0000000000484951

AUTHOR

Jakob Wittenstein

0000-0003-4397-1467

showing 3 related works from this author

Respiratory Mechanics and Gas Exchange in Thoracic Surgery: Changes in Classical Knowledge in Respiratory Physiology

2020

Respiratory mechanics describe the lung function through pressure and flow and the interplay between the two during the respiratory cycle. Derived indices are volume, compliance and resistance (Hess, Respir Care 59(11):1773–1794, 2014). Thoracic surgery in most cases requires the separation of the lungs in order to allow surgery of or near one lung and ventilation of the other lung, while the perfusion to the non-ventilated lung is continued. This has profound implications for the gas exchange and respiratory mechanics.

medicine.medical_specialtyLungbusiness.industryRespiratory physiologyrespiratory systemrespiratory tract diseasesCompliance (physiology)medicine.anatomical_structureCardiothoracic surgeryInternal medicineCardiologyBreathingMedicineRespiratory cyclebusinessPerfusionLung function
researchProduct

Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical…

2022

BACKGROUND: High intraoperative PEEP with recruitment manoeuvres may improve perioperative outcomes. We re-examined this question by conducting a patient-level meta-analysis of three clinical trials in adult patients at increased risk for postoperative pulmonary complications who underwent non-cardiothoracic and non-neurological surgery. METHODS: The three trials enrolled patients at 128 hospitals in 24 countries from February 2011 to February 2018. All patients received volume-controlled ventilation with low tidal volume. Analyses were performed using one-stage, two-level, mixed modelling (site as a random effect; trial as a fixed effect). The primary outcome was a composite of postoperati…

AdultLung Diseases*PEEP*postoperative pulmonary complicationsmechanical ventilationPositive-Pressure RespirationsurgeryAnesthesiology and Pain MedicinePostoperative ComplicationsTidal Volume*surgeryHumanspostoperative pulmonary complicationsPostoperative Period*mechanical ventilationmechanical ventilation; PEEP; postoperative pulmonary complications; surgery; Adult; Humans; Lung; Postoperative Complications; Postoperative Period; Randomized Controlled Trials as Topic; Tidal Volume; Lung Diseases; Positive-Pressure RespirationLungPEEPRandomized Controlled Trials as Topic
researchProduct

Correction to: Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR…

2019

Background Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Methods PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two differe…

medicine.medical_specialtyone-lung ventilationMedicine (miscellaneous)recruitment maneuverVentilaciólaw.invention03 medical and health sciencesStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawmedicinePharmacology (medical)030212 general & internal medicinePositive end-expiratory pressureTòrax2. Zero hungerProtocol (science)lcsh:R5-920Cirurgiabusiness.industryrespiratory systemOne lung ventilationthoracic surgery3. Good healthrespiratory tract diseasesProtective ventilationCardiothoracic surgeryAnesthesiapostoperative pulmonary complicationlcsh:Medicine (General)business030217 neurology & neurosurgerypositive end-expiratory pressure
researchProduct