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Related Concept Videos

Mechanical Ventilation II: Invasive Ventilation01:23

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Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
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Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
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Cerebral Blood Oxygenation Measurement Based on Oxygen-dependent Quenching of Phosphorescence
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Changes in cerebral oxygenation based on intraoperative ventilation strategy.

Elisabeth Dewhirst1, Hina Walia1, Walter P Samora2

  • 1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA, Elisabeth.Dewhirst@nationwidechildrens.org.

Medical Devices (Auckland, N.Z.)
|August 14, 2018
PubMed
Summary

Cerebral oxygenation (rSO2) monitoring using NIRS shows a slight decline during hypocarbia in adolescents. This decrease is reversible with increased oxygen levels, highlighting ventilation

Keywords:
cerebral oxygenationintraoperativenear infrared spectroscopy (nirs)pediatricventilation

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Area of Science:

  • Anesthesiology
  • Physiology
  • Medical Technology

Background:

  • Cerebral oximetry (regional oxygen saturation, rSO2) monitors brain oxygenation using near-infrared spectroscopy (NIRS).
  • rSO2 changes can precede pulse oximetry, aiding early detection of clinical deterioration.
  • Ventilation parameters, such as CO2 levels, can influence cerebral oxygenation measurements.

Purpose of the Study:

  • To evaluate the impact of intraoperative mechanical ventilation changes on cerebral oxygenation (rSO2) in adolescents.
  • To assess how transitions between normocarbia and hypocarbia, with varying fractions of inspired oxygen (FiO2), affect rSO2.
  • To determine the reversibility of ventilation-induced rSO2 changes.

Main Methods:

  • Near-infrared spectroscopy (NIRS) was used to monitor cerebral and tissue oxygenation in 30 adolescents.
  • Measurements were taken during four ventilation phases: normocarbia/low FiO2, hypocarbia/low FiO2, hypocarbia/high FiO2, and normocarbia/high FiO2.
  • Paired t-tests compared rSO2 values between sequential ventilation phases.

Main Results:

  • Cerebral oxygenation (rSO2) decreased significantly from 83% ± 8% during normocarbia to 79% ± 8% during hypocarbia (p < 0.01).
  • Increasing FiO2 partially reversed the rSO2 decline during hypocarbia (81% ± 9%).
  • rSO2 returned to baseline levels (83% ± 8%) upon returning to normocarbic conditions with high FiO2. Tissue oxygenation remained stable.

Conclusions:

  • Hypocarbia during general anesthesia in adolescents leads to a statistically significant, albeit slight, decrease in cerebral oxygenation (rSO2).
  • The reduction in rSO2 associated with hypocarbia is readily reversible by increasing supplemental oxygen levels.
  • Cerebral oximetry is sensitive to changes in ventilation, specifically CO2 levels.