Pleural Complications in the Intensive Care Unit

Strange, Charlie

doi:10.1016/s0272-5231(05)70144-1

Cited by 38 publications

(38 citation statements)

References 72 publications

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“…The increase in tidal volume and peak inspiratory pressure during ventilation with a manually operated self-inflating resuscitation bag can cause complications such as barotraumas, (8,9) pneumothorax, (10,11) gastric/esophageal dilatation or rupture with the formation pneumoperitoneum, (12) and aspiration of gastric content. (13) These complications, when accompanied by certain clinical situations, are potentially fatal.…”

Section: Discussionmentioning

confidence: 99%

“…During the test, the respiratory rate used in each resuscitation bag was 12 breaths/min, and the operator used two-handed compression, since this is the protocol commonly used for ventilation with a resuscitation bag. (8,9,11,14) Under the resistance and compliance conditions used, the resuscitation bags in which the oxygen inflow is directed to the interior of the bag had the patient valve stuck at the inspiratory position when receiving oxygen at a rate ≥ 5 L/min, altering the tidal volume and peak inspiratory pressure delivered. This did not occur with the resuscitation bags in which the oxygen inflow is directed to the exterior of the bag.…”

Section: Discussionmentioning

confidence: 99%

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Alterações da pressão de pico inspiratório e do volume corrente fornecidos por reanimadores manuais com balão auto-inflável em função do fluxo de entrada de oxigênio utilizado

2008

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Objective: To assess possible alterations in the tidal volume and peak inspiratory pressure delivered by seven models of manually operated self-inflating resuscitation bags as a function of the oxygen supply rate used. Methods: The resuscitation bags tested were the following: Oxigel, models A and B; CE Reanimadores; ProtecSolutions; Missouri; Axmed; and Narcosul. For the measurements, a wall oxygen flow meter, a flow meter/respirometer, a resuscitation bag, a sensor (Tracer 5 unit), and a test lung were connected. In addition, the Tracer 5 unit was connected to a notebook computer. Oxygen supply rates of 1, 5, 10, and 15 L/min were used. Results: The tidal volume delivered by the Oxigel model A resuscitation bag when receiving oxygen at a rate of 15 L/min was approximately 99% greater than that delivered when receiving oxygen at a rate of 1 L/min. Similarly, peak inspiratory pressure was approximately 155% greater. Under the same conditions, the tidal volume delivered by the Narcosul resuscitation bag was 48% greater, and peak inspiratory pressure was 105% greater. The remaining resuscitation bags tested showed no significant alterations in the tidal volume or peak inspiratory pressure delivered. Conclusions: Under the resistance and compliance conditions used, the resuscitation bags in which the oxygen inflow is directed to the interior of the bag had the patient valve stuck at the inspiratory position when receiving oxygen at a rate ≥ 5 L/min, significantly increasing the tidal volume and peak inspiratory pressure delivered. This did not occur with the resuscitation bags in which the oxygen inflow is directed to the exterior of the bag. ResumoObjetivo: Determinar possíveis alterações do volume corrente e da pressão de pico inspiratório fornecidos por sete modelos de reanimador manual com balão auto-inflável em função do fluxo de entrada de oxigênio utilizado. Métodos: Os reanimadores testados foram: Oxigel,modelos A e B; CE Reanimadores; ProtecSolutions; Missouri; Axmed; e Narcosul. Para as aferições, acoplaram-se um fluxômetro de oxigênio de parede, um fluxômetro/respirômetro, um reanimador, um sensor (aparelho Tracer 5) e um pulmão-teste. Além disso, acoplou-se o aparelho Tracer 5 a um notebook. Utilizaram-se fluxos de entrada de oxigênio de 1, 5, 10 e 15 L/min. Resultados: O volume corrente fornecido pelo reanimador Oxigel modelo A ao receber 15 L/min de oxigênio foi aproximadamente 99% maior que o fornecido ao receber 1 L/min de oxigênio. Da mesma forma, a pressão de pico inspiratório foi 155% maior. Nas mesmas condições, o volume corrente fornecido pelo reanimador Narcosul foi 48% maior, e a pressão de pico inspiratório foi 105% maior. Os demais reanimadores testados não apresentaram alterações significativas do volume corrente e da pressão de pico inspiratório fornecidos. Conclusões: Nas condições de resistência e complacência utilizadas, os reanimadores em que o fluxo de entrada de oxigênio é direcionado diretamente ao interior do balão tiveram a válvula do paciente presa em posição de inspira...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alterações da pressão de pico inspiratório e do volume corrente fornecidos por reanimadores manuais com balão auto-inflável em função do fluxo de entrada de oxigênio utilizado

