Thesis (M.M.S.)--Ohio State University, 1957. / Includes bibliographical references (leaves 89-95). Available online via OhioLINK's ETD Center

Inaug.-diss.-Leipzig. / At head of title: Aus dem veterinärinstitut der Universität Leipzig. "Literatur": p. 67-70.

Thesis (M.S.)--University of Wisconsin--Madison, 1981. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 125-127).

Maschinelle Beatmung kann eine vorbestehende Lungenerkrankung weiter aggravieren und das Lungenparenchym zuvor lungengesunder Patienten schädigen. Pulmonale Atelektasen können diese Schädigung noch verstärken. Aus diesem Grund ist es erstrebenswert das Auftreten von Atelektasen frühzeitig zu erkennen und zu quantifizieren, um Gegenmaßnahmen wie Rekrutierung oder PEEP-Applikation zu ergreifen. Den aktuellen Goldstandard zur Detektion und Quantifizierung von Belüftungsstörungen stellt die quantitative Analyse mittels Computertomographie (qCT) dar, welche jedoch nur mit hohem Aufwand und potenziellen Risiken für den Patienten durchführbar ist. Wir untersuchten daher anhand von 14 Schafen mit gesunden Lungen die Beziehung zwischen Atelektasen und intrapulmonaler Shuntfraktion sowie dem arteriellen Sauerstoffpartialdruck (PaO2) mit dem Hintergrund, eine möglichst bettseitig durchführbare Alternative zur qCT zum Zwecke der Quantifizierung der pulmonalen Atelektasen zu erhalten. Die Quantifizierung der Atelektasen könnte es ermöglichen, die Notwendigkeit einer Beatmungsoptimierung festzustellen und deren Erfolg zu beurteilen. Hierzu wurden die o.g. Schafe standardisiert mit einer inspiratorischen Sauerstofffraktion von 1 maschinell beatmet und das nichtbelüftete Lungengewebe mittels qCT quantifiziert. Parallel wurden der arterielle und gemischt-venöse Sauerstoffpartialdruck gemessen sowie die Shuntfraktion berechnet. Mittels Regressionsanalyse konnte eine starke Korrelation zwischen nichtbelüftetem Lungengewebe und natürlichem Logarithmus des PaO2 (R2=0,8) einerseits und der Shuntfraktion (R2=0,83) andererseits aufgezeigt werden. Aufgrund der Ergebnisse scheint es möglich über eine einfache Messung des PaO2 oder Berechnung des Shunts Rückschlüsse auf das Ausmaß der Atelektasen zu ziehen und so durch geeignete Gegenmaßnahmen die beatmungsassoziierte Schädigung von Lungenparenchym zu reduzieren.

Thesis--Western Reserve University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--Western Reserve University. / Includes bibliographical references.

No description available.

Cardiac surgery incisional pain can decrease inspiratory effort, alter normal respiratory mechanics, and increase the potential for post-operative pulmonary complications. Post-surgical atelectasis is the most frequent complication after coronary artery bypass grafting (CABG), ranging from 54% to 92%. All types of therapy such as an incentive spirometry (IS), deep breathing exercises (DBE) or continuous positive airway pressure (CPAP) have a valuable role to play in the prevention or the treatment of post-surgical atelectasis. However, the type of therapy that should be used is not completely clear yet. The present research aims to evaluate the benefit of early use of CPAP via mask therapy to treat or prevent post-surgical atelectasis after CABG, particularly in smokers and elderly patients, as compared to regular (IS) therapy. Also, it aims to evaluate the patients' and medical staff's experience about the use of the new method of CPAP via mask therapy. The present research was conducted at King Fahd Armed Forces Hospital in Saudi Arabia between March 2010 and December 2011. It used a mixed methods approach. The first two studies were intervention quantitative studies, which investigated the benefit of CPAP via mask therapy. The others were qualitative studies that evaluated the experience of patients and medical staff regarding CPAP therapy use.A total of 180 patients (male and female) (36 in each group) participated in the two quantitative studies. Ninety two participants (male and female) participated in the qualitative studies. The first quantitative study results showed an improvement in CPAP via mask therapy for half hours every two hours group measurements as compared to IS therapy groups. IC was increased significantly in the "CPAP every two hours group" as compared to control group (IS) (baseline mean for IS group 1.34L and "CPAP every two hours group" 1.42L, post- therapy mean 1.59L and 1.88L respectively, p= 0.037). In addition, when chest physiotherapy was added to the two regimens, the improvement of CPAP therapy measurements became more than IS therapy. Moreover, the patient’s acceptance rate for CPAP therapy every two hours was 93% and the medical staff acceptance rate was 86%. CPAP via mask therapy for half hour every two hours had better outcomes in treating or preventing post-surgical atelectasis after CABG, particularly in smokers and elderly patients. Adding chest physiotherapy led to even better outcomes. The use of the new method of CPAP therapy had high acceptance rate by the participants and medical staff.

Thesis--Helsinki. / At head of title: University of Helsinki Central Hospital, Surgical Clinic II. Bibliography: p. [128]-134.

