scholarly journals Transpulmonary pressure evaluation in an obese patient under mechanical ventilation

Critical Care ◽  
2008 ◽  
Vol 12 (Suppl 2) ◽  
pp. P320
Author(s):  
S Delisle ◽  
M Francoeur ◽  
M Albert
Keyword(s):  
Mechanical Ventilation ◽  
Obese Patient ◽  
Transpulmonary Pressure

Protective mechanical ventilation in the obese patient

2020 ◽  
Vol 58 (3) ◽  
pp. 53-57
Author(s):  
Luiz F.d.R. Falcão ◽  
Paolo Pelosi ◽  
Marcelo Gama de Abreu
Keyword(s):  
Mechanical Ventilation ◽  
Obese Patient ◽  
Protective Mechanical Ventilation

Ventilator trauma in the critically ill

2016 ◽  
Author(s):  
Marcelo Amato ◽  
Andreas Wolfgang Reske
Keyword(s):  
Mechanical Ventilation ◽  
Inflammatory Responses ◽  
Transpulmonary Pressure ◽  
Stress And Strain ◽  
Air Leak ◽  
Mechanically Ventilated ◽  
Ventilator Induced Lung Injury ◽  
Acute Form ◽  
Air Leak Syndrome ◽  
Definition Of

Ventilator trauma refers to complications of mechanical ventilation, which have an impact on morbidity and mortality. Two major forms of ventilator trauma may be distinguished—an acute form related to rupture of airspaces causing air-leak syndrome and a subacute form causing protracted inflammatory responses. A key feature of mechanically-ventilated lungs is the presence of non-aerated and unstable regions due to atelectasis, oedema, or consolidation. Because of mechanical interdependence, pressures acting in non-uniformly expanded lungs at the boundaries between non-aerated and aerated lung may be a multiple of the apparent transpulmonary pressure. The resulting effects have been reported to precipitate or contribute to ventilator-induced lung injury (VILI). The engineering terms stress and strain were recently proposed for better definition of risk-constellations for VILI. Because the aerated lung volume is positively correlated to compliance, driving-pressure can aid in identifying disproportionate combinations of tidal volumes and compliance.

Is Continuous Transpulmonary Pressure Better Than Conventional Respiratory Management of Hyaline Membrane Disease? A Controlled Study

PEDIATRICS ◽  
1976 ◽  
Vol 58 (6) ◽  
pp. 800-808
Author(s):  
David A. Belenky ◽  
Rosemary J. Orr ◽  
David E. Woodrum ◽  
W. Alan Hodson
Keyword(s):  
Mechanical Ventilation ◽  
Transpulmonary Pressure ◽  
Hyaline Membrane Disease ◽  
Controlled Study ◽  
Complication Rates ◽  
Control Groups ◽  
Respiratory Management ◽  
Significant Difference ◽  
Hyaline Membrane ◽  
And Control

The influence of continuous positive airway pressure (CPAP) and positive end-expiratory pressure (PEEP) on mortality and complication rates in severe hyaline membrane disease (HMD) was evaluated in a randomized, prospective study. Patients were admitted to the study if the PO2 was ≤ 50 mm Hg with FiO2 ≥ 0.6. Twenty-four patients in each of three weight groups were equally divided between treatment and control groups. The treatment regimen included CPAP (6 to 14 cm H2O) for spontaneously breathing patients and PEEP for patients requiring mechanical ventilation for apnea or hypercapnia (PCO2 ≥ 65 mm Hg). Control patients received oxygen and were mechanically ventilated if they had apnea, hypercapnia, or PO2 ≤ 50 mm Hg with FiO2 ≥ 0.8. Oxygenation improved after the start of CPAP or PEEP; however, PCO2 rose after CPAP was initiated. There was no significant difference between treatment and control groups in mortality, requirement for mechanical ventilation, or incidence of pulmonary sequelae. The incidence of pulmonary air-leak was increased with PEEP. The findings suggest that CPAP and PEEP have not significantly altered the outcome of HMD.

scholarly journals FEATURES OF CARDIOPULMONARY RESUSCITATION IN PATIENTS WITH MORBID OBESITY

2021 ◽  
pp. 19-23
Author(s):  
V. YEVSIEIEVA ◽  
Y. LISUN ◽  
Y ZUB
Keyword(s):  
Morbid Obesity ◽  
Mechanical Ventilation ◽  
Cardiopulmonary Resuscitation ◽  
Obese Patient ◽  
Healthcare Professionals ◽  
Cardiovascular Drugs ◽  
Special Consideration ◽  
Physiological Changes ◽  
Critical Components ◽  
Keyword Searches

Resume. Resuscitation of the obese patient presents a challenge for even the most skilled physician. Changes in anatomy, metabolic, cardiopulmonary reserve, ventilation, circulation, and pharmacokinetics require special consideration. This article focuses on critical components in the resuscitation of the obese patient, namely circulatory resuscitation, defibrillation, approach to the obese airway and mechanical ventilation, pharmacotherapy of cardiovascular drugs. Materials and methods: Electronic databases of Scopus and PubMed were searched using keyword searches Conclusions. Obesity causes important anatomical and physiological changes that affect resuscitation measures. Healthcare professionals should take into account the specifics of cardiopulmonary resuscitation in patients with morbid obesity to increase the effectiveness of resuscitation in this group of patients

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