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Improving lung protective mechanical ventilation: the individualised intraoperative open-lung approach.
Br J Anaesth
February 2025
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain.
Despite the maturity and sophistication of anaesthesia workstations, improvements in our understanding of intraoperative mechanical ventilation, and use of less invasive surgical techniques, postoperative pulmonary complications (PPCs) are still a common problem in surgical patients of all ages. PPCs are associated with a higher incidence of perioperative morbidity and mortality, longer hospital stays, and higher healthcare costs. PPCs are strongly associated with anaesthesia-induced atelectasis, which predisposes to lung damage when partially collapsed lungs are subjected to mechanical ventilation.
View Article and Find Full Text PDFSolid-state esophageal pressure sensor for the estimation of pleural pressure: a bench and first-in-human validation study.
Crit Care
January 2025
Intensive Care, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Background: Advanced respiratory monitoring through the measurement of esophageal pressure (Pes) as a surrogate of pleural pressure helps guiding mechanical ventilation in ICU patients. Pes measurement with an esophageal balloon catheter, the current clinical reference standard, needs complex calibrations and a multitude of factors influence its reliability. Solid-state pressure sensors might be able to overcome these limitations.
View Article and Find Full Text PDFIdiopathic pulmonary arteriovenous malformation: a rarity in clinical practice.
J Vasc Bras
January 2025
Universidade Federal da Paraíba - UFPB, Hospital Universitário Lauro Wanderley - HULW, João Pessoa, PB, Brasil.
Pulmonary arteriovenous malformations (PAVM) are characterized by abnormal pulmonary vessels forming arteriovenous shunts that compromise oxygenation of the blood, causing hypoxemia, and predispose to infections and cerebral ischemia. The patient in this case was a 38-year-old male who presented with tachypnea and dyspnea, cyanosis of extremities, and significant digital clubbing. The patient had structural epilepsy secondary to neurosurgery for a cerebral abscess during childhood.
View Article and Find Full Text PDFEffects of routine postural repositioning on the distribution of lung ventilation and perfusion in mechanically ventilated patients.
Intensive Crit Care Nurs
January 2025
Department of Intensive Care Medicine, Hospital Universitario de La Princesa, Madrid, Spain; Centro de investigación en red CIBERES de enfermedades respiratorias, Instituto de Salud, Carlos III, Madrid, Spain. Electronic address:
Objectives: To analyse the effects on respiratory function, lung volume and the regional distribution of ventilation and perfusion of routine postural repositioning in mechanically ventilated critically ill patients.
Methods: Prospective descriptive physiological study. We evaluated gas-exchange, lung mechanics, and Electrical Impedance Tomography (EIT) determined end-expiratory lung impedance and regional ventilation and perfusion distribution in five body positions: supine-baseline (S1); first lateralisation at 30° (L1); second supine position (S2), second contralateral lateralisation (L2) and third final supine position (S3).
Effects of Variable Ventilation on Gas Exchange in an Experimental Model of Capnoperitoneum: A Randomized Crossover Study.
Anesth Analg
January 2025
From the Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University of Geneva, Geneva, Switzerland.
Background: The rapid advancement of minimally invasive surgical techniques has made laparoscopy a preferred alternative because it reduces postoperative complications. However, inflating the peritoneum with CO2 causes a cranial shift of the diaphragm decreasing lung volume and impairing gas exchange. Additionally, CO2 absorption increases blood CO2 levels, further complicating mechanical ventilation when the lung function is already compromised.
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