2008

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“…Patients who received mechanical ventilation have an approximate incidence of barotrauma of 4%-15% [4,13,19,25] . It has been reported that a 14%-87% incidence of pneumothorax occurs depending on severity and duration of ARDS and mode of ventilator for management [1,21,26] .…”

Section: Epidemiologymentioning

confidence: 99%

Iatrogenic pneumothorax related to mechanical ventilation

Hsu¹

2014

WJCCM

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ral space prevents sonographic visualization of visceral pleura movements. Mechanically ventilated patients with a pneumothorax require tube thoracostomy placement because of the high risk of tension pneumothorax. Small-bore catheters are now preferred in the majority of ventilated patients. Furthermore, if there are clinical signs of a tension pneumothorax, emergency needle decompression followed by tube thoracostomy is widely advocated. Patients with pneumothorax related to mechanical ventilation who have tension pneumothorax, a higher acute physiology and chronic health evaluation Ⅱ score or PaO2/FiO2 < 200 mmHg were found to have higher mortality.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved. Key words: Barotrauma; Complication; Critical care; Mechanical ventilation; PneumothoraxCore tip: Patients with pneumothorax related to mechanical ventilation (PRMV) have a high mortality rate. PRMV often occurs in the early stage of mechanical ventilation and it may recur on the other side of lung in a short period of time. Low compliance is associated with a high incidence of PRMV, with PRMV being more related to the underlying process than the ventilatory setting. PRMV patients with tension pneumothorax, higher acute physiology and chronic health evaluation score or PaO2/FiO2 < 200 mmHg have a higher mortality.Hsu CW, Sun SF. Iatrogenic pneumothorax related to mechanical ventilation.

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“…Empyema is a rare diagnosis in critically ill patients because most patients have received antibiotics (that easily penetrate pleural space) for pneumonia thus preventing the progression of the pleural space infection [58]. Nevertheless, empyema becomes more likely if there is suspected fluid collection as well as pneumonia.…”

Section: Empyemamentioning

confidence: 99%

Pleural Effusions in Critically Ill Patients

Pneumatikos

Bouros²

2008

Respiration

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Pleural effusions (PEs) are common in critically ill patients mainly as a consequence of severe cardiopulmonary disorders frequently encountered in these patients. Their impact on the pathophysiology of acute respiratory failure remains unknown. They are usually small and uncomplicated transudates that are easily overlooked on a supine portable chest X-ray and do not require drainage or infectious exudates that always require thoracocentesis. The diagnosis of PEs in critically ill patients has been revolutionized with the advent of chest ultrasound allowing easy bedside quantification of pleural fluid and making thoracocentesis a safe procedure especially in high-risk patients on mechanical ventilation. CT provides a much more accurate evaluation of the size and location of PEs and is extremely helpful in the guidance of catheters into loculated fluid collections. Hemothorax in critically ill patients is usually related to trauma or surgical interventions and requires early drainage and possibly surgical exploration.

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Pleural Complications in the Intensive Care Unit

Cited by 38 publications

References 72 publications

Alterações da pressão de pico inspiratório e do volume corrente fornecidos por reanimadores manuais com balão auto-inflável em função do fluxo de entrada de oxigênio utilizado

Alterações da pressão de pico inspiratório e do volume corrente fornecidos por reanimadores manuais com balão auto-inflável em função do fluxo de entrada de oxigênio utilizado

Iatrogenic pneumothorax related to mechanical ventilation

Pleural Effusions in Critically Ill Patients

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