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Independent lung ventilation as a protective strategy in unilateral lung disease in children

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Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Independent Lung Ventilation (ILV) may be viewed as a lung protective ventilation strategy, since it avoids the overinflation of the healthy lung and allows adequate ventilation of the diseased lung. The aim of this paper is to provide a review of ILV as a protective strategy for the treatment of pediatric respiratory failure due to unilateral lung disease. An analysis of the literature regarding ventilator-associated lung injury, pathophysiology of unilateral lung disease and the efficacy of independent lung ventilation in the pediatric population was carried out. After an overview of unilateral lung disease and initial experience with ILV, the following topical areas are addressed: technique of selective bronchial intubation, mechanical ventilation and ventilator setting, and speculations about the future. Unilateral lung diseases can be treated successfully using SILV. In addition, SILV allows to selectively instilling into the lung medications such as surfactant. Despite its attractive characteristics, ILV has some drawbacks that still limit its use. Investigation in under way trying to simplify the technique and make it more accessible.
Twórcy
autor
  • Departament of Anesthesia & Intensive Care, Pediatric Intensive Care Unit, "Fatebenefratelli" & Ophtalmiatric Hospital, Milano, Italy
  • Departament of Anesthesia & Intensive Care, Pediatric Intensive Care Unit, "Fatebenefratelli" & Ophtalmiatric Hospital, Milano, Italy
  • Departament of Anesthesia & Intensive Care, Pediatric Intensive Care Unit, "Fatebenefratelli" & Ophtalmiatric Hospital, Milano, Italy
Bibliografia
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  • [3] Tremblay L. N., Valenza F., Ribeiro S.P. et al.: Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. J. Clin. Invest. 1997, 99, 944-952.
  • [4] Ranieri V. M., Suter P. M., Tortorella C., et al.: Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 1999, 282, 54-61.
  • [5] Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N. Engl. J. Med. 2000. 342, 1302-1308.
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  • [7] Verbrugge S.J.C., Bohm S.H., Gommers D., et al.: Surfactant impairment after mechanical ventilation with large alveolar surface area changes and the effects of positive end-expiratory pressure. Br. J. Anaesth. igg8, 80, 360-364.
  • [8] Carlon G.C., Ray C., Klein R., et al.: Criteria for selective positive end-expiratory pressure and independent synchronized ventilation of each lung. Chest 1078, 74, 501.
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  • [12] Baehrendtz S., Santesson J., Bindselv L., et al.: Differential ventilation in acute bilateral lung disease. Influence on gas exchange and central hemodynamic. Acta Anaesthesiol. Scand. 1083, 27, 270.
  • [13] Darowski M., Hedenstierna G., Baehrendtz S.: Development and evaluation of a flow-dividing unit for differential ventilation and selective PEEP. Acta Anaesthesiol. Scand. 1085, 20, 61.
  • [14] Hedenstierna G., Baehrendtz S., Frostell C., et al.: Differential ventilation in acute respiratory failure: indications and outcome. Bull. Eur. Physiopathol. Respir. 1085, 21, 281.
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  • [16] Marraro G.: The present technical possibilities for synchronized independent lung ventilation in pediatric age. Intensive Care Med. 1086, 12 (suppl.), 273.
  • [17] Marraro G.: Synchronized independent lung ventilation in pediatric age. Applied Cardiopulm. Pathophys. 1087, 2, 283.
  • [18] Marraro G., Marinari M., Rataggi M., et al.: Synchronized independent lung ventilation (SILV) and selective positive end-expiratory pressure: effects on children with lung pathology with monolateral prevalence. Intensive Care Med. 1086, 12, 273.
  • [19] Marraro G., Marinari M., Rataggi M.: The clinical application of synchronized independent lung ventilation in pulmonary disease with unilateral prevalence in pediatrics. J. Clin. Monit. Comput. 1087, 4, 123.
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  • [22] Marraro G.: Selective endobronchial intubation in paediatrics: the Marraro Paediatric Bilumen Tube. Paediatric Anaesthesia 1004, 4, 255.
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-article-BPZ1-0003-0051
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