Orientador: Desanka Dragosavac / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T13:03:30Z (GMT). No. of bitstreams: 1 DellaVia_Fabiana_M.pdf: 1891187 bytes, checksum: 4def93d7b8f4cf136b7e8e9214f38a3b (MD5) Previous issue date: 2011 / Resumo: INTRODUÇÃO: Os pacientes internados em Unidades de Terapia Intensiva (UTI) que necessitam de ventilação mecânica (VM) estão mais susceptíveis ao desenvolvimento de complicações respiratórias, principalmente a atelectasia e a broncopneumonia. Para que haja reversão ou mesmo prevenção dessas áreas atelectasiadas, são utilizadas técnicas fisioterapêuticas de expansão pulmonar, dentre elas destaca-se a manobra de compressão e descompressão torácica (MCDT). OBJETIVO: Avaliar as alterações respiratórias e hemodinâmicas após aplicação da MCDT nos pacientes em uso de VM. MÉTODO: Tratou-se de um estudo prospectivo, intervencionista, onde foram incluídos 65 pacientes em VM há mais de 24 horas. Todos os pacientes receberam manobras de higiene brônquica e após 30 minutos foram aplicadas 20 repetições da manobra de compressão e descompressão torácica em dez respirações consecutivas no hemitórax direito e depois dez no hemitórax esquerdo. Os dados foram coletados antes, imediatamente após e após um, cinco, dez, 15, 20, 25, 30, 35 e 40 minutos da aplicação da MCDT. Para análise estatística foram utilizados testes: Shapiro Wilks, Anova, Wilcoxon, T - Student, com nível de significância adotado de 5%. RESULTADOS: Foi observado aumento estatisticamente significante do volume corrente inspiratório (pré: 458,2ml ± 132,1; pós 1 min: 557,3 ± 139,1; pós 40 min: 574,4 ± 151), volume minuto corrente (pré: 7,0L/min ± 2,7; pós 1 min: 8,7 ± 3,3; pós 40 min: 8,8 ± 3,8) e oximetria de pulso (pré: 97,4% ± 2,2; pós 1 min: 97,9 ± 1,8; pós 40 min: 98,2 ± 1,6). Ocorreu redução no PetCO2 expirado (pré: 35,1mmHg ± 9,0; pós 1 min: 31,5 ± 8,2; pós 40 min: 31,5 ± 8,2). Não houve alteração significante da freqüência cardíaca (pré: 94,5bpm ± 20,5; pós 1 min: 94,7 ± 20,5 e pós 40 min: 94,9 ± 20,2) e pressão arterial média (pré: 91,2mmHg ± 19,1; pós 1 min: 89,5 ± 17,7 e pós 40 min: 89,0 ± 16,8). CONCLUSÃO: A MCDT possibilita a otimização dos volumes pulmonares e oximetria de pulso e redução do PetCO2 sem promover alterações hemodinâmicas nos pacientes submetidos a ventilação mecânica / Abstract: INTRODUCTION: Patients in Intensive Care Units (ICU) requiring mechanical ventilation (MV) are more likely to develop respiratory complications, especially atelectasis and bronchopneumonia. Reversing or even prevention of these areas of atelectasis, physiotherapeutic techniques are used for lung expansion, chief among which is the maneuver of chest compression and decompression (MCCD). OBJECTIVE: To evaluate the respiratory and hemodynamic changes after application of MCCD in patients submitted to mechanical ventilation (MV). METHOD: It's a prospective and interventionist study of 65 patients submitted to MV after 24 hours. All patients received a bronchial hygiene and after 30 minutes, they were submitted to 20 repetitions of the MCCD during ten consecutive respiratory cycles on right hemithorax and than ten in left hemithorax. The data were collected before, after immediately and after one, five, ten, 15, 20, 25, 30, 35 and 40 minutes following application of the MCCD. RESULTS: There were an significant improvement in the following parameters after MCCD during all phases of data collection until 40 minutes: inspiratory tidal volume (baseline: 458,2ml ± 132,1; post 1 min: 557,3 ± 139,1; post 40 min: 574,4 ± 151 ), minute volume (baseline: 7,0L/min ± 2,7; post 1 min: 8,7 ± 3,3; post 40 min: 8,8 ± 3,8), and pulse oximetry (baseline: 97,4% ± 22; post 1 min: 97,9 ± 1,8; post 40 min: 98,2 ± 1,6) . A reduction occurred in expiratory PetCO2 (baseline: 35,1mmHg ± 9,0; post 1 min: 31,5 ± 8,2; post 40 min: 31,5 ± 8,29). No alteration occurred in heart rate (baseline: 94,5bpm ± 20,5; post 1 min: 94,7 ± 20,5; post 40 min: 94,92 ± 20,20) and mean arterial pressure (baseline: 91,2mmHg ± 19,1; post 1 min: 89,5 ± 17,7; post 40 min: 89 ± 16,8). CONCLUSION: There were positive effects on the MCCD maneuver with increased lung volumes, pulse oximetry and reduction in expiratory PetCO2, without hemodynamic changes in patients submitted to mechanical ventilation / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências