An Evaluation of Intermittent Positive Pressure Breathing in the Prevention of Postoperative Pulmonary Complications

1969 ◽  
Vol 98 (6) ◽  
pp. 795 ◽  
Author(s):  
William D. Baxter
Keyword(s):  
Pulmonary Complications ◽  
Positive Pressure ◽  
Postoperative Pulmonary Complications ◽  
Intermittent Positive Pressure Breathing

scholarly journals Mechanical ventilation is controlled by volume or pressure during neurosurgery. Is there an advantage?

2021 ◽  
Vol 17 (8) ◽  
pp. 51-54
Author(s):  
R.O. Merza ◽  
Ya.M. Pidhirnyi
Keyword(s):  
Mechanical Ventilation ◽  
Pulmonary Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Pulmonary Complications ◽  
Volume Control ◽  
Positive Pressure ◽  
Postoperative Pulmonary Complications ◽  
Oxygen Fraction ◽  
Number Of Patients ◽  
Neurosurgical Patients

Background. One of the main technologies of modern anesthesiology is mechanical ventilation (MV). At present, the protective technology of MV is widely recognized. The feasibi-lity of using this technology in the operating room, especially in patients with intact lungs, is not so obvious. Most of the scientific sources that cover this problem relate to patients with abdominal pathology, and less coverage remains in patients with neurosurgical pathology. However, patients who are operated on for neurosurgical pathology belong to the group of patients of high surgical risk, which forced us to conduct this study. The study was aimed to examine the feasibility of using protective MV during surgery in neurosurgical patients. Materials and methods. We examined 46 patients who were hospitalized in KNP 8 MKL in Lviv for spinal pathology and who underwent surgery for vertebroplasty with spondylodesis. Patients were divided into two groups: in the first group (34 patients), MV was performed by S-IPPV technology — synchronized intermittent positive pressure ventilation with volume control; and in the second group (12 patients), MV was performed by PCV technology — controlled ventilation pressure. Results. We retrospectively determined the incidence of post-operative pulmonary complications (POPC) in patients of the first and second groups. Of the 34 patients of the first group, the signs of POPC were detected in 17 patients (50 %), and of 12 patients of the second group, POPC were detected in 4 patients (33.3 %). It should be noted that MV in patients of both groups did not differ in such parameters as respiratory rate, end-alveolar pressure, and the fraction of oxygen in the respiratory mixture. Conclusions. A relatively small number of patients clearly do not allow the conclusions to be drawn, but it should be noted that MV (especially volume-controlled) contributes to postoperative pulmonary complications in patients with intact lungs in the preoperative period. And pressure-controlled MV tends to reduce the incidence of postoperative pulmonary complications in the postoperative period. Given that respiration rate, end-alveolar expiratory pressure and oxygen fraction in the respiratory mixture were comparable in patients of both groups, it can be assumed that the factor influencing the incidence of POPC is the mechanics of pulmonary ventilation.

The Effects of Mechanical Insufflation-Exsufflation on Lung Function and Complications in Cardiac Surgery Patients

2020 ◽  
Author(s):  
Meng-Fang Wu ◽  
Tsai-Yu Wang ◽  
Da-Shen Chen ◽  
Shou-Fong Shiao ◽  
Han-Chuang Hu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Chest Pain ◽  
Lung Function ◽  
Clinical Outcomes ◽  
Tertiary Hospital ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Positive Pressure ◽  
Lung Expansion ◽  
Intermittent Positive Pressure Breathing

Abstract Background: Postoperative positive pressure lung expansion is associated with decreased pulmonary complications and improved clinical outcomes. The aim of the present study was to compare the differences in post-operative pulmonary complications and clinical outcomes between two groups of study subjects who underwent cardiac surgery; one included subjects who received mechanical insufflation-exsufflation (MI-E) and the other included subjects who received intermittent positive pressure breathing (IPPB) therapy.Methods: This retrospective study included 48 subjects, who underwent cardiac surgery in an intensive care unit of a tertiary hospital during the time period from June 2017 to February 2018. After liberation from mechanical ventilation, the subjects received lung expansion therapy by means of two type of positive pressure devices, MI-E (n=20) or IPPB (n=28). The pulmonary complications, lung function, and clinical outcomes were compared between the two groups.Results: Subjects in both groups displayed similar baseline characteristics and underwent similar types of surgical procedures. Compared to subjects who received non-oscillatory therapy, those who received MI-E therapy had higher post-operative force vital capacity (58.9±4.96 % vs. 45.21±3.60 %, p=0.026), forced expiratory volume in one second (63.35±5.4 % vs. 45.48±3.63 %, p=0.007), and peak flow rate (68.5±5.53 % vs. 54.75±4.11 %, p=0.047). However, the incidence of chest pain was higher in the MI-E group (n=13, 65%) than in the IPPB group (n=4, 14.3%; odds ratio, 11.14, 95% confidence interval, 2.74-45.26; p=0.001). The length of hospital and ICU stay, development of atelectasis, pneumonia, and pleural effusion were similar in both the groups.Conclusion: Both IPPB and MI-E therapies have similar effects on preventing post-operative complications in cardiac surgery patients. However, compared to IPPB therapy, MI-E therapy was associated with improved pulmonary function and higher incidence of chest pain.

scholarly journals The Effects of Mechanical Insufflation-Exsufflation on Lung Function and Complications in Cardiac Surgery Patients: A Pilot Study

2020 ◽  
Author(s):  
Meng-Fang Wu ◽  
Tsai-Yu Wang ◽  
Da-Shen Chen ◽  
Hsiu-Fong Hsiao ◽  
Han-Chuang Hu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Chest Pain ◽  
Lung Function ◽  
Clinical Outcomes ◽  
Tertiary Hospital ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Positive Pressure ◽  
Lung Expansion ◽  
Intermittent Positive Pressure Breathing

Abstract Background: Postoperative positive pressure lung expansion is associated with decreased pulmonary complications and improved clinical outcomes. The aim of the present study was to compare the differences in post-operative pulmonary complications and clinical outcomes between two groups of study subjects who underwent cardiac surgery; one included subjects who received mechanical insufflation-exsufflation (MI-E) and the other included subjects who received intermittent positive pressure breathing (IPPB) therapy. Methods: This retrospective study included 51 subjects, who underwent cardiac surgery in an intensive care unit of a tertiary hospital during the time period from June 2017 to February 2018. After liberation from mechanical ventilation, the subjects received lung expansion therapy by means of two types of positive pressure devices, MI-E (n=21) or IPPB (n=30). The pulmonary complications, lung function, and clinical outcomes were compared between the two groups. Results: Subjects in both groups displayed similar baseline characteristics and underwent similar types of surgical procedures. Compared to subjects who received non-oscillatory therapy, those who received MI-E therapy had higher post-operative force vital capacity (58.4±4.74 % vs. 46.0±3.70 %, p=0.042), forced expiratory volume in one second (62.4±5.23 % vs. 46.8±3.83 %, p=0.017), and peak flow rate (67.1±5.53 L vs. 55.7±4.44 L p=0.111). However, the incidence of chest pain was higher in the MI-E group (n=13, 61.9%) than in the IPPB group (n=4, 16.7%; odds ratio, 0.123, 95% confidence interval, 0.03-0.45; p=0.002). The length of hospital and ICU stay, development of atelectasis, pneumonia, and pleural effusion were similar in both the groups. Conclusion : Both IPPB and MI-E therapies have similar effects on preventing post-operative complications in cardiac surgery patients. However, compared to IPPB therapy, MI-E therapy was associated with better-preserved pulmonary function and higher incidence of chest pain.

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