Sunday, 25 August 2013

A Trial of Intraoperative Low Tidal Volume Ventilation in Abdominal Surgery

What effect does the ventilator settings have on the postoperative course of our patients? How often do you change the settings from the standard of 500 by 10? This original article makes a compelling argument for lung protective ventilation in any patient with intermediate to high risk of pulmonary complication having major abdominal surgery. Benefits include an almost 70% reduction in ventilatory support in the postoperative period, reduced hospital stay and less risk of pneumonia.

MP

2 comments:

  1. I read this article with interest.
    I gave my first anaesthetic as a medical student in 1975. I started anaesthetic training in earnest in 1977, at which time I was told to ventilated the patients using 'a bit of peep', 7 - 10 ml/Kg tidal volume and with occasional bigger breaths in order to prevent atalectasis.
    As one of the two people appointed as the first Senior Registrars in Intensive Care, I was interested to see that smaller tidal volumes (yes, around 7 ml/Kg) helped avoid higher ventilating pressures and "barotrauma" (really 'volutrauma' ) in intensive care patients.
    I think it was Voltaire who said "Plus ça change, plus c'est la même chose"
    Phil Cumpston
    MBBS, F.A.N.Z.C.A., F.C.I.C.M, F.A.C.E.M, Master of Information Technology

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  2. Or perhaps it just takes a really long time for some good ideas to filter through!

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