Protection of upper respiratory tract of patient in conditions of respiratory support: current state of issue

Власенко, А. В.; Koryakin, A. G.; Evdokimov, E. A.; Eryomin, D. A.

doi:10.33667/2078-5631-2019-1-16(391)-30-36

Cited by 6 publications

(2 citation statements)

References 53 publications

(24 reference statements)

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“…В клинической практике устоявшимся способом обеспечения оксигенации при ОЛВ является подача кислорода с постоянным положительным давлением в независимое легкое [1,2]. Независимое легкое постепенно раздувается потоком кислорода, создавая в дыхательных путях постоянное положительное давление за счет клапана давления.…”

Section: Introductionunclassified

Comparison of the efficacy of high-flow oxygen insufflations and continuous positive airway pressure during one-lung ventilation undergoing video-assisted thoracoscopic surgery

Farshatov

Ershov²,

Щеголев³

2023

Vestn. anesteziol. reanimatol.

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Isolation of one-lung leads to ventilation-perfusion mismatch and increases intrapulmonary shunt, which in some cases may lead to clinically significant hypoxemia.The objective was to compare the efficacy of hypoxemia correction and the convenience of surgical work during one-lung ventilation with the use of high-flow oxygen insufflation (HFI) and continuous positive airway pressure (CPAP) in the non-ventilated lung during video-assisted thoracoscopic surgery (VATS).Materials and methods. The study included 60 patients who underwent surgical intervention in the form of VATS lobectomy. All studied patients were randomly divided into two groups: group 1 included patients who received HFI into non-ventilated lung to correct hypoxemia, and group 2 – CPAP into non-ventilated lung. The study was divided into four stages. Stage I – two-lung ventilation. Stage II – one-lung ventilation. At stage III, HFI of 60 L/min (FiO2 = 0,5) into non-ventilated lung was used to correct hypoxemia in group 1, and CPAP of 5 cm H2O into non-ventilated lung was used in group 2. At stage IV, HFI of 30 L/min (FiO2 = 0,5) into non-ventilated lung was used to correct hypoxemia in group 1, and CPAP of 2 cm H2O into non-ventilated lung was used in group 2. The following parameters were recorded during the stages of the study: PaO2, PaCO2, SpO2, Qs/Qt, and surgical team satisfaction with lung collapse by 10-point visual analogue scale (VAS).Results. At stages I and II, there was no statistically significant difference between groups in such parameters as PaO2, PaCO2, SaO2, and SpO2 (p > 0.05). Starting from stage III, a statistically significant difference between the two groups was found for a parameter PaO2 (U 26.0; Z = –6.27; p < 0.001). For group 1, it was equal to 134.5 (126.0; 141.75) and for group 2 – 108.5 (104.0; 114.5) correspondingly. At stage IV, the values of PaO2 were higher in group 1: 118.5 (113.0; 122.25) vs 92.5 (89.0; 98.25) in group 2 (U 0.0; Z = –6.66; p < 0.001). When comparing PaCO2 between the two groups, there were no statistically significant differences at all stages (p > 0.35). When comparing SaO2 at stages I (U 450.0; Z = 0.0; p = 1.0), II (U 422.5; Z = –0.4; p = 0.69), III (U 339.0; Z = –1.8; p = 0.69), no statistically significant differences were indicated between the two groups. However, at stage IV, the value of SaO2 was higher (97 (96; 97)) in group 1 than in group 2 (94 (94; 95)), U 69.5; Z = –5.75; p < 0.001. When comparing SpO2 between the two groups, there was no statistical difference at all stages (p > 0.69). Comparing the two groups by such indicator as Qs/Qt, no statistically significant differences were found at the first three stages (p > 0.4). A comparison of Qs/Qt at stage IV revealed statistically significant differences (U 69.0; Z = –5.6; p < 0.001). This parameter was equal to 10.7% (9.5; 15.7) in group 1 and 21.3% (18.4; 23.9) in group 2 correspondingly. When assessing surgical team satisfaction levels with surgical field visualization by VAS, there were statistically significant differences between group 1 and group 2 at stage III (p < 0.001) and stage IV (p < 0.001). The satisfaction level was significantly higher in group 1.Conclusions. The usage of high-flow oxygen insufflation during one-lung ventilation undergoing VATS allows to effectively correcting hypoxemia similar to the CPAP method, but as opposed to CPAP, it can provide comfortable conditions for carrying out the surgical procedures.

