Document Detail

Differential ventilation with low-flow CPAP and CPPV in the treatment of unilateral chest trauma.
MedLine Citation:
PMID:  2661616     Owner:  NLM     Status:  MEDLINE    
A case of severe unilateral chest trauma with bronchopleural fistula is presented. Ventilatory therapy consisted of asynchronous independent lung ventilation (AILV). The injured lung was ventilated with intermittent positive pressure ventilation (IPPV) [tidal volume (TV) = 200 ml, f = 25/min, I:E = 0.5, minute volume (MV) = 5.0 l/min, FiO2 = 0.4], and the unaffected lung was ventilated with continuous positive pressure ventilation (CPPV) (TV = 600 ml, f = 12/min, I:E = 0.5, MV = 7.2 l/min, PEEP = 0.5 kPa, FiO2 = 0.4). Adequate gas exchange was obtained (PaO2 = 14.5 +/- 2.3 kPa, PaCO2 = 5.5 +/- 0.7 kPa), but high air leakage volumes persisted. Thus, differential low-flow CPAP (V = 5.0-7.5 l/min, PEEP = 0.5 kPa, FiO2 = 0.4) of the injured lung and CPPV (TV = 600 ml, f = 12/min, MV = 7.2 l/min, I:E = 0.5, PEEP = 0.5 kPa, FiO2 = 0.4) of the unaffected lung was applied for 36 hours. Further deterioration of pulmonary function was prevented, and the bronchopleural fistula closed after several hours. After another period of AILV the patient was treated with conventional mechanical ventilation, and finally weaned with high-flow CPAP.
M Wendt; T Hachenberg; G Winde; P Lawin
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Intensive care medicine     Volume:  15     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1989  
Date Detail:
Created Date:  1989-08-01     Completed Date:  1989-08-01     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  209-11     Citation Subset:  IM    
Clinic for Anesthesiology, Westfälische Wilhelms-Universität, Münster, FRG.
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MeSH Terms
Bronchial Fistula / etiology,  radiography,  therapy
Pleural Diseases / etiology,  radiography,  therapy
Positive-Pressure Respiration*
Thoracic Injuries / complications,  radiography,  therapy*

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