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Producer: Aspose.Pdf for .NET 10.1.0 PDF Creator http://www.pdf-tools.com; modified using iTextSharp™ 5.4.0 ©2000-2012 1T3XT BVBA (AGPL-version) CreationDate: Wed Mar 20 15:52:28 2019 CET ModDate: Mon Apr 8 11:25:37 2019 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 600.04 x 800.05 pts Page rot: 0 File size: 1178718 bytes Optimized: no PDF version: 1.4 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MinionPro-Regular2 CID Type 0C Identity-H yes no yes 25 0 REDAQV+MinionPro-It Type 1C Custom yes yes yes 26 0 MVZHOH+MinionStd-Black Type 1C Custom yes yes yes 27 0 RJXUXE+MinionPro-Regular22 Type 1C Custom yes yes yes 28 0 ZPNSSP+MinionPro-Regular CID TrueType Identity-H yes yes yes 1 0 AKMKVK+MinionMath-Regular Type 1C Custom yes yes yes 94 0 OECUHN+minionMathItalic Type 1C Builtin yes yes yes 165 0 HWNBDW+Minion-RegularSC Type 1C Custom yes yes yes 166 0 MinionPro-Regular22 Type 1C Custom yes no yes 178 0 IPMOKM+MinionPro-Regular3 Type 1C WinAnsi yes yes no 215 0 IPMOKN+MinionPro-It2 Type 1C WinAnsi yes yes no 216 0 NFTPBI+MinionMathSymbols Type 1C Builtin yes yes yes 254 0 YVNQKE+MinionPro-Bold Type 1C Custom yes yes yes 255 0 IPNIBO+MinionPro-Regular4 Type 1C Custom yes yes yes 272 0 IPMOKN+MinionPro-It2 Type 1C WinAnsi yes yes no 273 0 IPNIBO+MinionPro-Regular4 Type 1C Custom yes yes yes 279 0 IPMOKN+MinionPro-It2 Type 1C WinAnsi yes yes no 280 0 IPNIBO+MinionPro-Regular4 Type 1C Custom yes yes yes 287 0 IPMOKN+MinionPro-It2 Type 1C WinAnsi yes yes no 288 0 IPNIBO+MinionPro-Regular4 Type 1C Custom yes yes yes 292 0 IPMOKN+MinionPro-It2 Type 1C WinAnsi yes yes no 293 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2021-02-07 02:18:45 CET RepresentationInformation: 223568.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2020-11-11 17:28:51 CET Size: 1178718 Format: PDF Version: 1.4 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: ISO PDF/A-1, Level B PDFMetadata: Objects: 439 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Language: en Info: Creator: Aspose Ltd. Producer: Aspose.Pdf for .NET 10.1.0 PDF Creator http://www.pdf-tools.com; modified using iTextSharp™ 5.4.0 ©2000-2012 1T3XT BVBA (AGPL-version) CreationDate: Wed Mar 20 15:52:28 CET 2019 ModDate: Mon Apr 08 11:25:37 CEST 2019 ID: 0x29b1f7ce85a64fa99c9aba011632d0d0, 0x0b14309785126894a134caa9ab82f84e Filters: FilterPipeline: FlateDecode Fonts: Type0: Font: BaseFont: ZPNSSP+MinionPro-Regular Encoding: Identity-H ToUnicode: true Font: BaseFont: MinionPro-Regular2 Encoding: Identity-H ToUnicode: true Type1: Font: BaseFont: OECUHN+minionMathItalic FontSubset: true FirstChar: 1 LastChar: 132 FontDescriptor: FontName: OECUHN+minionMathItalic Flags: Symbolic FontBBox: -50, -180, 1000, 720 FontFile3: true ToUnicode: true Font: BaseFont: HWNBDW+Minion-RegularSC FontSubset: true FirstChar: 1 LastChar: 14 FontDescriptor: FontName: HWNBDW+Minion-RegularSC Flags: Nonsymbolic, SmallCap FontBBox: -141, -250, 1104, 812 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: REDAQV+MinionPro-It FontSubset: true FirstChar: 1 LastChar: 63 FontDescriptor: FontName: REDAQV+MinionPro-It Flags: Nonsymbolic, Italic FontBBox: -201, -360, 1684, 919 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: MVZHOH+MinionStd-Black FontSubset: true FirstChar: 1 LastChar: 51 FontDescriptor: FontName: MVZHOH+MinionStd-Black Flags: Nonsymbolic, ForceBold FontBBox: -173, -250, 1120, 827 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: RJXUXE+MinionPro-Regular22 FontSubset: true FirstChar: 1 LastChar: 96 FontDescriptor: FontName: RJXUXE+MinionPro-Regular22 Flags: Nonsymbolic FontBBox: -289, -360, 1684, 917 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: AKMKVK+MinionMath-Regular FontSubset: true FirstChar: 1 LastChar: 8 FontDescriptor: FontName: AKMKVK+MinionMath-Regular Flags: Nonsymbolic FontBBox: -1196, -2876, 2350, 3473 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: