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At least 469 records · Page 26Linked to original sources
PubMed1975

[Artificial respiration as treatment of postoperative complications after cardiovascular surgery: indication, technique, results (author's transl)].

From 1972 to 1974 524 patients underwent surgery with extra corporal circulation. 83 (15,8%) patients had to be postoperatively ventilated for a prolonged period or reintubed after a symptomfree interval due to anticipated or manifested complications. 31 (37%) out of these expired. There was no death due to the prolonged ventilation itself, shown by the group, in which the causes for the above treatment were others but respiratory failure or insufficiency. All patients of this group survived. Indications, technique and results are described and discussed.

Germany, West↗
PubMed2004

[Quantification of atelectases in artificial respiration: spiral-CT versus dynamic single-slice CT].

PURPOSE: Dynamic CT (dCT) allows visualization and quantification of ventilated lung and atelectases with high temporal resolution during continuous ventilation. This study compares a quantitative image analysis in a subcarinal single slice dCT series versus a whole lung spiral-CT, in order to analyze, whether the distribution of atelectasis of a single dCT series is representative for the whole lung. MATERIALS AND METHODS: dCT in sliding windows technique (slice thickness 1 mm, temporal increment 100 ms) was performed in 8 healthy pigs 3 cm caudal to the carina during continuous mechanical ventilation. Subsequently, a spiral-CT of the whole lung (slice thickness 2 mm; pitch 1.5; increment 2 mm) was acquired during inspiratory breath hold (airway pressure 20 mbar). Lung segmentation and planimetry of predefined density ranges were achieved using a dedicated software tool in both data-sets. Thus, the fractions of the following functional lung compartments were averaged over time: hyperinflated lung (- 1024 to - 910 HE), normal ventilated lung -900 to -300 HE) and atelectasis (-300 to +200 HE). RESULTS: Quantitative analysis of dCT-series during continuous respiration correlated with the density analysis in spiral-CT as follows: hyperinflated lung r = 0.56; normal ventilated lung r = 0.83 and atelectases r = 0.84. Analysis of spiral-CT showed the following distribution of functional lung compartments: hyperinflated lung 3.1% normal ventilated lung 77.9% and atelectasis 19.0%. In dCT, hyperinflated lung represented 6.4%, normal ventilated lung 65.2% and atelectasis 28.4% of total the lung area. CONCLUSION: The results of our study demonstrate that dCT allows monitoring of atelectasis formation in response to different ventilatory strategies. However, a deviation between dCT and spiral-CT has to be taken into account. In subcarinal dCT series, hyperinflated lung areas and atelectases were overestimated due to a craniocaudal gradient of atelectases, whereas normal ventilated lung was underestimated.

Animals↗
PubMed1992

[A new single-lumen endobronchial tube for artificial respiration following pneumonectomy in thoracic surgery].

If a patient who has undergone a major resection such as a pneumonectomy or radical pneumonectomy develops during the postoperative period respiratory failure requiring mechanical ventilation, this may cause problems with the respirator treatment. It is of particular interest that the newly sutured bronchus stump can be protected from high ventilation pressures. Until now, patients who have undergone pneumonectomy have been ventilated using a single lumen tube or a double lumen tube (Table 1). A major complication often leading to death is a bronchial stump dehiscence giving rise to a bronchopleural fistula on the operated side due to aggressive mechanical ventilation. Therefore, we developed a new single lumen endobronchial tube (produced by Willy Rüsch AG, W-7050 Waiblingen, Germany, Cat.No. 115900) for the mechanical ventilation of pneumonectomised patients (Fig. 1). The sutured bronchial stump lies between the bronchial and tracheal cuff (Fig. 2) and for that reason is not exposed to any increased ventilation pressure. This new tube contributes to a lower complication rate in mechanically ventilated patients after pneumonectomy.

Bronchi↗
PubMed1991

[Artificial respiration in the prone position in a case of acute respiratory distress syndrome].

