Postoperative Mechanical Ventilation-Humidification
Humidification in the Intensive Care Unit: The Essentials, Springer International Publishing Ag, ss.121-127, 2023
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2023
- Doi Numarası: 10.1007/978-3-031-23953-3_11
- Yayınevi: Springer International Publishing Ag
- Sayfa Sayıları: ss.121-127
- Anahtar Kelimeler: Active and passive humidifiers, Airway lubrication, Complication of invasive mechanical ventilation, Humidifiers, Invasive mechanical ventilation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Postoperative invasive mechanical ventilation (IMV) is particularly common following longer-duration major cardiovascular, brain, lung, and abdominal as well as non-elective catastrophic trauma surgeries. IMV application modes are similar in all patients with normal lung function; however, certain protective ventilation strategies are used in patients with lung parenchymal disorders or after pneumonectomy. During IMV, dry air and gas mixture are applied to the patient’s endobronchial mucosa; during aspiration, the dried and fragile endobronchial mucosa can easily bleed, resulting in airway obstruction, and this causes re-intubation. The absence of airway patency results in atelectasis and increases work of breathing and arterial partial carbon dioxide pressure (PaCO2); morbidity and mortality rates increase in patients receiving postoperative IMV. Every patient undergoing IMV should have their airways humidified. The postoperative airway mucosa should be moisturized to protect it from the drying effect of the gas-dry air mixture and to prevent mucosal fragility, bleeding, and atelectasis. Airway humidification can be accomplished with either a heat and moisture exchanger (HME) (cost-effective) or a heated humidifier (HH) (expensive). Although HME and HH have comparable airway protective efficacy, when thick secretion, atelectasis, or hypothermia is present in patients with postoperative IMV, HH should be suggested.