NFTPBI+MinionMathSymbols FontSubset: true FirstChar: 1 LastChar: 153 FontDescriptor: FontName: NFTPBI+MinionMathSymbols Flags: Symbolic FontBBox: -50, -180, 1000, 720 FontFile3: true ToUnicode: true Font: BaseFont: YVNQKE+MinionPro-Bold FontSubset: true FirstChar: 1 LastChar: 7 FontDescriptor: FontName: YVNQKE+MinionPro-Bold Flags: Nonsymbolic, ForceBold FontBBox: -318, -360, 1684, 917 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true CIDFontType0: Font: BaseFont: MinionPro-Regular2 CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: MinionPro-Regular2 Flags: Nonsymbolic FontBBox: -290, -360, 1684, 989 FontFile3: true CIDFontType2: Font: BaseFont: ZPNSSP+MinionPro-Regular CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: ZPNSSP+MinionPro-Regular Flags: Nonsymbolic FontBBox: -289, -360, 1684, 917 FontFile2: true XMP: application/pdfNoninvasive Ventilation Weaning in Acute Hypercapnic Respiratory Failure due to COPD Exacerbation: A Real-Life Observational StudyFaverio, PaolaStainer, AnnaDe Giacomi, FedericaMessinesi, GraziaPaolini, ValentinaMonzani, AnnaSioli, PaoloMemaj, IrdiSibila, OriolMazzola, PaoloPesci, AlbertoThe most recent British Thoracic Society/Intensive Care Society (BTS/ICS) guidelines on the use of noninvasive ventilation (NIV) in acute hypercapnic respiratory failure (AHRF) suggest to maximize NIV use in the first 24 hours and to perform a slow tapering. However, a limited number of studies evaluated the phase of NIV weaning. The aim of this study is to describe the NIV weaning protocol used in AHRF due to acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), patients’ characteristics, clinical course, and outcomes in a real-life intermediate respiratory care unit (IRCU) setting. We performed a retrospective study on adult patients hospitalized at the IRCU of San Gerardo Hospital, Monza, Italy, from January 2015 to April 2017 with a diagnosis of AHRF due to COPD exacerbation. The NIV weaning protocol used in our institution consists of the interruption of one of the three daily NIV sessions at the time, starting from the morning session and finishing with the night session. The 51 patients who started weaning were divided into three groups: 20 (39%) patients (median age 80 yrs, 65% males) who completed the protocol and were discharged home without NIV (Completed Group), 20 (39%) did not complete it because they were adapted to domiciliary ventilation (Chronic NIV Group), and 11 (22%) interrupted weaning ex abrupto mainly due to NIV intolerance (Failed Group). Completed Group patients were older, had a higher burden of comorbidities, but a lower severity of COPD compared to Chronic NIV Group. Failed Group patients experienced higher frequency of delirium after NIV discontinuation. None of the patients who completed weaning had AHRF relapse during hospitalization. While other NIV weaning methods have been previously described, our study is the first to describe a protocol that implies the interruption of a ventilation session at the time. The application of a weaning protocol may prevent AHRF relapse in the early stages of NIV interruption and in elderly frail patients.Canadian Respiratory JournalHindawi2019/03/25Research articledoi:10.1155/2019/3478968en Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 288, 416, 380, 425 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 183, 66, 187, 76 Flags: Print AppearanceDictionary: true Destination: 23 Annotation: Subtype: Link Rect: 192, 66, 197, 76 Flags: Print AppearanceDictionary: true Destination: 23 Annotation: Subtype: Link Rect: 458, 99, 463, 109 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 468, 99, 473, 109 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 428, 76, 433, 86 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 158, 537, 168, 547 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 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