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Section: Introductionunclassified

Comparison of the efficacy of high-flow oxygen insufflations and continuous positive airway pressure during one-lung ventilation undergoing video-assisted thoracoscopic surgery

Farshatov

Ershov²,

Щеголев³

2023

Vestn. anesteziol. reanimatol.

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“…Увлажнение вдыхаемых газов оптимально, когда граница изотермического насыщения возвращается в исходное положение, чтобы моделировать условия, которые обычно преобладают в ды-хательных путях [17]. У человека температура во рту составляет приблизительно 32 °C, а средняя абсолютная влажность во рту, которая считается оптимальной, составляет 27,3 мг H 2 O/л.…”

Section: Introductionunclassified

External humidifier for ventilator: PID control based on the Ziegler-Nichols method

Lipchak¹,

Dushkina²,

Chupov³

2020

UREJ

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Due to the ubiquitous spread of SARS-CoV-2 coronavirus infection, the demand for anaesthesia and respiratory devices has significantly increased since the beginning of 2020. In particular, artificial ventilation devices, inhalation anaesthesia devices, or oxygen inhalers. The respiratory support devices must include special medical devices designed to heat and increase the moisture content of the respiratory mixture supplied to the patient from the respiratory therapy apparatus. These medical devices are known to as humidifiers. The production of a humidifier for breathing mixtures “TEVLAR” – “UOMZ” according to TU 32.50.21-121-07539541-2018 with accessories was organized jn the territory of Joint Stock Company “Production Association “Urals Optical & Mechanical Plant” named after Mr. E. S. Yalamov”. The electronic measuring instruments unit of the device has been modified within the framework of the project for the modernization of the humidifier of breathing mixtures “TEVLAR” – “UOMZ”. In particular, in order to increase the accuracy of thermal stability of the heating element when heating the breathing mixtures to the target temperature, the software of the electronic measuring instruments unit was modernized by the Medical Devices Design Bureau, namely, the stable PID controller was implemented and tuned. Thus, this article provides an overview of the methods for tuning the PID controller, justifies the choice of PID tuning by the Ziegler-Nichols method and also provides the experimental results to confirm device operation stability.

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Contemporary principles of hypoxia management in case of ARDS of various origin. Part 1

Власенко

Evdokimov

Rodionov

2020

Vestn. anesteziol. reanimatol.

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The review summarizes data on contemporary approaches to diagnosis, prevention and treatment of severe acute parenchymal respiratory failure of various origins including in acute respiratory distress syndrome (ARDS) caused by bacterial and viral pneumonia. It is based on the data of modern properly organized studies, an analysis of international clinical guidelines with a high degree of evidence, as well as the results of many years of own experimental research and clinical observations of treatment of patients with ARDS of various origin, including those with viral pneumonia in 2009–2016–2020. The article states scientifically-based procedures for prevention, differential diagnosis and personalized treatment of severe acute respiratory failure with the use of innovative medical technologies and a wide range of respiratory treatments. The authors did their best to adapt specific proposals for everyday clinical practice.

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Protection of upper respiratory tract of patient in conditions of respiratory support: current state of issue

Cited by 6 publications

References 53 publications

Comparison of the efficacy of high-flow oxygen insufflations and continuous positive airway pressure during one-lung ventilation undergoing video-assisted thoracoscopic surgery

Comparison of the efficacy of high-flow oxygen insufflations and continuous positive airway pressure during one-lung ventilation undergoing video-assisted thoracoscopic surgery

External humidifier for ventilator: PID control based on the Ziegler-Nichols method

Contemporary principles of hypoxia management in case of ARDS of various origin. Part 1

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