China
Africa
Explore chapters and articles related to this topic
Intensive Care Medicine
Published in Elizabeth Combeer, The Final FRCA Short Answer Questions, 2019
Mean airway pressure, fraction of inspired oxygen (FiO2), and arterial partial pressure of oxygen (PaO2) are used to calculate the oxygenation index:
Section 6
Published in Padmanabhan Ramnarayan, MCQs in Paediatrics for the MRCPCH, Part 1, 2017
Curosurf is a natural surfactant from porcine lungs. Antenatal steroids are given intramuscularly 12 hours apart. Either dexamethasone or betamethasone are used and for maximum benefit should be given at least 12 hours prior to delivery. They need to be repeated after a week if preterm delivery is still imminent. Mean airway pressure (MAP) is influenced most by a change in PEEP (positive end-expiratory pressure). Other factors include PIP (peak inspiratory pressure) and inspiratory time. MAP is the chief determinant of oxygénation. Rate affects the minute ventilation and therefore C02 elimination. Pressure-volume curves shift to the right with surfactant (increased compliance of the lung).
Mechanical ventilation and support
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
This is controlled by the mean airway pressure. This is a function of the inspiratory time, PIP and PEEP. To improve oxygenation, the PIP or PEEP can be increased. Note, increasing the PEEP will reduce the tidal volume and therefore reduce CO2 clearance.
Mild Hypothermia via External Cooling Improves Lung Function and Alleviates Pulmonary Inflammatory Response and Damage in Two-Hit Rabbit Model of Acute Lung Injury
Published in Journal of Investigative Surgery, 2022
Onat Akyol, Serdar Demirgan, Aslıhan Şengelen, Hasan Cem Güneyli, Duygu Sultan Oran, Funda Yıldırım, Damla Haktanır, Mehmet Salih Sevdi, Kerem Erkalp, Ayşin Selcan
Throughout the procedure, systolic, diastolic and mean arterial pressure (MAP) with heart rate (HR) were monitored using Nihon-Kohden Patient Monitor (Tokyo, Japan) via continuous femoral artery cannulation. Also, body temperature was monitored continuously. Arterial blood gas analysis for oxygen saturation (SaO2), partial oxygen pressure (PaO2), partial carbon dioxide pressure (PaCO2), pH, and lactate levels were also obtained from the femoral artery during the procedure using an ABL 720 blood gas analyzer (Radiometer, Copenhagen, Denmark). The P/F (mmHg) parameter was calculated as the ratio between PaO2 and FiO2. Mean airway pressure (Paw) and end-tidal CO2 levels were monitored during the experiment. Additionally, oxygenation index (OI) was calculated as the following formula: [Paw (kPa) × FiO2 (%)]/PaO2 (kPa).
Managing respiratory complications in infants and newborns with congenital diaphragmatic hernia
Published in Expert Opinion on Orphan Drugs, 2020
Sandeep Shetty, Fahad M. S. Arattu Thodika, Anne Greenough
High-frequency oscillatory ventilation is considered as rescue therapy, if the infant is difficult to ventilate and required peak airway pressures more than 25–28 cm H2O [58,62]. The starting oscillatory settings suggested are a mean airway pressure of between 13 and 17 cmH2O, a frequency of 10 Hz and a delta P of 30–50 cmH2O depending on chest rise [58,62]. Caution must be taken to monitor hyperinflation of the lungs, as high mean airway pressures can cause pneumothoraces and reduce venous return and cardiac output [74]. The VICI trial was a randomized trial involving nine centers in the CDH EURO consortium. The trial compared conventional mechanical ventilation (CMV) to high-frequency oscillatory ventilation (HFOV) as the initial mode of ventilation. There was no statistical significant difference in the primary outcome which was death or bronchopulmonary dysplasia at 28 days between the ventilation groups. The CMV group, however, required a shorter duration of ventilation and vasoactive medication and were less likely to require other medications to treat pulmonary hypertension or require ECMO [75]. There are limited data on the use of high-frequency jet ventilation in infants with CDH, but it has been used as a rescue ventilation mode during transport [76].
The acute respiratory distress syndrome
Published in Baylor University Medical Center Proceedings, 2020
Christopher Wood, Vivek Kataria, Ariel M. Modrykamien
Airway pressure release ventilation is a time-cycled, pressure-targeted ventilation mode that allows for spontaneous breathing across the entire breath cycle. It increases mean airway pressure without increasing peak pressure by employing long inspiratory times followed by very short expiratory times. Studies have shown that airway pressure release ventilation can improve alveolar recruitment, increase oxygenation, and decrease peak airway pressure.63–67 However, no trials to date have shown a mortality benefit when compared to conventional low tidal volume ventilation. Of note, given the allowance of spontaneous breaths, it has been shown that maintaining low tidal volumes (<6.5 mL/kg) may not be feasible on a day-to-day basis during utilization of this mode of ventilation.68