Search results for "Atelectasi"
showing 10 items of 39 documents
Systemic PaO2 oscillations cause mild brain injury in a pig model
2016
OBJECTIVE: Systemic PaO2 oscillations occur during cyclic recruitment and derecruitment of atelectasis in acute respiratory failure and might harm brain tissue integrity. DESIGN: Controlled animal study. SETTING: University research laboratory. SUBJECTS: Adult anesthetized pigs. INTERVENTIONS: Pigs were randomized to a control group (anesthesia and extracorporeal circulation for 20 hr with constant PaO2, n = 10) or an oscillation group (anesthesia and extracorporeal circulation for 20 hr with artificial PaO2 oscillations [3 cycles min⁻¹], n = 10). Five additional animals served as native group (n = 5). MEASUREMENTS AND MAIN RESULTS: Outcome following exposure to artificial PaO2 oscillations…
New evidence in one-lung ventilation
2017
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also includes routine use of PEEP and alveolar recr…
Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis
2021
Background General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP. Methods This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with Higher versus Lower Levels of Positive End-Expiratory Pressure in Obese Patients (PROBESE) trial (n = 42) and likewise all obese patients from a local single-center trial (n = 54). Inclusion criteria for both trials were elective laparoscopic abdominal…
Analysis of atelectasis, ventilated, and hyperinflated lung during mechanical ventilation by dynamic CT.
2005
Study objective: To study the dynamics of lung compartments by dynamic CT (dCT) imaging during uninterrupted pressure-controlled ventilation (PCV) and different positive end-expiratory pressure (PEEP) settings in healthy and damaged lungs. Design: Experimental animal investigation. Setting: Experimental animal facility of a university department. Interventions: In seven anesthetized pigs, static inspiratory pressure volume curves were obtained to identify the individual lower inflection point (LIP) before and after saline solution lung lavage. During PCV, PEEP was adjusted 5 millibars (mbar) below the individually determined LIP (LIP - 5), at the LIP, and 5 mbar above the LIP (LIP + 5). Mea…
Observation of ventilation-induced Spo(2) oscillations in pigs: first step to noninvasive detection of cyclic recruitment of atelectasis?
2010
High arterial partial oxygen pressure (Pao(2)) oscillations within the respiratory cycle were described recently in experimental acute lung injury. This phenomenon has been related to cyclic recruitment of atelectasis and varying pulmonary shunt fractions. Noninvasive detection of Spo(2) (oxygen saturation measured by pulse oximetry) as an indicator of cyclic collapse of atelectasis, instead of recording Pao(2) oscillations, could be of clinical interest in critical care. Spo(2) oscillations were recorded continuously in three different cases of lung damage to demonstrate the technical feasibility of this approach. To deduce Pao(2) from Spo(2), a mathematical model of the hemoglobin dissoci…
German Thoracic Research Scholarship 1996: lung volume reduction for endstage pulmonary emphysema at the Washington University of St. Louis.
1998
The Thoracic Research Scholarship 1996 of the German Society for Thoracic and Cardiovascular Surgery enabled me to visit Barnes Hospital at the Washington University of St. Louis, USA, from May to July 1996. At that center Prof. J. D. Cooper has established lung-volume reduction surgery as a successful surgical treatment for patients with endstage pulmonary emphysema. The operation is performed using left-sided double-lumen intubation. After opening of the chest and pleura and starting single-lung ventilation the less diseased parts of the second lung collapse due to absorption atelectasis whereas the more diseased portion of the lung stays hyperinflated. Linear staplers buttressed with bov…
Otite media atelettasica, adesiva, timpanosclerotica: update medico e chirurgico
2011
Otitis media secretive is one of the most common ear diseases characterized by frequent sequelae and complications; in particular the authors describe middle ear atelectasis with pocket retraction of tympanic membrane, pocket retraction limited to pars tensa or to pars flaccida, adhesive otitis media, partial or total myringosclerosis and tympanosclerosis. For each disease the Authors comment the best surgical approaches to preserve and restore conductive hearing loss. As for middle ear atelectasis, adhesive otitis media, myringosclerosis and partial tympanosclerosis it was evidenced a significant hearing gain while in total tympanosclerosis there was an initial hearing improvement in a sho…
Easy removal of a large mucus plug with a flexible paediatric bronchoscope after administration of rhDNase (Pulmozyme).
2006
Mucoid impaction and plastic bronchitis are relatively rare disorders affecting patients of any age. Here we report the case of mucoid impaction developing in a four-year-old child as a complication of pneumonic infection treated four weeks prior. p.a. chest X-ray and fiberoptic bronchoscopy showed atelectasis and the location of a mucus cast in the left upper lobe. After extraction of the cast via the suction channel of the bronchoscope had failed, we administered 2.5 mg of undiluted recombinant human deoxyribonuclease (rhDNase) instilled directly over the affected area of occlusion for 15 minutes. This mucolytic agent mobilized the cast by reducing viscoelasticity and adherence of mucus. …
Quantification of Lung Volume at Different Tidal Volumes and Positive End-Expiratory Pressures in a Porcine Model by Using Retrospective Respiratory …
2008
PURPOSE: This feasibility study in healthy animals should prove the concept that it is possible to quantitatively assess the effects of different ventilatory settings on the lung parenchyma during ongoing ventilation in respiratory gated 4-dimensional (D)-computed tomography (CT). For this purpose, the influence of different tidal volumes and positive end-expiratory pressure (PEEP) on quantitative assessment of lung volumes (LVs) and lung compartments was analyzed. METHODS: Five anesthetized and ventilated (20 breaths/min, inspiratory/expiratory ratio of 1:2) healthy pigs underwent 16-row multidetector CT with retrospective respiratory gating using a noncontact charge-coupled device camera …
Mastoidectomy in surgical procedures to treat retraction pockets: a single-center experience and review of the literature
2022
Abstract Purpose Retraction pocket (RP) is a common event affecting the middle ear when a negative pressure within it causes a retraction of a single part of the tympanic membrane (TM). Patients can be asymptomatic or can experience hearing loss, fullness feeling and/or ear discharge. RP can be stable or develop a cholesteatoma; aim of the study was to investigate if mastoidectomy may play a role in the surgical management of patients suffering from RP, both reporting our experience and discussing the existing literature. Methods Fifty-one patients affected by RP were referred for surgery and randomly divided into two groups. Patients of G1 group underwent tympanoplasty with mastoidectomy, …