Comparisons of Mechanical Power and Respiratory Mechanics in Pressure-Controlled Ventilation and Volume-Controlled Ventilation during Laparoscopic Cholecystectomy in Elderly Patients

Jo, Youn Yi; Chang, Young Jin; Lee, Dong Chul; Kim, Yong Beom; Jung, Junsu; Kwak, Hyun Jeong

doi:10.3390/jpm13020201

Cited by 4 publications

(1 citation statement)

References 35 publications

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“…Additionally, in recent years, various mechanical ventilation modes have been developed and employed in the clinical practice, with primary aim to optimize patient-ventilator interaction and minimize ventilator-induced lung injury (VILI). Among these, volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) are the two commonly used modes in treating critically ill patients with respiratory failure[ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

Wang,

Zhou,

Zhang

2023

World J Clin Cases

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Fasting during the month of Ramadan is one of the five fundamental principles of Islam, and it is obligatory for healthy Muslim adults and adolescents. During the fasting month, Muslims usually have two meals a day, suhur (before dawn) and iftar (after dusk). However, diabetic patients may face difficulties when fasting, so it is important for medical staff to educate them on safe fasting practices. Prolonged strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis, but with proper knowledge, careful planning, and medication adjustment, diabetic Muslim patients can fast during Ramadan. For this review, a literature search was conducted using PubMed and Google Scholar until May 2023. Articles other than the English language were excluded. Current strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition, regular monitoring of blood glucose, medications, and insulin therapy. Insulin therapy can be continued during fasting if properly titrated to the patients’ needs, and finger prick blood sugar levels should be assessed regularly. If certain symptoms such as hypoglycemia, hyperglycemia, dehydration, or acute illness occur, or blood glucose levels become too high (> 300 mg/dL) or too low (70 mg/dL), the fast should be broken. New insulin formulations such as pegylated insulin and medications like tirzepatide, a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors, have shown promise in managing blood sugar levels during Ramadan. Non-insulin-dependent medications like sodium-glucose-cotransporter-2 inhibitors, including the Food and Drug Administration-approved ertugliflozin, are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.

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Section: Introductionmentioning

confidence: 99%

Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

Wang,

Zhou,

Zhang

2023

World J Clin Cases

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Current Concepts in Intraoperative Ventilation during Anesthesia for Laparoscopic and Robot–Assisted Surgery – a Narrative Review

Jimenez-Santana,

Díaz-Cambronero,

Schultz

et al. 2024

Curr Anesthesiol Rep

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Purpose of Review Laparoscopic and robot–assisted procedures have become preferred over open abdominal surgery due to their numerous benefits, such as reduced postoperative pain, lower infection risk, and quicker recovery. However, these techniques pose unique challenges for intraoperative ventilation due to the need for CO2 insufflation to create a pneumoperitoneum and specific patient positioning, both of which adversely affect respiratory mechanics. This narrative review aims to summarize these challenges and describes current strategies to overcome them. Recent Findings Implementing lung–protective ventilation with low tidal volumes and personalized PEEP, along with measures to reduce mechanical power of ventilation, have been shown to reduce postoperative pulmonary complications (PPCs). Summary Effective and safe intraoperative ventilation during laparoscopic and robot–assisted surgery requires a nuanced understanding of respiratory mechanics and tailored ventilation strategies. Lung-protective ventilation is crucial for minimizing lung injury and optimizing patient outcomes.

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Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial

Qi,

Fan,

Wang

et al. 2023

BMC Anesthesiol

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Background Based on electroencephalogram (EEG) analysis, index of consciousness (IoC) monitoring is a new technique for monitoring anesthesia depth. IoC is divided into IoC1 (depth of sedation) and IoC2 (depth of analgesia). The potential for concurrent monitoring of IoC1 and IoC2 to expedite postoperative convalescence remains to be elucidated. We investigated whether combined monitoring of IoC1 and IoC2 can effectively enhances postoperative recovery compared with bispectral index (BIS) in elderly patients undergoing laparoscopic urological surgery under general anesthesia. Methods In this prospective, controlled, double-blinded trail, 120 patients aged 65 years or older were arbitrarily assigned to either the IoC group or the control group (BIS monitoring). All patients underwent blood gas analysis at T1 (before anesthesia induction) and T2 (the end of operation). The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were administered to all patients at T0 (1 day before surgery) and T4 (7 days after surgery). Serum concentrations of C-reactive protein (CRP) and glial fibrillary acid protein (GFAP) were assessed at T1, T2, and T3 (24 h after surgery). Postoperative complications and the duration of hospitalization were subjected to comparative evaluation. Results The incidence of postoperative cognitive dysfunction (POCD) was notably lower in the IoC group (10%) than in the control group (31.7%) (P = 0.003). Postoperative serum CRP and GFAP concentrations exhibited significant differences at time points T2 (CRP: P = 0.000; GFAP: P = 0.000) and T3 (CRP: P = 0.003; GFAP: P = 0.008). Postoperative blood glucose levels (P = 0.000) and the overall rate of complications (P = 0.037) were significantly lower in Group IoC than in Group control. Conclusion The employment of IoC monitoring for the management of elderly surgical patients can accelerate postoperative convalescence by mitigating intraoperative stress and reducing peripheral and central inflammatory injury. Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR1900025241 (17/08/2019).

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Comparisons of Mechanical Power and Respiratory Mechanics in Pressure-Controlled Ventilation and Volume-Controlled Ventilation during Laparoscopic Cholecystectomy in Elderly Patients

Cited by 4 publications

References 35 publications

Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure

Current Concepts in Intraoperative Ventilation during Anesthesia for Laparoscopic and Robot–Assisted Surgery – a Narrative Review

Index of consciousness monitoring during general anesthesia may effectively enhance rehabilitation in elderly patients undergoing laparoscopic urological surgery: a randomized controlled clinical trial

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