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Ventilatory Strategies (ventilatory + strategy)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Ventilatory strategies for the extremely premature infant

PEDIATRIC ANESTHESIA, Issue 5 2008
ANNE GREENOUGH
Summary Bronchopulmonary dysplasia (BPD), which has long-term adverse outcomes, is common following extremely premature birth. BPD has a multifactorial etiology, including a high level or prolonged use of mechanical ventilation. Numerous research studies, therefore, have attempted to identify ventilatory techniques which reduce the likelihood of baro/volutrauma and hence BPD; these have been critically examined in this review, particularly with regard to their relevance to the extremely prematurely born infant. This has highlighted that few randomized studies of ventilatory strategies have concentrated exclusively on those high-risk infants. Overall, in prematurely born infants, advantages have been suggested by the results of studies examining pressure support, proportional assist and volume-targeted ventilation. In addition, High-Frequency Oscillatory Ventilation (HFOV) may reduce the deterioration seen in lung function of prematurely born infants over the first year after birth. In conclusion, more randomized studies are required which concentrate exclusively on the extremely prematurely born population who are at highest risk of BPD. It is essential in such studies that long-term follow-up assessment is inbuilt so that the benefits/adverse effects can be appropriately identified. [source]

Lung protective ventilatory strategies in acute lung injury and acute respiratory distress syndrome: from experimental findings to clinical application

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 2 2007
Serge J. C. Verbrugge
Summary This review addresses the physiological background and the current status of evidence regarding ventilator-induced lung injury and lung protective strategies. Lung protective ventilatory strategies have been shown to reduce mortality from adult respiratory distress syndrome (ARDS). We review the latest knowledge on the progression of lung injury by mechanical ventilation and correlate the findings of experimental work with results from clinical studies. We describe the experimental and clinical evidence of the effect of lung protective ventilatory strategies and open lung strategies on the progression of lung injury and current controversies surrounding these subjects. We describe a rational strategy, the open lung strategy, to accomplish an open lung, which may further prevent injury caused by mechanical ventilation. Finally, the clinician is offered directions on lung protective ventilation in the early phase of ARDS which can be applied on the intensive care unit. [source]