ICU Management & Practice, Volume 17 - Issue 1, 2017
Mechanical ventilation has become the established standard therapy for acute respiratory failure in modern intensive-care medicine. Although intensive-care ventilation frequently represents the only option to ensure sufficient pulmonary gas exchange and adequate tissue oxygenation, ventilation therapy can also cause further lung damage and lead to ventilation-induced lung injury (VILI).
While ventilation-induced lung injury
(VILI) used to be commonly referred to as “barotrauma”, new findings have led
to a more nuanced understanding since the start of the new millennium. It is
now known that cyclic alveolar collapse, along with atelectrauma, high tidal
volumes (volutrauma) and high ventilation pressures (barotrauma) are the chief
mechanisms of ventilator-associated lung injury (VALI). Further study results
have demonstrated that lung-protective ventilation reduces mortality rates in
patients with acute lung injury by preventing VALI.
The objective must be to recognize and treat any ventilation situation that may cause VALI as early as possible. The individual, adequate and disease-specific adjustment of ventilation therapy is therefore an essential requirement for preventing ventilator-associated lung injury. elisa800VIT offers a wide range of diagnostic tools for this purpose.
With ventilator-integrated impedance tomography, elisa800VIT offers the latest EIT generation for non-invasive lung monitoring.
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The PEEPfinder® can be used as a universal diagnostic and recruitment tool in the event of acute respiratory failure.
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Electrical impedance tomography (EIT) is an example of
a bedside method that for the first time offers reliable, non-invasive
assessment of the regional lung function without radiation exposure. This
latest generation of the EIT technology includes a textile belt with integrated
electronics. In combination with powerful new time filter technologies and
relatively high acquisition rates, EIT now enables the identification of even
the smallest differences in dynamic tissue response. Such algorithms can be used
to measure, e.g., pressure/volume curves, regional time constants, regional
opening and closing pressures, regional compliance of the respiratory system,
ventilation delay, regional gas distribution, and potentially recruitable lung
volume. Further tools, such as transpulmonary pressure measurement, the
PEEPfinder, and special ventilation modes facilitate the implementation of
lung-protective ventilation in routine clinical situations and thus help reduce
VALI and VILI.
Heinen and Löwenstein has been dedicated to the
development, production and distribution of innovative products for
anaesthesia, intensive care, and home care for over 30 years. With elisa 800
and 600, HUL is setting new standards in clinical intensive-care medicine.
Heinen + Löwenstein
Arzbacher Straße 80
D-56130 Bad Ems
Rheinland-Pfalz
phone: +49 (0) 2603 9600-0
fax: +49 (0) 2603 9600-50
e-mail: [email protected]
www.hul.de