Pressure controlled ventilation (PCV) is an alternative mode of ventilation which is used widely in severe respiratory failure. In this study, PCV was used for one-lung anaesthesia and its effects on airway pressures, arterial oxygenation and haemodynamic state were compared with volume controlled ventilation (VCV). We studied 48 patients undergoing thoracotomy. After two-lung ventilation with VCV, patients were allocated randomly to one of two groups. In the first group (n = 24), one-lung ventilation was started by VCV and the ventilation mode was then switched to PCV. Ventilation modes were performed in the opposite order in the second group (n = 24). We observed that peak airway pressure (P = 0.000001), plateau pressure (P = 0.01) and pulmonary shunt (P = 0.03) were significantly higher during VCV, whereas arterial oxygen tension (P = 0.02) was significantly higher during PCV. Peak airway pressure (Paw) decreased consistently during PCV in every patient and the percentage reduction in Paw was 4-35% (mean 16.1 (SD 8.4) %). Arterial oxygen tension increased in 31 patients using PCV and the improvement in arterial oxygenation during PCV correlated inversely with preoperative respiratory function tests. We conclude that PCV appeared to be an alternative to VCV in patients requiring one-lung anaesthesia and may be superior to VCV in patients with respiratory disease.

The present study discusses the demystification of the urban sublime in Paul Auster’s In the Country of Last Things. It sets the term in a US context and discusses its specificity through the examination of the relationship of the urban sublime with a pair of interrelated concepts: the technological sublime and the consumer’s sublime. This theoretical preview verifies that the architectural and technological structure of the city has been subordinated to the logics of capitalist economy. The paper evaluates Auster’s novel as a critique of the deferential elevation of the urban landscape through its reduction to the dystopian images of garbage and waste; through the reversal of the object of the sublime from the infinitely large to the infinitely small, from the urban to the natural; and through the subversion of the power dynamics attributed to the skyscraper, the central emblem of the urban sublime. It asserts that the foregrounding of the act of falling, set against the pronounced upward orientation of the urban landscape, defines the city as an inherently lethal area capable of arousing a single passion linked to the notion of the sublime—terror.