aim of this clinical review is to summarize the main physiological and clinical studies assessing the effi cacy (arterial oxygenation, intubation rate, outcome and tolerance) of NIV delivered with the helmet. A computerized search of MEDLINE/PubMed (January 2000 to May 2012) and EMBASE (January 2000 to May 2012) for articles in English, Spanish and Italian was conducted, limiting the search to retrospective, prospective, non-randomized and randomized trials. Th e keywords 'noninvasive ventilation' , 'helmet' and 'interface' were combined with any of the terms 'chronic obstructive pulmonary disease' , 'hypoxemic acute respiratory failure' , 'continuous positive airway pressure' , 'bi-level airway pressure' and 'pressure support ventilation' . Th e bio graphies of all selected articles were hand searched for additional relevant articles.

Journal of Trauma-injury Infection and Critical Care, Sep 1, 1991

Journal of Critical Care, Jun 1, 2014

Advances in Respiratory Medicine, 2020

Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxe... more Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed.

Critical Care Neurology Part I, 2017

Neuropulmonology refers to the complex interconnection between the central nervous system and the... more Neuropulmonology refers to the complex interconnection between the central nervous system and the respiratory system. Neurologic injury includes traumatic brain injury, hemorrhage, stroke, and seizures, and in each there are far-reaching effects that can result in pulmonary dysfunction. Systemic changes can induce impairment of pulmonary function due to changes in the core structure and function of the lung. The conditions and disorders that often occur in these patients include aspiration pneumonia, neurogenic pulmonary edema, and acute respiratory distress syndrome, but also several abnormal respiratory patterns and sleep-disordered breathing. Lung infections, pulmonary edema - neurogenic or cardiogenic - and pulmonary embolus all are a serious barrier to recovery and can have significant effects on outcomes such as hospital course, prognosis, and mortality. This review presents the spectrum of pulmonary abnormalities seen in neurocritical care.

Noninvasive Mechanical Ventilation and Difficult Weaning in Critical Care, 2016

The use of noninvasive ventilation (NIV) has gained popularity in a variety of applications, incl... more The use of noninvasive ventilation (NIV) has gained popularity in a variety of applications, including acute respiratory failure, and it has been shown to be beneficial in the reduction of complications and improvement in outcomes [1]. A variety of factors can lead to failure to tolerate NIV, and the use of sedation can be effective in keeping the patient comfortable, yet awake and arousable, so as to prevent distress while providing a suitable level of sedation. A survey of the use of sedation in patients receiving NIV revealed that practices vary widely, likely because of a lack of evidence, and as such its application is underused [2]. There are inconsistencies in how often sedation and analgesia are provided, which agents are used, methods of administration, and determination of patient requirements. This lack of consistency sets up a situation in which the patient is exposed to circumstances that make it more difficult to be successfully weaned from mechanical ventilation.

Pneumonologia polska, 2021

Wentylacja nieinwazyjna odgrywa coraz większą rolę w leczeniu ostrej hipoksemicznej lub hiperkapn... more Wentylacja nieinwazyjna odgrywa coraz większą rolę w leczeniu ostrej hipoksemicznej lub hiperkapnicznej niewydolności oddychania i ma wiele zalet w porównaniu z inwazyjną wentylacją mechaniczną. Do zalet tych zalicza się zachowanie mechanizmów obronnych dróg oddechowych, zmniejszoną potrzebę sedacji i zmniejszenie ryzyka powikłań związanych z intubacją dotchawiczą. Mimo niewątpliwych walorów wentylacji nieinwazyjnej istnieją również pewne przeciwwskazania do stosowania tej metody, jak na przykład ciężka encefalopatia. W niniejszym artykule przeglądowym przeanalizowano podstawy teoretyczne, dowody naukowe i wady stosowania wentylacji nieinwazyjnej u pacjentów z hiperkapnią lub bez hiperkapni, znajdujących się w stanie zaburzonej świadomości

Cardiovascular Surgery

The use of blood products is common in the period after cardiopulmonary bypass. A rare cause of a... more The use of blood products is common in the period after cardiopulmonary bypass. A rare cause of adult respiratory distress syndrome is a reaction to antileukocyte antibodies. The plasma transfused may contain a potent leukocyte antibody that may cause severe problems in the intensive care unit.

Sultan Qaboos University Medical Journal [SQUMJ], 2018

Noninvasive ventilation (NIV) refers to the use of techniques to deliver artificial respiration t... more Noninvasive ventilation (NIV) refers to the use of techniques to deliver artificial respiration to the lungs without the need for endotracheal intubation. As NIV has proven beneficial in comparison to invasive mechanical ventilation, it has become the optimal modality for initial respiratory support among children in respiratory distress. High-flow nasal cannulae (HFNC) therapy is a relatively new NIV modality and is used for similar indications. This review discusses the usefulness and applications of conventional NIV in comparison to HFNC.Keywords: Noninvasive Ventilation; Nasal Cannulae; Endotracheal Intubation; Mechanical Ventilation; Children.

Noninvasive Mechanical Ventilation, 2016

Acute respiratory failure (ARF) is a major complication in patients with hematological malignancy... more Acute respiratory failure (ARF) is a major complication in patients with hematological malignancy, with outcome largely depending on the cause. Noninvasive ventilation (NIV) is useful as a form of prophylactic support in early ARF and, by avoiding intubation, may improve outcome in patients with reversible ARF. This chapter summarizes the current evidence regarding outcome, application, and limitations of NIV in these patients.

Journal of Anesthesia & Clinical Research, 2013

American Journal of Obstetrics and Gynecology, 1991

A rare case of severe adult respiratory distress syndrome associated with a Po2 of 9 mm Hg after ... more A rare case of severe adult respiratory distress syndrome associated with a Po2 of 9 mm Hg after surgical resection of a cornual pregnancy at 10 weeks' gestation was treated successfully with positive end-expiratory pressure. The underlying cause, extensive pulmonary embolism, was subsequently revealed. The patient survived without residual brain damage. The possible causes of adult respiratory distress syndrome in pregnancy are discussed.