Proposal for Coronavirus Disease 2019 Management.

Setting: The coronavirus disease 2019 pandemic has raised fear throughout the nation. Current news and social media predictions of ventilator, medication, and personnel shortages are rampant.

Patients: Patients with coronavirus disease 2019 are presenting with early respiratory distress and hypoxemia, but not hypercapnia.

The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy.

Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes.

"Open lung ventilation optimizes pulmonary function during lung surgery".

Background: We evaluated an "open lung" ventilation (OV) strategy using low tidal volumes, low respiratory rate, low FiO2, and high continuous positive airway pressure in patients undergoing major lung resections.

Materials And Methods: In this phase I pilot study, twelve consecutive patients were anesthetized using conventional ventilator settings (CV) and then OV strategy during which oxygenation and lung compliance were noted. Subsequently, a lung resection was performed.

Postoperative hypoxemia: common, undetected, and unsuspected after bariatric surgery.

Background: Patients undergoing gastric bypass are at greater than ordinary risk for postoperative respiratory insufficiency, presumably related to obstructive sleep apnea (OSA) and patient-controlled analgesia (PCA). This study was proposed to quantify the magnitude of the problem.

Methods: Fifteen patients undergoing gastric bypass had oxygen saturation (SpO(2)) recorded continuously, but not displayed, for 24h postoperatively; eight also had arterial blood analysis every 4h.

Supplemental oxygen impairs detection of hypoventilation by pulse oximetry.

Study Objective: This two-part study was designed to determine the effect of supplemental oxygen on the detection of hypoventilation, evidenced by a decline in oxygen saturation (Spo(2)) with pulse oximetry.

Design: Phase 1 was a prospective, patient-controlled, clinical trial. Phase 2 was a prospective, randomized, clinical trial.

Chest wall disruption with and without acute lung injury: effects of continuous positive airway pressure therapy on ventilation and perfusion relationships.

Objective: We investigated the evolution of lung injury in an animal model with multiple rib fractures, both with and without acute lung injury, and the influence of spontaneous breathing with continuous positive airway pressure (CPAP) therapy on the relative distributions of alveolar ventilation ([OV0312]a) and perfusion ([OV0422]).

Design: Prospective, randomized laboratory investigation using an established porcine model with instrumentation for measurement of ventilation/perfusion distribution, pulmonary mechanics and gas exchange, and cardiovascular variables.

Setting: University experimental research laboratory.

Has oxygen administration delayed appropriate respiratory care? Fallacies regarding oxygen therapy.

Modern clinical use of supplemental oxygen supposes that: (1) exposure to F(IO)(2) < or = 60% is without adverse effects, (2) an individual at risk of developing arterial hypoxemia can be protected by administering high F(IO)(2), and (3) routine administration of supplemental oxygen is useful, harmless, and clinically indicated. There is now substantial evidence that none of those 3 suppositions are correct, and, on the contrary, supplemental oxygen is actually detrimental to many of the patients who receive it. Supplemental oxygen is much overused and its use should be limited to the few conditions and situations in which it is truly effective, useful, and non-detrimental.

Effect of low isoflurane concentrations on the ventilation-perfusion distribution in injured canine lungs.

Background: Rapid recovery and weaning from ventilatory support and cardiovascular stability are suggested advantages of isoflurane inhalation, in concentrations ranging from 0.1 to 0.6 vol%, for long-term sedation in mechanical ventilated patients.