[Preoperative evaluation in thoracic surgery].
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Biomedical subjects
Publications and source records attributed to R T Stoica.
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Non-Invasive Mechanical Ventilation (NIMV) is often considered as first indication of ventilatory support in COPD exacerbations. Controlled studies with NIMV performed in specialized centers report avoidance of endotracheal intubation in more than 70% of patients with COPD and ventilatory support, a reduction of time spent in ICU and a mortality of less than 10%. These good results are obtained with a proper selection of patients needing NIMV a well trained personnel, familiarized with the technique of NIMV and the availability of the necessary equipment. The most frequent techniques of NIMV are with facial or nasal masks. For hypoxemic patients oxygen-therapy with helmet can be a good option. The most popular modes of ventilation are those with pressure or volume support. The initial settings of the ventilator (pressure, tidal volume, respiratory rate, PEEP) are dependent on the patients' respiratory pattern, the type of ventilator and the skills of the respiratory therapist.
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A right lung cancer case is presented, aged 65 years, obese, submitted to a right lung resection. Stress is laid on the difficult evolution concerning the haemodynamics and particularly the breathing owing to the association of risk factors.