FACTORS LIMITING USE OF ARTIFICIAL PULMONARY VENTILATION UNDER VOLUME CONTROL WHEN PERFORMING BRONCHOSCOPY WITH THE ENDOTRACHEAL TUBE (EXPERIMENTAL RESEARCH)

Background. An important goal of treating respiratory disorders in newborns during the first stage of perinatal care is effective and safe pulmonary ventilation, enabling the administration of surfactant therapy, reducing alveolar dead space, and providing adequate gas exchange. Objective. The aim of this study is to improve the quality of newborns respiratory therapy using double pressure and volume control at the first stage of perinatal care. Materials and methods. The study involved newborns from week 27 to week 42 gestation with respiratory failure requiring invasive pulmonary ventilation. The ventilation mode was evaluated with pressure control and volume guarantee option compared with routine pressure ventilation. For the comparative characteristic of the compared ventilation methods, we used targets, such as the duration of artificial pulmonary ventilation, reduction of FiO2, dynamics of venous blood lactate, peak and average pressure in the respiratory tract, dynamics of lung compliance, and the development of complications. Results and conclusions. Given the heterogeneity of lung damage in newborns, the use of the guaranteed volume option reduced the duration of mechanical ventilation, the development frequency of IVH, and the frequency of surfactant use.

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Comprehensive Overview of Pediatric Airway Management

10.2310/em.4402 ◽

2019 ◽

Author(s):

Dale Woolridge ◽

Lisa Goldberg ◽

Garrett S. Pacheco

Keyword(s):

Airway Management ◽

Endotracheal Tube ◽

Endotracheal Intubation ◽

Emergency Physician ◽

Laryngeal Mask ◽

Volume Control ◽

Comprehensive Overview ◽

Insertion Depth ◽

Pediatric Airway ◽

Core Skill

Pediatric endotracheal intubation is a procedure that can be stress provoking to the emergency physician. Although the need for this core skill is rare, when confronted with this situation, the emergency physician must have knowledge of the anatomic, physiologic, and pathologic components unique to the pediatric airway to optimize success. Furthermore, the emergency physician should be well versed in the various equipment and adjuncts as well as techniques developed to effectively manage the pediatric airway. This review covers the pathophysiology and practice of endotracheal intubation. Figures show a gum elastic bougie; the Mallampati classification; appropriate oropharyngeal, laryngeal, and tracheal axes; advancing the laryngoscope to lift the epiglottis; endotracheal tube position in neonates; and synchronized intermittent mandatory ventilation pressure-regulated volume control mechanical ventilation. Tables list endotracheal tube sizes, neonatal endotracheal tube sizes, pediatric laryngeal mask airway sizes, commonly used induction agents, and endotracheal tube insertion depth guidelines. This review contains 6 figures, 8 tables, and 77 references. Key words: emergent tracheal intubation; endotracheal tube; laryngoscopy; pediatric airway; pediatric airway management; pediatric endotracheal intubation; pediatric laryngeal mask; video laryngoscopy

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Comprehensive Overview of Pediatric Airway Management

10.2310/tywc.4402 ◽

2019 ◽

Author(s):

Dale Woolridge ◽

Lisa Goldberg ◽

Garrett S. Pacheco

Keyword(s):

Airway Management ◽

Endotracheal Tube ◽

Endotracheal Intubation ◽

Emergency Physician ◽

Laryngeal Mask ◽

Volume Control ◽

Comprehensive Overview ◽

Insertion Depth ◽

Pediatric Airway ◽

Core Skill

Pediatric endotracheal intubation is a procedure that can be stress provoking to the emergency physician. Although the need for this core skill is rare, when confronted with this situation, the emergency physician must have knowledge of the anatomic, physiologic, and pathologic components unique to the pediatric airway to optimize success. Furthermore, the emergency physician should be well versed in the various equipment and adjuncts as well as techniques developed to effectively manage the pediatric airway. This review covers the pathophysiology and practice of endotracheal intubation. Figures show a gum elastic bougie; the Mallampati classification; appropriate oropharyngeal, laryngeal, and tracheal axes; advancing the laryngoscope to lift the epiglottis; endotracheal tube position in neonates; and synchronized intermittent mandatory ventilation pressure-regulated volume control mechanical ventilation. Tables list endotracheal tube sizes, neonatal endotracheal tube sizes, pediatric laryngeal mask airway sizes, commonly used induction agents, and endotracheal tube insertion depth guidelines. This review contains 6 figures, 8 tables, and 77 references. Key words: emergent tracheal intubation; endotracheal tube; laryngoscopy; pediatric airway; pediatric airway management; pediatric endotracheal intubation; pediatric laryngeal mask; video laryngoscopy

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Automatic Regulation of Artificial Pulmonary Ventilation

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.1966.tb01010.x ◽

1966 ◽

Vol 10 ◽

pp. 187-190

Author(s):

T. M. Darbinjan

Keyword(s):

Pulmonary Ventilation ◽

Automatic Regulation ◽

Artificial Pulmonary Ventilation

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Artificial Pulmonary Ventilation during Surgery under Extracorporeal Circulation

International Anesthesiology Clinics ◽

10.1097/00004311-197614030-00002 ◽

1976 ◽

Vol 14 (3) ◽

pp. 33-48

Author(s):

TIGRAN M. DARBINYAN

Keyword(s):

Extracorporeal Circulation ◽

Pulmonary Ventilation ◽

Artificial Pulmonary Ventilation

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Comparison of responses to CO2 under the conditions of natural respiration and controlled artificial pulmonary ventilation

Human Physiology ◽

10.1134/s0362119706040098 ◽

2006 ◽

Vol 32 (4) ◽

pp. 440-444

Author(s):

