scholarly journals Effects of Head Extension on Peak Airway Pressure During Mask-Ventilation: A Prospective, Randomized, Clinical Single-Centre Trial

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna Fiala ◽  
Ruth Kroess ◽  
Sabrina Neururer ◽  
Patrick Braun ◽  
Nicole Nachbar ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Peak Airway Pressure ◽  
Mask Ventilation ◽  
Single Centre ◽  
Head Extension

scholarly journals Manual hyperinflation and the role of physical therapy in intensive care and emergency units

2017 ◽  
Vol 30 (suppl 1) ◽  
pp. 241-248
Author(s):  
Rafael Vinícius Santos Cruz ◽  
Fabiana do Socorro da Silva Dias de Andrade ◽  
Pollyanna Dórea Gonzaga de Menezes ◽  
Bruno Oliveira Gonçalves ◽  
Robson da Silva Almeida ◽  
...  
Keyword(s):  
Intensive Care ◽  
Physical Therapy ◽  
Airway Pressure ◽  
Physical Therapists ◽  
High Peak ◽  
Peak Airway Pressure ◽  
Routine Practice ◽  
Perceived Benefits ◽  
Therapy Technique ◽  
Emergency Units

Abstract Introduction: Although manual hyperinflation (MHI) is a physical therapy technique commonly used in intensive care and emergency units, there is little consensus about its use. Objective: To investigate the knowledge of physical therapists working in intensive care and emergency units about manual hyperinflation. Methods: Data were collected through self-administered questionnaires on manual hyperinflation. Data collection took place between September 2014 and January 2015, in Itabuna and Ilhéus, Bahia, Brazil. Results: The study sample was composed of 32 physical therapists who had between 4 months and 10 years working experience. All respondents affirmed that they used the technique in their professional practice. However, only 34.4% reported it to be a routine practice. 90.6% stated that the most common patient position during manual hyperinflation is “supine”. Participants were almost unanimous (93.8%) in citing secretion removal and cough stimulation as perceived benefits of MHI. High peak airway pressure was identified as being a precaution to treatment with MHI by 84.4% of participants, whilst 100% of the sample agreed that an undrained pneumothorax was a contraindication to MHI. Conclusion: The most common answers to the questionnaire were: supine position during MHI; secretion removal and cough stimulation as perceived benefits; high peak airway pressure as a precaution; and an undrained pneumothorax as a contraindication.

scholarly journals Massive Subcutaneous Emphysema during Laparoscopic Cholecystectomy

1970 ◽  
Vol 21 (1) ◽  
pp. 77-79
Author(s):  
ASM Moosa ◽  
M Baharul Islam ◽  
Shahina Akther ◽  
M Latifur Rahman ◽  
Nazim Uddin Ahmed
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Partial Pressure ◽  
Subcutaneous Emphysema ◽  
Airway Pressure ◽  
Surgical Techniques ◽  
Lung Ventilation ◽  
Peak Airway Pressure ◽  
Sudden Increase ◽  
Partial Pressure Of Oxygen

Laparoscopic surgical techniques are increasingly being applied to treat cholelithiasis and other indications of gallbladder diseases. These procedures however are not without potential morbidity. Herein we describe two patients treated with laparoscopic cholecystectomy; those cases were complicated with subcutaneous emphysema and hypercarbia per-operatively. After discontinuation of pneumoperitoneum, saturation of partial pressure of oxygen (SpO2) gradually increased with improvement of the neck subcutaneous emphysema, at the same time the lung ventilation also improved. Our findings show that we have to stop pneumoperitoneum or decrease partial pressure of end carbon dioxide level immediately, when we find a sudden increase of the peak airway pressure or decrease SpO2 with subcutaneous emphysema during laparoscopic cholecystectomy.   doi: 10.3329/taj.v21i1.3225 TAJ 2008; 21(1): 77-79

