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Heart-lung interactions

Heart-lung interactions

Topics

Combine mechanical ventilation and advanced monitoring 

The physiological increase of intrathoracic pressures - when performing mechanical ventilation during surgeries - has hemodynamic consequences. The anesthesiologist can monitor shifts in cardiac index, and the blood flow proactively by using minimally invasive hemodynamic monitoring prior, during, and after complex surgical interventions.

Hand in hand for better patient care
  • Before the stepwise recruitment maneuver (RM) it’s advisable to optimize the patient’s volume status
  • During the RM shifts in the cardiac output should be monitored closely
  • After the RM patients with noticeable stroke volume variation are likely to be preload responsive and cardiac output may increase with fluids

Thus, monitoring the hemodynamic condition during ventilation phases and initiating proactive therapy decisions, allows the safe implementation of lung-protective ventilation strategies.

 

A good ventilatory strategy involves a good hemodynamic strategy.

Did you know that atelectasis affects over 90 % patients undergoing surgery?[1]

Anesthesia-induced lung collapse is a well-known entity which can be avoided by a good ventilatory strategy. Flow-i’s new lung recruitment maneuver aims to gently open the alveoli to make a lasting difference for your patients.

Postoperative pulmonary complications

  • Hypoxemia
  • Pneumonia
  • Local inflammatory response
  • Ventilator induced lung injury

In the automatic recruitment maneuver, a stepwise increase in pressure is applied for a time period set by the user. It’s designed to reduce the occurrence of hemodynamic compromise. In combination with the ProAQT technology it is possible to detect any hemodynamic changes automatically, continuously and in real time – prior, during and after an recruitment maneuver.

Lung protective ventilation helps

In a stepwise recruitment maneuver there will be less hemodynamic compromise.

Lung recruitment with Maquet Flow-i allows you to choose between an automatic or manual maneuver. Whichever you choose, the recruitment will be stepwise. Flow-i measures and displays the dynamic compliance in real time, which is used to find the optimal lowest PEEP that keeps the lungs open.

Learn more about mechanical ventilation 

Advanced hemodynamic monitoring helps

Use of Advanced Patient Monitoring shows the response of your patient to lung recruitment.

The change of CO and SV is detected in realtime. Also Preload (SVV, PPV), Afterload (SVRI) and Contractility (dPmx, CPI) parameters provide clinicians better insights.

Occult hypovolemia can be detected prior to the recruitment maneuver followed by appropriate perioperative fluid management that will decrease post-surgical complications.

Lean more about Advanced Patient Monitoring 

Heart-lung interactions during the recruitment maneuver can be monitored by the ProAQT technology 


Visualize hemodynamic conditions

Fluid management fact

37 % – 55 %

of postoperative complications can
be prevented through perioperative
goal directed fluid therapy.[2],[3]


Safety and simplicity for lung recruitment in the OR

Lung recruitment fact

5 – 10 %

of all surgical patients develop Postoperative
Pulmonary Complications (PPCs).
In thoracic or abdominal surgeries
even up to 30 – 40 % develop PPCs .[4]

Hand in hand for better patient care

 

FLOW-i® and ProAQT®

 

Download the FLOW-i and ProAQT flyer

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All references

  1. Tusman G, Bohm SH, Warner DO, Sprung J.
    Atelectasis and perioperative pulmonary complications in high risk patients. Curr Opin Anesthesiol 2012, 25:1-10.

  2. Goepfert M, et al.
    Individually optimized hemodynamic therapy reduces complications and length of stay in the intensive care unit. Anesthesiology 2013, 119(4):824-36.

  3. Cecconi M, Fasano N, Langiano N, Divella M, Costa M, Rhodes A, Rocca G.
    Goal-directed haemodynamic therapy during elective total hip arthroplasty under regional anaesthesia. Critical Care 2011, 15:R132.

  4. Khuri SF, Henderson WG, DePalma RG, Mosca C, Healey NA, Kumbhani DJ.
    Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005, 242: 326-41.