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.

Comparison of Early Nasal Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure in Preterm Infants with Respiratory Distress Syndrome

2018 ◽  
Vol 65 (4) ◽  
pp. 352-360 ◽  
Author(s):  
Mesut Dursun ◽  
Sinan Uslu ◽  
Ali Bulbul ◽  
Muhittin Celik ◽  
Umut Zubarioglu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure

Abstract Aims To compare the effect of early nasal intermittent positive pressure ventilation (nIPPV) and nasal continuous positive airway pressure (nCPAP) in terms of the need for endotracheal ventilation in the treatment of respiratory distress syndrome (RDS) in preterm infants born between 24 and 32 gestational weeks. Methods This is a randomized, controlled, prospective, single-centered study. Forty-two infants were randomized to nIPPV and 42 comparable infants to nCPAP (birth weight 1356 ± 295 and 1359 ± 246 g and gestational age 29.2 ± 1.7 and 29.4 ± 1.5 weeks, respectively). Results The need for endotracheal intubation and invasive mechanical ventilation was significantly lower in the nIPPV group than the nCPAP group (11.9% and 40.5%, respectively, p < 0.05). There were no differences in the duration of total nasal respiratory support, duration of invasive mechanical ventilation, bronchopulmonary dysplasia or other early morbidities. Conclusion nIPPV compared with nCPAP reduced the need for endotracheal intubation and invasive mechanical ventilation in premature infants with RDS.

Lung Ventilation: Natural and Mechanical

2017 ◽  
Author(s):  
Yuan Lei
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Respiratory System ◽  
Positive Pressure Ventilation ◽  
Lung Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Artificial Lung ◽  
Positive Pressure ◽  
Anatomy And Physiology ◽  
Artificial Lung Ventilation

‘Lung Ventilation: Natural and Mechanical’ describes the processes of respiration and lung ventilation, focusing on those issues related directly to mechanical ventilation. The chapter starts by discussing the anatomy and physiology of respiration, and the involvement of the lungs and the entire respiratory system. It continues by introducing the three operating principles of mechanical ventilation. It then narrows its focus to intermittent positive pressure ventilation (IPPV), the operating principle of most modern critical care ventilators, explaining the pneumatic process of IPPV. The chapter ends by comparing natural and mechanical/artificial lung ventilation.

Medical Ventilator System Basics: A clinical guide

2017 ◽  
Author(s):  
Yuan Lei
Keyword(s):  
Mechanical Ventilation ◽  
Positive Pressure Ventilation ◽  
Breathing Circuit ◽  
Building Blocks ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Control Parameters ◽  
Anatomy And Physiology ◽  
Ventilation Modes ◽  
Therapy Education

Medical Ventilator System Basics: A clinical guide—unlike books that focus on clinical applications, or that provide specifics about individual ventilator models, this is a practical guide about the equipment used for positive pressure mechanical ventilation. This book provides the information a clinician needs every day: how to assemble a ventilator system, how to determine appropriate ventilator settings, how to make sense of monitored data, how to respond to alarms, and how to troubleshoot ventilation problems. The book applies to all ventilators based on the intermittent positive pressure ventilation (IPPV) operating principle. In a systematic and comprehensive way, the book steps the user through the ventilator system, starting with its pneumatic principles to an explanation of the anatomy and physiology of respiration. It describes the system components, including the ventilator, breathing circuit, humidifier, and nebulizer. The book then introduces ventilation modes, starting with an explanation of the building blocks of breath variables and breath types. It describes the major ventilator functions, including control parameters, monitoring, and alarms. Along the way the book provides much practical troubleshooting information. Clearly written and generously illustrated, the book is a handy reference for anyone involved with mechanical ventilation, clinicians and non-clinicians alike. It is suitable as a teaching aid for respiratory therapy education and as a practical handbook in clinical practice.

Sign in / Sign up

Export Citation Format

Share Document