Benefits from PCV (lower work of breathing and patient comfort)usually comes from decelerating flow waveform and benefits from VCV are related to reducing volutrauma
The majority of otherwise healthy patients are capable to successfully compensate for these changes, but obese patients and those with chronic respiratory diseases are susceptible to development of numerous complications such as intraoperative hypoxia, barotrauma and volutrauma
during laparoscopic procedures (1).
Lung damage is often exacerbated by volutrauma
, hyperoxia and mechanical ventilation.
sup] However, because of barotrauma, volutrauma
, and biotrauma, MV could cause or aggravate acute lung injury not only in acute respiratory distress syndrome (ARDS) patients but also in patients with normal lung function.
Pressure-controlled mechanical ventilation, to avoid barotraumas or volutrauma
, is recommended14.
T] could lead to volutrauma
and/or barotrauma which may not be apparent clinically.
1,5) Seja qual for o metodo selecionado, o importante e o ajuste do metodo para evitarmos hiperinsuflacao dinamica, volutrauma
, barotrauma, atelectasia e toxicidade por oxigenio (quando usamos Fi[O.
may develop from increased airway pressure with alveolar over-distension, or from shear forces applied during opening and closing of small airways.
Os efeitos negativos da ventilacao com altos volumes e pressao foram demonstrados em animais e o conceito de repouso pulmonar foi progressivamente aceito (2) em consequencia a tais resultados e nos anos 90, adotou-se a utilizacao de baixos volumes correntes (6 a 7 ml/kg) para evitar danos provocados pela ventilacao mecanica, como o volutrauma
Differences in the performance of VHI, such as inspiratory flow rates, plateau time, peak pressures and volumes delivered, raise concerns about the efficacy of treatment and patient safety with regards to barotrauma and volutrauma
Ventilator strategies include tidal volumes of 10 to 12ml/kg for limiting volutrauma
, respiratory rates up to 14 breaths/minute for maintaining normocapnia, and positive end-expiratory pressure of 5 to 10cm H2O for improving oxygenation.
This is especially true with increasing awareness of the complications of mechanical ventilation, such as barotrauma, volutrauma