A patient is presented in whom an acute respiratory distress syndrome (ARDS) developed after severe lung contusion. Exchange of gas was markedly restricted under aggressive respiration (FiO2 = 1.0, PEEP = 10 mmHg, breathing time quotient = 0.5, respiratory minute volume = 16 litres; gas exchange values: PaO2 = 67 mmHg, PaCO2 = 45 mmHg, PA-aO2 = 461 mmHg). After control of the computed tomogram of the lungs showed marked densifications in those parts of the lung that are lower most by gravitation according to the positioning of the patient at a particular time the patient was ventilated in ventricumbent (prone) position for 60 hours. After having remained in this position for 48 hours, there was a significant improvement in the gas exchange (PaO2 = 89 mmHg, PaCO2 = 36 mmHg, PA-aO2 = 77 mmHg at FiO2 = 0.3, PEEP = 6 mmHg, breathing time quotient = 0.5 and respiratory minute volume = 9 litres). The control CT in dorsal position showed that the dorsal densifications had disappeared completely. Five days later the patient could be extubated. Respiration in ventricumbent (prone) position may considerably improve oxygenation by perfusion of well-ventilated regions of the lung that are lower-most by gravitation according to the relative positioning of the patient. Besides regions not well ventilated or not ventilated at all (according to the patient's position) may be better ventilated or re-opened and made accessible to ventilation by this method.

Adult↗
PubMedDate not supplied

[Noninvasive, continuous monitoring of artificial respiration in premature and newborn infants by the constant measurement of respiratory minute volume, oxygen consumption and carbon dioxide release].

A system of instrumentation for the continuous measurement of the respiratory gases during assisted ventilation of neonates and premature infants based upon "breath-by-breath-method" is described. The four respiratory parameters flow (V), ventilation pressure (p), oxygen-concentration and carbon dioxide-concentration are measured. These datas are processed by a computer to generate a continuous display of the respiratory minute volume, the tidal volume, the breath rate, the oxygen consumption and the carbon dioxide production. All parameters are stored and can be displayed or plotted as trends. The flow-measurement is performed using hot-wire-anemometry. The very small flow sensor is adapted directly to the tube. Next to this sensor, the respiratory gas for the analysis of the O2- and CO2- concentration is suctioned off continuously. First clinical experience in mechanically ventilated newborns is characterized.

Carbon Dioxide↗
PubMedDate not supplied

[Experience using transcutaneous pO2 measurement (tcpO2 measurement) during the transport of premature and newborn infants with artificial respiration].

In 55 high-risk neonates of different birth-weight and gestational age, transcutaneous pO2 (tcpO2) was continuously monitored during transports from the Obstetric Units to the Neonatal Intensive Care Units. We were able to demonstrate that the need for oxygen was overestimated in most of the children and thus FiO2 could be reduced in nearly all cases. In this way, FiO2 can be adapted to the real need of the children and hypoxemias can be avoided as far as possible frequency and duration of hyperoxemias can be reduced. Moreover, valuable knowledge about further management of mechanical ventilation may be obtained. Complications, as e.g. obstruction of endotracheal tube, are more rapidly recognized than by ECG-monitoring alone.

Blood Gas Monitoring, Transcutaneous↗
PubMedDate not supplied

[Central venous air embolism in an artificially respirated premature infant with respiratory distress syndrome].

We report a 935 g 27 weeks gestational age male infant born to a 30 year old mother on chronic intermittent hemodialysis for three years prior to the pregnancy. Immediately after birth the infant presented with severe respiratory distress requiring mechanical ventilation. Chest x-ray showed severe hyaline membrane disease with interstitial emphysema. The infant developed a left tension pneumothorax and systemic air embolism of the right heart, the inferior and superior vena cava and the hepatic vein, from which it subsequently died about 12 h later.

Embolism, Air↗
PubMed1986

[Keratoplasty for severe lagophthalmic keratitis in patients with long-term artificial respiration].

The authors report on 2 patients who developed dense opacities of the thinned cornea during long-term unconsciousness under intensive care, due to insufficient care of the cornea in the case of lagophthalmic keratitis. Although the keratoplasty performed was finally successful, postoperative treatment was very difficult, because the very thin host cornea made re-suturing necessary. The authors recommend using a donor graft 0.2 to 0.3 mm larger in such cases. In order to prevent a keratitis with subsequent corneal opacities. It is very important to instruct the nursing staff to take care to apply eye ointments regularly in unconscious patients with lagophthalmus.

Adult↗