Respiratory mechanics in the open chest: effects of parietal pleurae

Hemodynamic effect of sustained pulmonary hyperinflation in patients after cardiac surgery: open vs. closed chest

“…In addition, in our study the pericardium and the pleurae were opened (both pleurae in one and the left pleura in the other patients), and the results might have been different if the pericardium and the pleurae had been intact. However, when the pericardium and the pleurae are intact, the pleurae produce resistance towards lung expansion as well as the caval veins being exposed to the normal pericardial pressure (29). Thus, theoretically, with intact pleurae and pericardium, the hemodynamic effects of a pulmonary hyperinflation would be even more equal between the open and closed chest conditions than seen in our study.…”

A importância da pressão pleural na avaliação da mecânica respiratória

“…They were able to record concomitant oscillations of esophageal and airway pressures, thus validating esophageal balloon position 38 . Barnas et al have performed abdominal compressions associated to airway occlusion in 13 anesthetized paralyzed patients in the postoperative period of cardiac procedures, validating the balloon technique 39 . A study with 1.5 cm catheter-balloon system positioned in the esophagus at 2-cm intervals has analyzed esophageal pressure along intra-thoracic and cervical segments of healthy humans.…”

“…Nesse estudo, puderam ser registradas as oscilações concomitantes das pressões esofágica e de via aérea, validando a posição do balão esofágico 38 . Barnas e col. realizaram compressões abdominais, associadas à oclusão da via aérea em 13 pacientes anestesiados e paralisados no pós-operatório de cirurgia cardíaca, validando a técnica do balão 39 . Estudo realizado utilizando sistema cateter-balão de 1,5 cm, posicionado no esôfago, em intervalos de 2 cm, analisou a pressão esofágica ao longo dos segmentos intratorácicos e cervical em seres humanos saudáveis.…”

Mechanical ventilation and cardiopulmonary bypass: a narrative review of the mechanistic lung protective measures

“…Numerous reports describe the association between the surgical technique and changes in respiratory mechanics and lung function [22,[29][30][31][32][33] . Median sternotomy disrupts sternum integrity, provokes chest wall instability (i.e., uncoordinated rib cage expansion, decrease compliance), and reduces lung volumes with subsequent impaired pulmonary mechanics [29,31] .…”