Pulmonary complications following cardiopulmonary bypass (CPB) are relatively common, with up to 12% of patients experiencing acute lung injury (ALI). The treatment for ALI or acute respiratory distress syndrome (ARDS) is primarily supportive with specific modes of mechanical ventilation. We report a 46-year-old man withARDS after cardiac surgery whose arterial oxygenation was surprisingly impr...

INTRODUCTION Lung fibrosis, reduced lung compliance, and severe hypoxemia found in patients with acute lung injury often result in a need for the support of mechanical ventilation. High-tidal-volume mechanical ventilation can increase lung damage and fibrogeneic activity but the mechanisms regulating the interaction between high tidal volume and lung fibrosis are unclear. We hypothesized that h...

The most commonly used mode of noninvasive mechanical ventilation (NMV) is volume-controlled intermittent positive pressure ventilation (IPPV). Pressure support ventilation has recently become increasingly popular, but its merits have not been clearly defined. In an open, nonrandomized follow-up study, we evaluated two modes of NMV, volume-controlled (IPPV) and pressure-controlled ventilation (...

PEEP was described to improve oxygenation in ventilated patients with ARDS in 1967,1 although the mechanism of action was not clear. The potential benefits of lung volume recruitment maneuvers became apparent from results of a randomized controlled trial of mechanical ventilation of patients with ARDS in 1998.2 Since that time there has been a proliferation of literature in the area of lung vol...

UNLABELLED The Laryngeal Tube is a new supraglottic ventilatory device for airway management. It has been developed to secure a patent airway during either spontaneous or mechanical ventilation. In this study, we sought to determine the effectiveness of the Laryngeal Tube for primary airway management during routine surgery with mechanical ventilation. One-hundred-seventy-five subjects classifi...

BACKGROUND Preservation of spontaneous breathing (SB) is sometimes debated because it has potentially both negative and positive effects on lung injury in comparison with fully controlled mechanical ventilation (CMV). We wanted (1) to verify in mechanically ventilated patients if the change in transpulmonary pressure was similar between pressure support ventilation (PSV) and CMV for a similar t...

Mechanical ventilation is a prominent lifesaving treatment. It is, however, associated with an array of adverse effects, which include ventilator-associated pneumonias, volume-induced lung injury and, more recently identified, ventilator-induced diaphragm dysfunction (VIDD) [1–3]. VIDD combines diaphragm weakness with muscle fibre atrophy, remodelling and injury. Its mechanisms involve decrease...

During positive-pressure ventilation parenchymal deformation can be assessed as strain (volume increase above functional residual capacity) in response to stress (transpulmonary pressure). The aim of this study was to explore the relationship between stress and strain on the regional level using computed tomography in anesthetized healthy pigs in two postures and two patterns of breathing. Airw...

INTRODUCTION The most appropriate tidal volume in patients without acute respiratory distress syndrome (ARDS) is controversial and has not been rigorously examined. Our objective was to determine whether a mechanical ventilation strategy using lower tidal volume is associated with a decreased incidence of progression to ARDS when compared with a higher tidal volume strategy. METHODS A systema...