A Randomized Crossover Comparison of Airway Sealing with the Laryngeal Mask Airway Ambu AuraFlex at Three Intracuff Pressures in Pediatric Laparoscopic Surgery

2019 ◽  
Author(s):  
Xiang Liu ◽  
Xiaona Tan ◽  
Qi Zhang ◽  
Li Qiao ◽  
Lei Shi
Keyword(s):  
Laparoscopic Surgery ◽  
Laryngeal Mask Airway ◽  
Airway Pressure ◽  
Laryngeal Mask ◽  
Peak Airway Pressure ◽  
Supraglottic Airway ◽  
Intracuff Pressure ◽  
Leak Pressure ◽  
Oropharyngeal Leak Pressure ◽  
Mucosal Change

Abstract Objective An adequate intracuff pressure is important to ensure sufficient sealing function when using supraglottic airway devices to protect the airway from secretions and achieve adequate positive pressure ventilation. The aim of this study is to analyze a feasible and effective alternative Ambu AuraFlex intracuff pressure in child's laparoscopic surgery. Study Design Seventy-two children were included in this study. After insertion of the laryngeal mask airway AuraFlex, oropharyngeal leak pressure (OLP) was measured at intracuff pressures of 10, 30, and 60-cmH2O according to one of six sequences produced on the basis of 3 × 6 Williams crossover design. During the intraoperative period, AuraFlex was maintained using the last intracuff pressure of the allocated sequence. Oropharyngeal leak pressure, peak airway pressure, the fiberoptic view, mucosal change, and complications were assessed at three intracuff pressures. Results The OLP at the intracuff pressure of 10 cmH2O was significantly lower than that of 30 cmH2O (2# 18.1 ± 1.5 vs. 19.5 ± 1.4 cmH2O, p = 0.001; 2.5# 17.7 ± 1.2 vs. 20.2 ± 1.4, p = 0.001) and 60 cmH2O (2# 18.1 ± 1.5 vs. 20.0 ± 1.3 cmH2O, p = 0.002; 2.5# 17.7 ± 1.2 vs. 20.8 ± 1.1, p = 0.003). Compared with the peak airway pressure in pre-and postpneumoperitoneum, the OLP was significantly higher. Subgroup analysis showed no differences in mucosal change and complications. Conclusion Intracuff pressures of 30 may be sufficient for the Ambu AuraFlex in child's laparoscopic surgery, and there may be no added benefit of an intracuff pressure of 60 cmH2O, as oropharyngeal leak pressures were similar.

Effect of frequency on perceived magnitude of added loads to breathing

1985 ◽  
Vol 58 (5) ◽  
pp. 1616-1621 ◽  
Author(s):  
K. J. Killian ◽  
E. Summers ◽  
M. Basalygo ◽  
E. J. Campbell
Keyword(s):  
Duty Cycle ◽  
Airway Pressure ◽  
Normal Subjects ◽  
Peak Airway Pressure ◽  
Inspiratory Pressure ◽  
Sensory Magnitude ◽  
Magnitude Scaling ◽  
Quantitative Effect

Using open-magnitude scaling, six normal subjects estimated the perceived magnitude of a range of added elastic loads (20–76 cmH2O/l), applied for a sequence of five breaths, at frequencies varying from 5 to 26.4 breaths/min. Two experiments were performed. In the first, frequency was increased by a reduction in expiratory duration (TE), and the duty cycle (ratio of inspiratory duration to total breath duration, TI/TT) ranged between 0.10 and 0.52. The perceived magnitude psi increased significantly with the peak airway pressure (Pm) (P less than 0.0001) but did not reach conventional significance with frequency (fb) (P = 0.15): psi = K0Pm1.23fb0.07 (r = 0.911). However, the sensory magnitude increased significantly as the duty cycle increased (P less than 0.01), but when it was included, the magnitude decreased minimally with frequency (P less than 0.01): psi = K0Pm1.3fb-0.97 TI/TT1.14 (r = 0.92). In the second experiment the duty cycle (TI/TT) was kept constant [(0.43 +/- 0.008 (SE)] and frequency (5–26.4 breaths/min) increased at the expense of shortening both TI and TE. The perceived magnitude of the added elastances decreased with the increase in frequency. However, when the perceived magnitude was corrected for the duration of inspiration, which is known to increase the sensory magnitude, psi = K0Pm1.3TI0.56, the sensory magnitude increased significantly with frequency (P less than 0.001): psi/TI0.56 = K0Pm1.21fb0.28 (r = 0.773). The decrease in inspiratory duration had a greater quantitative effect decreasing sensory magnitude than frequency had on increasing the magnitude. The effect of increasing frequency is complex and depends on the simultaneous intensity, duration of inspiratory pressure, and the duty cycle.