M. A. Pogodin ◽

M. P. Granstrem ◽

A. I. Dimitrienko

Keyword(s):

Pulmonary Ventilation ◽

Artificial Pulmonary Ventilation

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Nudegimų gydymas pasireiškus bakteriemijai

Lietuvos chirurgija ◽

10.15388/lietchirur.2005.1.2328 ◽

2005 ◽

Vol 3 (1) ◽

pp. 0-0

Author(s):

Kristina Vostrugina ◽

Daiva Gudavičienė ◽

Rytis Rimdeika

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Therapy ◽

Plastic Surgery ◽

Pulmonary Ventilation ◽

Age Factors ◽

Multiple Organ ◽

Parenteral Feeding ◽

Burned Area ◽

Hospital Department ◽

Artificial Pulmonary Ventilation

Kristina Vostrugina, Daiva Gudavičienė, Rytis RimdeikaKauno medicinos universiteto klinikųPlastinės chirurgijos ir nudegimų skyrius,Eivenių g. 2, LT-50009 KaunasEl paštas: [email protected] Tikslas Ištirti 1999–2003 m. Kauno medicinos universiteto klinikų Plastinės chirurgijos ir nudegimų skyriaus ligonių, kuriems patvirtinta bakteriemija, gydymo aspektus. Ligoniai ir metodai Atlikta retrospektyvi 82 nudegusių ligonių, kuriems patvirtinta bakteriemija, ligos istorijų analizė. Vertintas pacientų amžius, nudegimą sukėlę veiksniai, nudegimo plotas, kvėpavimo takų nudegimas. Analizuota, kokiam skaičiui pacientų reikėjo kateterizuoti centrines venas, prireikė dirbtinės plaučių ventiliacijos, enterinio ar parenterinio maitinimo, kokių radosi komplikacijų, kokie mikroorganizmai išaugo žaizdų pasėliuose ir toks jų sutapimas su kraujo pasėlių duomenimis, nagrinėti antibiotikų terapijos aspektai. Rezultatai Pacientų, kuriems patvirtinta bakteriemija, vidutinis amžius buvo 50 metų, standartinis nuokrypis – 16. Vyravo nudegimai liepsna (82%) ir skysčiais (8,5%). Vidutinis nudegusio kūno paviršiaus plotas buvo 29%, standartinis nuokrypis – 19. Centrines venas reikėjo kateterizuoti 78% pacientų. Dirbtinės plaučių ventiliacijos prireikė 13% pacientų. Enterinis maitinimas skirtas 48% pacientų, parenteriniu būdu maitinta 90% ligonių. Pneumonija nustatyta 29% pacientų, kardiovaskulinis nepakankamumas – 15%, dauginis organų funkcijos nepakankamumas – 13%, inkstų funkcijos nepakankamumas – 7% ligonių. Visais atvejais sutapo žaizdos ir kraujo pasėlių duomenys, kai iš kraujo išaugo Pseudomonas aeruginosa, 87% – kai išaugo meticilinui atsparus Staphylococcus aureus ir 74% – kai išaugo meticilinui jautrus S. aureus. Antibiotikais gydyta 80 ligonių, dažniausiai penicilinu, gentamicinu ir vankomicinu. Išvados Bakteriemija dažnai nustatoma didelius plotus nudegusiems ligoniams, kuriems tenka kateterizuoti centrines venas, skirti parenterinį maitinimą. Dažniausiai iš kraujo mėginių išauga tie mikroorganizmai, kurie auga žaizdų pasėliuose. Reikšminiai žodžiai: nudegimai, bakteriemija, antibiotikų terapija Treatment of burned patients with diagnosed bacteremia Kristina Vostrugina, Daiva Gudavičienė, Rytis RimdeikaKaunas University of Medicine Hospital,Department of Plastic Surgery and Burns,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Objective The aim of the study was to investigate the aspects of treatment of burned patients with confirmed bacteremia treated at Kaunas University of Medicine Hospital Department of Plastic Surgery and Burns during 1999–2003. Patients and methods A retrospective analysis of case histories of 82 burned patients with confirmed bacteremia was performed. The evaluated factors included the patients’ age, factors that caused the burns, the burned area, and burns of the airways. We also analyzed how many patients required catheterization of the central veins, artificial pulmonary ventilation, enteral or parenteral feeding, and complications, as well as what microorganisms grew in wound crops, how many cases corresponded to the blood crop findings, and the aspects of antibiotic therapy. Results Mean age of patients with confirmed bacteremia was 50 years, standard deviation (SD) – 16. Flame burns (82%) and scalds (8.5%) predominated. Mean burned body surface area was 29%, SD – 19. 78% of patients required catheterization of central veins, and 13% – artificial pulmonary ventilation. 48% of patients were fed enterally, and 90% – parenterally. 29% of patients had pneumonia, 15% – cardiovascular insufficiency, 13% – multiple organ failure, and 7% – renal failure. The coincidence of the findings of wound and blood crops was 100% in cases of Pseudomonas aueruginosa growth, 87% – in cases of methicillin-resistant Staphylococcus aureus growth, and 74% – in cases of methicillin-sensitive Staphylococcus aureus growth. 80 patients received antibiotics, mostly penicillin, gentamicin, and vancomycin. Conclusions Bacteremia was very common among extensively burned patients requiring catheterization of the central veins and parenteral feeding. In most cases, microorganisms that grew in wound crops also grew in blood samples. Key words: burns, bacteremia, antibiotic therapy

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

EMERGENCY MEDICINE ◽

10.22141/2224-0586.17.8.2021.245574 ◽

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.

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