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Recognition and Management of the Difficult Airway
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Valerie Cunningham, Alistair McNarry
Mechanism: The most common mistake made about jet ventilation is in its mechanism of action. It does not work by the Venturi effect; it works by friction. There are actually six postulated mechanisms as to how it might function: Convective or Bulk flow.Laminar flow in the small airways.Pendelluft.Cardiogenic mixing.Molecular Diffusion.Taylor type dispersion.
Ventilators
Published in Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod, The Primary FRCA Structured Oral Examination Study Guide 1, 2017
Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod
The mechanism of oxygenation with this type of ventilation is not fully understood, but diffusion, convection and Pendelluft (i.e. movement of gas between different alveolar units with different time constants) are thought to play a part.
Structure and Function of the Respiratory System
Published in Hans Bisgaard, Chris O’Callaghan, Gerald C. Smaldone, Drug Delivery to the Lung, 2001
Janet Stocks, Alison A. Hislop
When two compartments have different time constants due to differences in resistance or compliance, gas can be flowing out of one at the same time as it is flowing into the other. This “pendelluft” phenomenon reduces effective tidal volume results in frequency dependence of dynamic compliance and resistance measurements, and again makes prediction of aerosol distribution in the presence of disease highly complex (269) (Fig. 18).
How to recognize patients at risk of self-inflicted lung injury
Published in Expert Review of Respiratory Medicine, 2022
Tommaso Pettenuzzo, Nicolò Sella, Francesco Zarantonello, Alessandro De Cassai, Federico Geraldini, Paolo Persona, Elisa Pistollato, Annalisa Boscolo, Paolo Navalesi
According to Yoshida et al, therefore, the heterogeneity of regional PL variations may explain why a spontaneous effort may cause an intrapulmonary displacement of gas from non-dependent to dependent lung regions (more subject to diaphragm activity) at the onset of the inspiratory effort, even before the initiation of the ventilator’s insufflation [21]. This phenomenon is named pendelluft, a term deriving from German language, pendulum (pendel) and air (luft), to mean ‘swinging air’. Pendelluft induced transient intra-tidal recruitment, i.e. the opening of dependent lung regions during inspiration and their closing during expiration, and local volutrauma in experimental models of ARDS [21,29]. Important, these injurious effects occurring during assist-control ventilation can be eliminated or reduced to a large extent by muscle paralysis and controlled mechanical ventilation at the same tidal volume and overall PL [21]. Moreover, higher positive end-expiratory pressure (PEEP) was found to reduce pendelluft by recruiting the dependent lung [21].
Targeting transpulmonary pressure to prevent ventilator-induced lung injury
Published in Expert Review of Respiratory Medicine, 2019
Luciano Gattinoni, Lorenzo Giosa, Matteo Bonifazi, Iacopo Pasticci, Mattia Busana, Matteo Macri, Federica Romitti, Francesco Vassalli, Michael Quintel
Anyway, even if Plateau pressure does not always reflect alveolar pressure, it represents the best clinical way to assess the airway pressure under static conditions, and thus estimate PL. Plateau pressure has actually two components, P1 and P2 (see Figure 1). The difference between P1 and P2 is almost completely explained by a viscoelastic property of the respiratory system [33] which is called stress relaxation (a progressive reduction of stress at a constant level of strain) [34]. Part of this difference is instead explained by the so-called pendelluft [35] which is a redistribution of gas between alveoli with different time constants once the flow has been stopped. It has been shown in dogs, however, that pendelluft has a much smaller role than stress relaxation in explaining the difference between P1 and P2 [36]. It is clear that in order for plateau pressure to better reflect the real pressure distending the respiratory system P2 should be preferred to P1 in the estimation of PL. With the exception of very high inspiratory flows, however, the difference between P1 and P2 is minimal [37] and, in the clinical practice, a mean value of plateau pressure can be used to calculate PL.
A comparative study between Thoracic Epidural Anesthesia in non-intubated video-assisted thoracoscopes and the conventional general anesthesia with one lung ventilation
Published in Egyptian Journal of Anaesthesia, 2022
Mohammed Reda Ashour, Samia AbdelMohsen AbdelLatif, Waleed A. M. Altaher, Hany Hasan ElSayed, Ahmed Farouk Koraitim, Mohamed A. Alhadidy
On the other side, Pompeo and colleagues [10] noted paradoxical breathing (Pendelluft effect) may develop between both lungs (when air is sucked interchangeably between the ventilated the non-ventilated lungs), increasing the risk of intraoperative hypercapnia and hypoxemia. In most cases, hypercapnia resolves spontaneously, and postoperative PaCO2 is lower than after conventional anesthesia.