scholarly journals Preoxygenation in difficult airway management: high-flow oxygenation by nasal cannula versus face mask (the PREOPTIDAM study). Protocol for a single-centre randomised study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025909 ◽  
Author(s):  
Mickael Vourc’h ◽  
Donatien Huard ◽  
Fanny Feuillet ◽  
Gabrielle Baud ◽  
Arthur Guichoux ◽  
...  
Keyword(s):  
Airway Management ◽  
Face Mask ◽  
High Flow ◽  
Nasal Cannula ◽  
University Hospital ◽  
Rapid Sequence Intubation ◽  
Controlled Study ◽  
Mask Ventilation ◽  
Single Centre ◽  
Randomised Study

IntroductionAlthough preoxygenation and airway management respond to precise algorithms, difficult intubation (DI) remains a daily challenge in intensive care units and in the operating rooms because of its frequent complications, including hypoxaemia. To prevent desaturation during DI, high-flow oxygenation by nasal cannula (HFNC) could prove beneficial. Indeed, contrary to standard preoxygenation device, it can be held in place throughout the intubation trying to perform apnoeic oxygenation during DI. Hence, recent guidelines recommend HFNC during DI, but its relevance has never been evaluated in this setting in a large randomised study until now.Methods and analysisThe PREOPTIDAM trial is a prospective, single-centre, randomised, controlled study in Nantes University Hospital. In anticipated DI, we hypothesised that HFNC can decrease the incidence of desaturation ≤94% or face mask ventilation from 16% to 4% compared with standard device. Using a two-sided t-test with a first species risk of 5% and 80% power, a total of 186 patients will be included. Using a computer-generated randomisation, with a 1:1 allocation ratio, patients will be randomised to HFNC or face mask preoxygenation. Randomisation will be stratified on intubation sequence: Rapid sequence intubation or awake fibreoptic intubation. The primary objective is to determine whether HFNC is more efficient than standard oxygenation techniques to prevent desaturation ≤94% or face mask ventilation during DI. Intent-to-treat and per-protocol analysis are planned for the primary outcome.Ethics and disseminationThe study project has been approved by an independent ethics committee. Written informed consent will be obtained before study inclusion. Participant recruitment begins in September 2018. Results will be submitted to international peer-reviewed medical journals.Trial registration numberNCT03604120.

Peak Airway Pressure Associated with Increased Transfusion in Lumbar Surgery

2012 ◽  
Vol 12 (9) ◽  
pp. S126-S127
Author(s):  
Ernest Y. Young ◽  
Navkirat Bajwa ◽  
Nicholas U. Ahn
Keyword(s):  
Airway Pressure ◽  
Peak Airway Pressure ◽  
Lumbar Surgery

The Effects of Neuromuscular Block on Peak Airway Pressure and Abdominal Elastance During Pneumoperitoneum

1997 ◽  
Vol XLI (3) ◽  
pp. 184
Author(s):  
DOMINIQUE CHASSARD ◽  
KHALID BERRADA ◽  
JEAN-PIERRE TOURNADRE ◽  
PAUL BOUL??TREAU
Keyword(s):  
Airway Pressure ◽  
Neuromuscular Block ◽  
Peak Airway Pressure
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