ABSTRACT
BACKGROUND: Noninvasive mechanical ventilation (NIMV) is the delivery of positive pressure ventilation through an interface to upper airways without using the invasive airway. Use of NIMV is becoming common with the increasing recognition of its benefits. OBJECTIVES: This study was done to evaluate the feasibility and outcome of NIMV in tertiary care centres. MATERIALS AND METHODS: An observational, retrospective study conducted over a period of 18 months in two tertiary level hospitals of north India on 184 consecutive patients who were treated by NIMV, regardless of the indication. NIMV was given in accordance with the arterial blood gas (ABG) parameters defining respiratory failure (Type 1/Type 2). RESULTS: The most common indication of NIMV in our hospitals was acute exacerbation of chronic obstructive pulmonary disease (AE-COPD 80.43%), and 90.54% AE-COPD patients were improved by NIMV. Application of NIMV resulted in significant improvement of pH and blood gases in COPD patients, while non-COPD patients showed significant improvement in partial pressure of oxygen (PaO2) alone. The mean duration of NIMV was 8.35 ± 5.98 days, and patients of interstitial lung disease (ILD) were on NIMV for the maximum duration (17 ± 8.48 days). None of the patients of acute respiratory distress syndrome were cured by NIMV; 13.04% patients on NIMV required intubation and mechanical ventilation. CONCLUSION: This study demonstrates and encourages the use of NIMV as the first-line ventilatory treatment in AE-COPD patients with respiratory failure. It also supports NIMV usage in other causes of respiratory failure as a promising step toward prevention of mechanical ventilation.
ABSTRACT
The activity of the methanol oxidation reaction of a multiwalled carbon nanotube (MWCNT)-supported PtRu catalyst was investigated and compared with the Vulcan XC-72 carbon-supported catalyst. The PtRu nanoparticles with 1:1 and 7:3 atomic ratios (with similar PtRu loadings and morphological structures) were deposited both on the MWCNTs and on the carbon. Cyclicvoltammetry results demonstrated that the MWCNT-supported PtRu catalyst exhibited a higher mass activity (mA mg(-1) of PtRu) for the methanol oxidation reaction than the carbon-supported PtRu under the condition that both catalysts possess more or less the same PtRu loadings, particle sizes, dispersions, and electrochemical surface area. The direct methanol fuel cell performance test data showed that MWCNT-supported PtRu catalysts yielded about 35-39% higher power densities than the carbon-supported PtRu.
