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Severe post‐transplant hypoxemia, which is defined as <50 mm Hg of the partial pressure of oxygen in arterial blood/fraction of inspired oxygen (P/F) ratio, is a major post‐operative complication with high mortality rates in patients with hepatopulmonary syndrome (HPS). Non‐invasive positive pressure ventilation therapy and mechanical ventilation are options for respiratory support of patients with severe post‐transplant hypoxemia. However, these therapies are associated with several problems, such as compliance, ventilator‐associated pneumonia, and lung injury. We here firstly described two children with HPS who developed severe post‐transplant hypoxemia (lowest post‐operative P/F ratio, 49.7 and 34.0 mm Hg, respectively) that was successfully managed with high‐flow nasal cannula (HFNC) oxygen therapy and vasodilation drugs without adverse complications or necessity of reintubation. We consider that HFNC oxygen therapy could become a safe alternative respiratory therapy or be added to the other such as inhaled nitric oxide (iNO), methylene blue (MB), inhaled epoprostenol, embolization of abnormal pulmonary vessels, and combination of iNO and MB for severe post‐transplant hypoxemia in children with HPS. [ABSTRACT FROM AUTHOR]

The article discusses a study which used Plasma Krebs von den Lungen glycoprotein plasma levels to evaluate and detect subclinical noninvasive ventilation (NIV)-associated lung injury. The study concluded that intergroup plasma Krebs von den Lungen glycoprotein plasma levels were not very different and that NIV when used at volumes and invasive ventilatory support was not found to bring about alveolar septal barrier injury commonly observed in invasive mechanical ventilation.

Abstract: We describe survival in Duchenne dystrophy by invasive and noninvasive ventilation vs. untreated. Patients were untreated prior to 1984 (Group 1), underwent tracheotomy from 1984 until 1991 (Group 2), and were managed by noninvasive mechanical ventilation and cardioprotective medications subsequently (Group 3). Symptoms, vital capacity, and blood gases were monitored for all and spirometry, cough peak flows, carbon dioxide tension, and oximetry for Group 3. Sleep nasal ventilation was initiated for symptomatic hypoventilation. An oximeter and mechanical cough assistance were prescribed for maximum assisted cough peak flow <300L/m. Patients used continuous noninvasive ventilation and mechanically assisted coughing as needed to maintain pulse oxyhemoglobin saturation ⩾95%. Survival was compared by Kaplan–Meier analysis. The 56 of Group 1 died at 18.6±2.9, the 21 Group 2 at 28.1±8.3years of age with three still alive, and the 88 using noninvasive ventilation had 50% survival to 39.6years, p <0.001, respectively. We conclude that noninvasive mechanical ventilation and assisted coughing provided by specifically trained physicians and therapists, and cardioprotective medication can result in more favorable outcomes and better survival by comparison with invasive treatment. [ABSTRACT FROM AUTHOR]