Document Detail


Differential ventilation in acute respiratory failure. Indications and outcome.
MedLine Citation:
PMID:  3890989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute respiratory failure (ARF) is a life-threatening condition which frequently requires ventilatory support. Many patients die of hypoxaemia despite a high inspired oxygen concentration and application of general positive end-expiratory pressure (PEEP). Differential ventilation has been used in selected patients with unilateral lung disease or with large inequalities in pathology between the two lungs. An important contributor to the hypoxaemia is a vertical inequality in the ventilation-perfusion (V/Q) matching. This can be compensated for by placing the patient in the lateral position, ventilating each lung separately in proportion to its assumed blood flow, and applying PEEP selectively to the dependent lung to counteract airway closure and alveolar collapse and thus improve the gas distribution within that lung. This ventilatory regime should promote V/Q matching better than general PEEP, and will not impede cardiac output. Major improvement in gas exchange has been achieved in short-term experiments and in prolonged ventilator treatment of patients with ARF.
Authors:
G Hedenstierna; S Baehrendtz; C Frostell; C Mebius
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Bulletin européen de physiopathologie respiratoire     Volume:  21     ISSN:  0395-3890     ISO Abbreviation:  Bull Eur Physiopathol Respir     Publication Date:    1985 May-Jun
Date Detail:
Created Date:  1985-08-19     Completed Date:  1985-08-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7605263     Medline TA:  Bull Eur Physiopathol Respir     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  281-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Anoxia / etiology
Female
Humans
Male
Middle Aged
Oxygen / blood
Positive-Pressure Respiration
Posture
Pulmonary Gas Exchange
Respiration, Artificial / methods*
Respiratory Insufficiency / complications,  physiopathology,  therapy*
Tidal Volume
Ventilation-Perfusion Ratio
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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