Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Mechanical ventilation and the total artificial heart: optimal ventilator trigger to avoid post-operative autocycling - a case series and literature review. | Shoham et al. Journal of Cardiothoracic Surgery 2010 5 39 http content 5 1 39 Jdfrs JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Mechanical ventilation and the total artificial heart optimal ventilator trigger to avoid post-operative autocycling - a case series and literature review Allen B Shoham 1 Bhavesh Patel2 Francisco A Arabia3 and Michael J Murray1 Abstract Many patients with end-stage cardiomyopathy are now being implanted with Total Artificial Hearts TAHs . We have observed individual cases of post-operative mechanical ventilator autocycling with a flow trigger and subsequent loss of autocycling after switching to a pressure trigger. These observations prompted us to do a retrospective review of all TAH devices placed at our institution between August 2007 and May 2009. We found that in the immediate postoperative period following TAH placement autocycling was present in 50 5 10 of cases. There was immediate cessation of autocycling in all patients after being changed from a flow trigger of 2 L minute to a pressure trigger of 2 cm H2O. The autocycling group was found to have significantly higher CVP values than the non-autocycling group P . Our data suggest that mechanical ventilator autocycling may be resolved or prevented by the use of a pressure trigger rather than a flow trigger setting in patients with TAHs who require mechanical ventilation. Background In 2006 end-stage cardiomyopathy was the primary cause of death for almost 60 000 Americans 1 . Transplantation would have prevented many of these deaths however only 3205 patients worldwide received transplanted hearts in 2006 2 . Since the publication of the REMATCH study 3 patients with end-stage cardiomyopathy have increasingly received total artificial hearts TAHs as a bridge to cadaveric cardiac transplantation with surgeons currently implanting third-generation devices 4 . We must be diligent in maintaining our knowledge of these devices as well .
