Check out the timestamps below to help you navigate through the many topics we discussed.
On This Episode:
In this episode, hosts Terry and Garry take listeners on a journey through the evolution of anesthesia, reflecting on the remarkable changes witnessed since their early days in the field. From manual adjustments of OR beds to sophisticated ventilator technologies, they explore the transformative advancements that have revolutionized patient care.
Focusing on lung protective ventilation strategies, Terry and Garry delve into the intricacies of reducing postoperative pulmonary complications, drawing upon historical practices and cutting-edge research to provide valuable insights for anesthesia providers.
With a blend of anecdotal reminiscences and evidence-based discussions, they aim to empower listeners with knowledge to enhance patient outcomes and navigate the complexities of modern anesthesia.
Join Terry and Garry as they embark on a captivating exploration of the past, present, and future of anesthesia.
Here’s some of what we discuss in this episode:
- The transformation of anesthesia technology over the years.
- Understanding atelectasis and its impact on pulmonary physiology.
- The role of PEEP, tidal volumes, and recruitment maneuvers in lung protection.
- The significance of limiting driving pressure during mechanical ventilation.
- The concept of mechanical power and how it relates to potential lung injury.
- Strategies for optimizing patient outcomes and mitigating postoperative complications.
Anesthesia Machine Commercial mentioned in the show:
https://www.youtube.com/watch?v=w13QxH9vS1E
References
Güldner, A., et al. (2015). Intraoperative protective mechanical ventilation for prevention of post-operative pulmonary complications. Anesthesiology 123 (3) 692-713.
Deng, Q., et al. (2020). Intraoperative ventilation strategies to prevent post-operative pulmonary complications: a network meta-analysis of randomized controlled trials. British Journal of Anaesthesia.124 (3) 324-335.
Musch, G., (2022). Intraoperative protective mechanical ventilation: Fact or fiction? Anesthesiology 137 (4). 381-383.
Turan, A., et al. (2022) Tidal volume and positivie end-expiratory pressure and postoperative hypoxemia during general anesthesia: A single-center mulitiple crossover factorial cluster trial. Anesthesiology 137 (4) 406-417.
Ball, L., Almondo, C., and Pelosi, P. (2020). Perioperative lung protection: General mechanisms and protective approaches. Anesthesia and Analgesia 131 (6) 1789-1798.
Douville, N.J. et al. (2020) Association of Intraoperative ventilator management with postoperative oxygenation, pulmonary complications, and mortality. Anesthesia and Analgesia 130 (1) 165-175.
Santer, P., et al. (2022) Meachanical power during general anesthesia and postoperative respiratory failure: A multicenter retrospective cohort study. Anesthesiology 137 (1) 41-54.
Gama, M., Sessler, D.I., (2022) Mechanical power: Correlate or cause of ventilator-induced lung injury? Anesthesiology 137 (1) 6-8.
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Honestly, we stress this a lot with our students. We tell them when you lay somebody down and paralyze them, their lungs are going to have some alveolar collapse. And it's like putty.
- Garry & Terry
