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PubMed1982

[Artificial respiration in cerebral resuscitation].

CO2 is a potent cerebral vasodilator which induces major changes in cerebral blood flow and volume. Acute hypocapnia decreases cerebral blood volume; thus the intracranial pressure can be reduced rapidly, thereby improving cerebral hemodynamics. Hypocapnia, rapidly achieved by controlled hyperventilation, is therefore a valid treatment in cerebral resuscitation, especially when associated with elevated intracranial pressure. However, the effect of hypocapnia is short and unusually does not exceed a few hours. Consequently the indications for prolonged hyperventilation are very limited, if they exist at all. Intracranial pressure and cerebral blood flow changes induced by PEEP are still controversial.

Carbon Dioxide↗
PubMed1980

[Hemodynamics in patients during artificial respiration].

The assessment and monitoring of the hemodynamic variables during mechanical ventilation must be interpreted in terms of both the cardiovascular status and the influence of several pathophysiological features observed frequently in patients requiring ventilatory support for the treatment of acute pulmonary failure, i.e. 1. hyperdynamic cardiovascular status, 2. pulmonary hypertension, 3. cardio-circulatory depression by mechanical ventilation, and 4. errors in the measured values secondary to the variations in intrathoracic pressure. An understanding of these factors, as well as of the influence of mechanical ventilation and of the circulating blood volume, allows precise evaluation of the cardio-circulatory situation.

Cardiac Output↗
PubMed1980

[Inversed ratio ventilation (IRV). Role of the respiratory time ratio in artificial respiration in ARDS].

Considering the advantages shown by the experiences of Reynolds on prolonged inspiration time it was suggested to study this type of ventilation also in ARDS. We tried the inverse ratio ventilation (IRV) in patients with ARDS and in postoperative cardiac surgical patients. An obvious improvement of gas transfer in the lung is seen and becomes better with increased duration of this type of ventilation. A better filling of various parts of the lung with longer time constants is achieved with prolonged inspiration. An effect similar to PEEP caused by an air trapping mechanism, can be seen with the shortening of expiration time. This air trapping mechanism is followed by autonomous adaption of PEEP for the local situation in various parts of the lung. A higher PEEP in poorly ventilated areas is automatically adjusted with IRV, than in areas with a short time constant (individual PEEP).

Biophysical Phenomena↗