Archive for the ‘ Strategies ’ Category

Gina report 2019

From Gina” The 2019 update of the Global Strategy for Asthma Management and Prevention incorporates new scientific information about asthma based on a review of recent scientific literature by an international panel of experts on the GINA Science Committee. This comprehensive and practical resource about one of the most common chronic lung diseases worldwide contains extensive citations from the scientific literature and forms the basis for other GINA documents and programs. “


Scott D. Weingart, MD, Richard M. Levitan, MD

Alveoli will continue to take up oxygen even without diaphragmatic movements or lung expansion. In an apneic patient, approximately 250 mL/minute of oxygen will move from the alveoli into the bloodstream. Conversely, only 8 to 20 mL/minute of carbon dioxide moves into the alveoli during apnea, with the remainder being buffered in the bloodstream.53 The difference in oxygen and carbon dioxide movement across the alveolar membrane is due to the significant differences in gas solubility in the blood, as well as the affinity of hemoglobin for oxygen. This causes the net pressure in the alveoli to become slightly subatmospheric, generating a mass flow of gas from pharynx to alveoli. This phenomenon, called apneic oxygenation, permits maintenance of oxygenation without spontaneous or administered ventilations. Under optimal circumstances, a PaO2 can be maintained at greater than 100 mm Hg for up to 100 minutes without a single breath, although the lack of ventilation will eventually cause marked hypercapnia and significant acidosis.

 Read Article Below

Pre Oxygenate



How to Quit Smoking

  • Why quitting seems so hard
  • Your personal stop smoking plan
  • Smoking triggers
  • Nicotine withdrawal
  • Cigarette cravings
  • Preventing weight gain
  • Medication and therapy
  • What to do if you relapse

Start your stop smoking plan with START

S = Set a quit date.

Choose a date within the next 2 weeks, so you have enough time to prepare without losing your motivation to quit. If you mainly smoke at work, quit on the weekend, so you have a few days to adjust to the change.

T = Tell family, friends, and co-workers that you plan to quit.

Let your friends and family in on your plan to quit smoking and tell them you need their support and encouragement to stop. Look for a quit buddy who wants to stop smoking as well. You can help each other get through the rough times.

A = Anticipate and plan for the challenges you’ll face while quitting.

Most people who begin smoking again do so within the first 3 months. You can help yourself make it through by preparing ahead for common challenges, such as nicotine withdrawal and cigarette cravings.

R = Remove cigarettes and other tobacco products from your home, car, and work.

Throw away all of your cigarettes (no emergency pack!), lighters, ashtrays, and matches. Wash your clothes and freshen up anything that smells like smoke. Shampoo your car, clean your drapes and carpet, and steam your furniture.

T = Talk to your doctor about getting help to quit.

Your doctor can prescribe medication to help with withdrawal and suggest other alternatives. If you can’t see a doctor, you can get many products over the counter at your local pharmacy or grocery store, including the nicotine patch, nicotine lozenges, and nicotine gum.



How to Quit Smoking: A Guide to Kicking the Habit for Good


NovaLung function

Cait P. Searl

Consultant Cardiothoracic Anaesthetist / Intensivist


Broken Lungs2 (PDF)

Broken Lungs2 (PPT)

•High CO2 gradient between blood and

sweep gas allows diffusion across the membrane, allowing efficient CO2 removal

•Oxygenation limited due to arterial inflow
•Low resistance to blood flow (7mmHg at 1.5l /minute) allowing the heart to be the pump for the device
•Heparin coated biocompatible surface

The artificial lung from Novalung GmbH is the first of its kind to be naturally supplied with blood from the human heart. Since the beginning of 2003, the ILA device (Interventional Lung Assist) has been utilised to provide intermittent lung support to more than 300 patients with acute lung failure following severe inflammation or injuries, for instance. Dr. Matheis explains that it is not necessary to open up the patient’s chest and not even a general anaesthetic is needed. “The ILA device can be connected to the blood flow by two tubes without requiring an operation. It removes carbon dioxide and increases oxygen levels in the blood. This relieves the strain on the lung and gives it time to heal.”

The artificial lung, which measures only 14 x 14 cm, is capable of complementing and in some cases replacing traditional mechanical ventilation, which can seriously affect the functioning of the human body. “Mechanical ventilation is a double-edged sword,” says Dr. Matheis. “Respiratory air is normally drawn into the human lung through the creation of a partial vacuum, whereas respirators actually force air into the respiratory tract. In the case of lung failure, this unnatural pressure can damage the lung,” he explains. Affected patients require lung support for a period of approx. ten days on average, but applications lasting over a month, for example when waiting for a lung transplant, have already cropped up. By reducing mechanical ventilation, the ILA device is a safe and cost-effective alternative.

(Baden-WĂĽrttemberg – our favorite location in Europe)

N Engl J Med 2013.
DOI: 10.1056/NEJMoa1214103

prone ards


In patients with severe ARDS, early application of prolonged prone-positioning ses- sions significantly decreased 28-day and 90-day mortality. (Funded by the Programme Hospitalier de Recherche Clinique National 2006 and 2010 of the French Ministry of Health; PROSEVA number, NCT00527813.)


proning in ARDS


The Novalung® Interventional Lung Assist, often referred to as “The Novalung” or “The i-LA”, is a medical device used to remove carbon dioxide from a patient’s blood.

Download PDF full version of document


More information also available from the link below:


The Novalung(R) iLA membrane ventilator: technical aspects

Ventilation Strategies and Experimental Lung Injury

John Baier M.D.

University of Manitoba

 Hypercapnea_lecture_(rev_2004) PPT version

Tissue damage in lungs following high tidal volume mechanical ventilation Tissue sections of the lungs 

In the multivariate analysis, high and traditional tidal volumes were independent risk factors for organ failure, multiple organ failure, and prolonged stay in the intensive care unit. Organ failures were associated with increased intensive care unit stay, hospital mortality, and long-term mortality.

Conclusion: Tidal volumes of more than 10 ml/kg are risk factors for organ failure and prolonged intensive care unit stay after cardiac surgery. Women and obese patients are particularly at risk of being ventilated with injurious tidal volumes.

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