Acute respiratory failure induced by mechanical pulmonary ventilation at a peak inspiratory pressure of 40 cmH20

1988 ◽  
Vol 2 (2) ◽  
pp. 176-183 ◽  
Author(s):  
Kyoji Tsuno ◽  
Yuji Sakanashi ◽  
Yasushi Kishi ◽  
Kenji Urata ◽  
Tadashi Tanoue ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pulmonary Ventilation ◽  
Peak Inspiratory Pressure ◽  
Inspiratory Pressure

scholarly journals Goal-Directed Mechanical Ventilation: Are We Aiming at the Right Goals? A Proposal for an Alternative Approach Aiming at Optimal Lung Compliance, Guided by Esophageal Pressure in Acute Respiratory Failure

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Arie Soroksky ◽  
Antonio Esquinas
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Chest Wall ◽  
Respiratory System ◽  
Transpulmonary Pressure ◽  
Esophageal Pressure ◽  
Plateau Pressure ◽  
Lung Compliance ◽  
Inspiratory Pressure

Patients with acute respiratory failure and decreased respiratory system compliance due to ARDS frequently present a formidable challenge. These patients are often subjected to high inspiratory pressure, and in severe cases in order to improve oxygenation and preserve life, we may need to resort to unconventional measures. The currently accepted ARDSNet guidelines are characterized by a generalized approach in which an algorithm for PEEP application and limited plateau pressure are applied to all mechanically ventilated patients. These guidelines do not make any distinction between patients, who may have different chest wall mechanics with diverse pathologies and different mechanical properties of their respiratory system. The ability of assessing pleural pressure by measuring esophageal pressure allows us to partition the respiratory system into its main components of lungs and chest wall. Thus, identifying the dominant factor affecting respiratory system may better direct and optimize mechanical ventilation. Instead of limiting inspiratory pressure by plateau pressure, PEEP and inspiratory pressure adjustment would be individualized specifically for each patient's lung compliance as indicated by transpulmonary pressure. The main goal of this approach is to specifically target transpulmonary pressure instead of plateau pressure, and therefore achieve the best lung compliance with the least transpulmonary pressure possible.

Intratracheal Pulmonary Ventilation at Low Airway Pressures in a Ventilator-Induced Model of Acute Respiratory Failure Improves Lung Function and Survival

CHEST Journal ◽  
1998 ◽  
Vol 114 (4) ◽  
pp. 1147-1157 ◽  
Author(s):  
Nicola Rossi ◽  
Theodor Kolobow ◽  
Michele Aprigliano ◽  
Kyoji Tsuno ◽  
Matteo Giacomini
Keyword(s):  
Respiratory Failure ◽  
Lung Function ◽  
Acute Respiratory Failure ◽  
Pulmonary Ventilation ◽  
Airway Pressures

Intratracheal Pulmonary Ventilation and Continuous Positive Airway Pressure in a Sheep Model of Severe Acute Respiratory Failure

CHEST Journal ◽  
1997 ◽  
Vol 112 (4) ◽  
pp. 1060-1067 ◽  
Author(s):  
Matteo Giacomini ◽  
Theodor Kolobow ◽  
Chiara Reali-Forster ◽  
Rudolf Trawöger ◽  
Maurizio Cereda
Keyword(s):  
Respiratory Failure ◽  
Continuous Positive Airway Pressure ◽  
Acute Respiratory Failure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pulmonary Ventilation ◽  
Sheep Model
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