COMPARTMENTAL VOLUME CHANGES AND CHEST WALL MECHANICS AFTER EPIDURAL FENTANYL

1986 ◽  
Vol 65 (Supplement 3A) ◽  
pp. A498 ◽  
Author(s):  
B. Mankikian ◽  
J. F. Brichant ◽  
B. Riou ◽  
M. A. Delima ◽  
R. Sartene ◽  
...  
Critical Care ◽  
10.1186/cc841 ◽  
2000 ◽  
Vol 4 (Suppl 1) ◽  
pp. P121
Author(s):  
A Aliverti ◽  
R Dellacà ◽  
A Lo Mauro ◽  
E Carlesso ◽  
W Del Frate ◽  
...  

1995 ◽  
Vol 81 (4) ◽  
pp. 744-750 ◽  
Author(s):  
Brenda G. Fahy ◽  
George M. Barnas ◽  
John L. Flowers ◽  
Sheryl E. Nagle ◽  
Mary J. Njoku

CHEST Journal ◽  
1996 ◽  
Vol 110 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Arthur F. Gelb ◽  
Robert J. McKenna ◽  
Matthew Brenner ◽  
Richard Fischel ◽  
Ahmet Baydur ◽  
...  

1992 ◽  
Vol 73 (2) ◽  
pp. 427-433 ◽  
Author(s):  
Z. Hantos ◽  
A. Adamicza ◽  
E. Govaerts ◽  
B. Daroczy

In nine anesthetized and paralyzed cats, the mechanical impedances of the total respiratory system (Zrs) and the lungs (ZL) were measured with small-volume pseudorandom forced oscillations between 0.2 and 20 Hz. ZL was measured after thoracotomy, and chest wall impedance (Zw) was calculated as Zw = Zrs-ZL. All impedances were determined by using input airflow [input impedance (Zi)] and output flow measured with a body box [transfer impedance (Zt)]. The differences between Zi and Zt were small for Zrs and negligible for ZL. At 0.2 Hz, the real and imaginary parts of ZL amounted to 33 +/- 4 and 35 +/- 3% (SD), respectively, of Zrs. Up to 8 Hz, all impedances were consistent with a model containing a frequency-independent resistance and inertance and a constant-phase tissue part (G-jH)/omega alpha, where G and H are coefficients for damping and elastance, respectively, omega is angular frequency, and alpha determines the frequency dependence of the real and imaginary parts. G/H was higher for Zw than for ZL (0.29 +/- 0.05 vs. 0.22 +/- 0.04, P less than 0.01). In four cats, the amplitude dependence of impedances was studied: between oscillation volumes of 0.8 and 3 ml, GL, HL, Gw, and Hw decreased on average by 3, 9, 26, and 29%, respectively, whereas the change in G/H was small for both ZL (7%) and Zw (-4%). The values of H were two to three times higher than the quasistatic elastances estimated with greater volume changes (greater than 20 ml).


2019 ◽  
Vol 80 (12) ◽  
pp. 711-715
Author(s):  
Jonathan B Simon ◽  
Alex J Wickham

Trauma affecting the chest wall, even in isolation, can carry a significant morbidity and mortality and thus appropriate management is vital. Consequences of chest wall trauma may include significant pain, altered chest wall mechanics, hypoventilation, infection and respiratory failure. In order to best determine the appropriate management, risk stratification tools have been developed to identify patients at highest risk of complications who would most benefit from more invasive management strategies. Early optimization of analgesia is vital both for patient experience and to reduce the risk of pulmonary complications. The analgesic options range from multimodal oral analgesia to invasive regional anaesthetic techniques such as thoracic epidurals, paravertebral catheters, intercostal nerve blocks and fascial plane blocks. Other important considerations include provision of appropriate oxygen therapy, ventilation support and physiotherapy. For a selected group of patients with the most significant injuries, surgical rib fixation may be appropriate if chest wall mechanics are sufficiently impaired.


2008 ◽  
Vol 4 (4) ◽  
pp. 240-249 ◽  
Author(s):  
Andrea Aliverti

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