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Mechanical Ventilation in the Operating Room

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Pediatric and Neonatal Mechanical Ventilation

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Abstract

During the provision of general anesthesia, some type of support of ventilatory function is generally necessary given the depressant effects of the various anesthetic and opioid agents that are administered to provide amnesia and analgesia. Furthermore, for major thoracic or abdominal procedures, neuromuscular blocking agents are frequently administered, thereby necessitating full control of ventilation. As with ventilation outside of the operating room (OR), variation options exist for respiratory support during the provision of general anesthesia including volume- or pressure-limited modalities or more recently the use of pressure support ventilation to augment spontaneous ventilation. Given the limitations of commercially available OR ventilators, critically ill patients may require the use of sophisticated ICU ventilators in the OR setting. In such instances, as the inhalational anesthetic agents cannot generally and easily be administered through such ventilators, general anesthesia is provided by intravenous anesthetic agents (total intravenous anesthesia or TIVA). This chapter reviews the basics of anesthesia breathing systems, options for ventilator support during anesthetic care, and special situations in the operating including the administration of adjunctive agents (helium, nitric oxide, nitrogen, and carbon dioxide) as well as the use of one-lung ventilation (OLV) during thoracic surgical procedures.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA

    Joseph D. Tobias MD

  2. Department of Anesthesiology and Pediatrics, The Ohio State University, 700 Children’s Drive, Columbus, OH, 43205, USA

    Joseph D. Tobias MD

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  1. Joseph D. Tobias MD
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Correspondence to Joseph D. Tobias MD .

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Editors and Affiliations

  1. Service of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital of Geneva, Geneve, Switzerland

    Peter C. Rimensberger

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Tobias, J.D. (2015). Mechanical Ventilation in the Operating Room. In: Rimensberger, P. (eds) Pediatric and Neonatal Mechanical Ventilation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01219-8_65

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  • DOI: https://doi.org/10.1007/978-3-642-01219-8_65

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-01218-1

  • Online ISBN: 978-3-642-01219-8

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