Pulmonary, Chest Wall, and Lung-Thorax Elastances in Acute Respiratory Failure

CHEST Journal ◽  
1982 ◽  
Vol 82 (2) ◽  
pp. 202
Author(s):  
Jeffrey A. Katz ◽  
H. Barrie Fairley ◽  
Gerard M. Ozanne ◽  
Steven E. Zinn
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Chest Wall

scholarly journals Salvage Treatment of Acute Respiratory Failure after Transcomposite Myocutaneous Flaps Transplantation for Chronic Empyema Combined with Chest wall sinus: A Case Report

2021 ◽  
Author(s):  
Lei Wang ◽  
Zhongliang He
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Chest Wall ◽  
Clinical Symptoms ◽  
Medical Center ◽  
Vastus Lateralis ◽  
Bronchopleural Fistula ◽  
Left Lung ◽  
Muscle Flap ◽  
Chronic Empyema

Abstract BackgroundChronic empyema with chest wall sinus is a complex and refractory disease caused by multiple factors.It may be combined with bronchopleural fistula, residual bone and other necrotic tissue,causing local infection difficult to control, and the disease is a vicious circle.Case presentationThis paper reports a 62-year-old male patient who underwent right pneumonectomy for squamous cell carcinoma of the lung 11 years ago and began to develop empyema with purulent sinus in the anterior chest wall 3 years ago. Therefore, he was admitted to our medical center for further treatment. Chest computed tomography (CT) showed the right pleural effusion with the chest wall rupture sinus. According to his clinical symptoms and imaging examination, he was diagnosed as chronic empyema with chest wall sinus.Due to the large empyema cavity,the patient should be treated with free vastus lateralis musculocutaneous flap combined with pedicled pectoralis major muscle flap transplantation.After the operation, acute respiratory failure occurred due to left lung aspiration pneumonia.ConclusionsAfter a series of treatment measures such as tracheal intubation, tracheotomy, anti-infection, maintenance of circulatory stability, and rehabilitation training, he was finally rescued and cured.Follow-up after discharge showed that the tissue flap survived and empyema was eliminated.

Pulmonary, Chest Wall, and Lung-Thorax Elastances in Acute Respiratory Failure

CHEST Journal ◽  
1981 ◽  
Vol 80 (3) ◽  
pp. 304-311 ◽  
Author(s):  
Jeffrey A. Katz ◽  
Steven E. Zinn ◽  
Gerard M. Ozanne ◽  
H. Barrie Fairley
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Chest Wall

scholarly journals Goal-Directed Mechanical Ventilation: Are We Aiming at the Right Goals? A Proposal for an Alternative Approach Aiming at Optimal Lung Compliance, Guided by Esophageal Pressure in Acute Respiratory Failure

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Arie Soroksky ◽  
Antonio Esquinas
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Chest Wall ◽  
Respiratory System ◽  
Transpulmonary Pressure ◽  
Esophageal Pressure ◽  
Plateau Pressure ◽  
Lung Compliance ◽  
Inspiratory Pressure

Patients with acute respiratory failure and decreased respiratory system compliance due to ARDS frequently present a formidable challenge. These patients are often subjected to high inspiratory pressure, and in severe cases in order to improve oxygenation and preserve life, we may need to resort to unconventional measures. The currently accepted ARDSNet guidelines are characterized by a generalized approach in which an algorithm for PEEP application and limited plateau pressure are applied to all mechanically ventilated patients. These guidelines do not make any distinction between patients, who may have different chest wall mechanics with diverse pathologies and different mechanical properties of their respiratory system. The ability of assessing pleural pressure by measuring esophageal pressure allows us to partition the respiratory system into its main components of lungs and chest wall. Thus, identifying the dominant factor affecting respiratory system may better direct and optimize mechanical ventilation. Instead of limiting inspiratory pressure by plateau pressure, PEEP and inspiratory pressure adjustment would be individualized specifically for each patient's lung compliance as indicated by transpulmonary pressure. The main goal of this approach is to specifically target transpulmonary pressure instead of plateau pressure, and therefore achieve the best lung compliance with the least transpulmonary pressure possible.

scholarly journals Salvage Treatment of Acute Respiratory Failure after Transcomposite Myocutaneous Flaps Transplantation for Chronic Empyema Combined with Chest Wall Sinus: A Case Report

2021 ◽  
Author(s):  
Lei Wang ◽  
Zhongliang He
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Chest Wall ◽  
Clinical Symptoms ◽  
Medical Center ◽  
Vastus Lateralis ◽  
Bronchopleural Fistula ◽  
Left Lung ◽  
Muscle Flap ◽  
Chronic Empyema

Abstract BackgroundChronic empyema with chest wall sinus is a complex and refractory disease caused by multiple factors.It may be combined with bronchopleural fistula, residual bone and other necrotic tissue,causing local infection difficult to control, and the disease is a vicious circle.Case presentationThis paper reports a 62-year-old male patient who underwent right pneumonectomy for squamous cell carcinoma of the lung 11 years ago and began to develop empyema with purulent sinus in the anterior chest wall 3 years ago. Therefore, he was admitted to our medical center for further treatment. Chest computed tomography (CT) showed the right pleural effusion with the chest wall rupture sinus. According to his clinical symptoms and imaging examination, he was diagnosed as chronic empyema with chest wall sinus.Due to the large empyema cavity,the patient should be treated with free vastus lateralis musculocutaneous flap combined with pedicled pectoralis major muscle flap transplantation.After the operation, acute respiratory failure occurred due to left lung aspiration pneumonia.ConclusionsAfter a series of treatment measures such as tracheal intubation, tracheotomy, anti-infection, maintenance of circulatory stability, and rehabilitation training, he was finally rescued and cured.Follow-up after discharge showed that the tissue flap survived and empyema was eliminated.

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