Pressure control ventilation and minitracheotomy in treating severe flail chest trauma

Gregoretti, Cesare; Beltrame, Fabio; Giugiaro, P. M.; Biolino, Piera; Burbi, Laura; Turello, Marina; Agostini, Fulvio; Berardino, Maurizio; Musto, P.

doi:10.1007/bf01700674

Cited by 36 publications

(35 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among them the experience and familiarity to NIV use, which hypoxemic patient do we have to prefer to undergo NIV (i.e. ARDS vs non ARDS), which patients should need immediate IMV, inspiratory synchronization especially when high VT is undesirable Maybe, we can reason in another way starting a new soccer game: late vs early extubation (using NIV as tool to early extubate our patients) in hypoxemic patients to prevent IMV complications (23)(24)(25).…”

Section: Associate Editor Nahit çAkarmentioning

confidence: 99%

Noninvasive Ventilation in Hypoxemic Patients: an Ongoing Soccer Game or a Lost One?

Gregoretti¹,

Cortegiani²,

Raineri³

et al. 2018

Turk J Anaesth Reanim

View full text Add to dashboard Cite

Section: Associate Editor Nahit çAkarmentioning

confidence: 99%

Noninvasive Ventilation in Hypoxemic Patients: an Ongoing Soccer Game or a Lost One?

Gregoretti¹,

Cortegiani²,

Raineri³

et al. 2018

Turk J Anaesth Reanim

View full text Add to dashboard Cite

“…GREGORETTI et al [4] have recently reported the use of pressure control ventilation delivered through a minitracheotomic cannula as an alternative to conventional tracheal ventilation to treat severe flail chest. They found that this method could achieve a suitable gas exchange and provide stabilization in a flail chest condition, at the same time reducing the side-effects of tracheal intubation.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical stabilization has also been suggested for severe flail chest, but its use has been questioned due to complications [3]. Other forms of achieving pneumatic stabilization have developed in recent years, including the use of mini-invasive [4] and noninvasive techniques [5]. These methods of achieving pneumatic stabilization are reliable and are now widely practised [4][5][6].…”

mentioning

confidence: 99%

“…Other forms of achieving pneumatic stabilization have developed in recent years, including the use of mini-invasive [4] and noninvasive techniques [5]. These methods of achieving pneumatic stabilization are reliable and are now widely practised [4][5][6]. Hence, there has been a change in attitude and management practice over the years from the traditional invasive methods to the current less invasive or noninvasive techniques.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Use of bilevel positive airway pressure ventilatory support for pathological flail chest complicating multiple myeloma

Abisheganaden¹,

Chee²,

Wang³

1998

Eur Respir J

View full text Add to dashboard Cite

Multiple myeloma is a common disease that universally involves the skeletal system. Although rib involvement may occur, the development of pathological flail chest is rare. We describe the treatment and course of this condition in an elderly female, and the use of the bilevel positive airway pressure (BiPAP) ventilatory system in providing pneumatic stabilization, while definitive chemotherapy was given to heal the pathological fractures. Our experience with this patient suggests that, despite its dramatic clinical manifestation, the association of flail chest with multiple myeloma may not predict a poor prognosis. We have also found that pneumatic stabilization can be achieved by using the bilevel positive airway pressure ventilatory support through a tracheostomy.

show abstract

“…[7][8][9] Patients with acute respiratory failure who failed mask ventilation were randomized to either conventional mechanical ventilation through a cuffed orotracheal tube, or transtracheal open ventilation, defined as ventilatory support through an uncuffed mini-tracheostomy tube. Mechanical ventilation was delivered using a pressure control mode.…”

Section: Résultatsmentioning

confidence: 99%

Translaryngeal open ventilation to treat acute respiratory failure in acute exacerbation of chronic obstructive pulmonary disease. A preliminary report

Skrobik

Gregoretti²

2001

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: To describe a minimally invasive alternative to conventional mechanical ventilation, using a small size uncuffed nasotracheal tube (translaryngeal open ventilation) paired with pressure control ventilation, in acute respiratory failure complicating chronic obstructive pulmonary disease (COPD).Clinical features: Two cooperative COPD patients, who failed noninvasive mechanical ventilation, were intubated nasotracheally. Mechanical ventilation was initiated in pressure control mode via an uncuffed 6 mm tube.Results: Respiratory rate improved after 1 hour (from 44 to 28 breaths·min -1 in case 1 and from 32 to 25 breaths·min -1 in case 2); PaC0 2 decreased (from 120 to 62 mmHg in case 1 and from 69 to 51 mmHg in case 2); with pressure control mode levels of 45 cm H 2 O and 55 cm H 2 O respectively. PaO 2 increased from 40 mmHg (with FIO 2 0.3) to 55 mmHg (with FIO 2 0.3) in the first patient and from 55 mmHg (with FIO 2 0.4) to 60 mmHg (with F IO 2 0.4 ) in the second patient; pH improved from 7.18 to 7.31 in case 1 and from 7.22 to 7.39 in case 2. Patients were able to trigger the ventilator, speak, swallow and to clear secretions spontaneously. Both patients were ventilated for three days in this manner without any adverse effects. Both survived and were discharged home after 20 and 18 days in hospital respectively.Conclusion: This very preliminary report suggests that, in carefully selected patients who fail mask ventilation, mechanical support with translaryngeal open ventilation can improve gas exchange, breathing pattern and tachypnea, without hindering glottic function.

show abstract

Pressure control ventilation and minitracheotomy in treating severe flail chest trauma

Abstract: We conclude that a suitable gas exchange and pneumatic stabilization in a flail chest condition can be achieved using minitracheostomic ventilation. At the same time, this treatment could reduce some side effects of traditional tracheal intubation.

Cited by 36 publications

References 7 publications

Noninvasive Ventilation in Hypoxemic Patients: an Ongoing Soccer Game or a Lost One?

Noninvasive Ventilation in Hypoxemic Patients: an Ongoing Soccer Game or a Lost One?

Use of bilevel positive airway pressure ventilatory support for pathological flail chest complicating multiple myeloma

Translaryngeal open ventilation to treat acute respiratory failure in acute exacerbation of chronic obstructive pulmonary disease. A preliminary report

Contact Info

Product

Resources

About