The Faculty of Medicine and Dentistry of the Universitat de València participates in a pioneering research to advance the prevention of lung damage when providing mechanical ventilation in operations that require general anaesthesia. The professor of the Department of Surgery Francisco Javier Belda, also Chief Department of Anaesthesia and Intensive Care at the Clinical University Hospital of Valencia and Dr. Carlos Ferrando, from the same institute, have led an experimental work that shows for the first time the utility of the stress index to adjust in real time artificial ventilation supply in order to avoid lung injuries. The results of this work have just been published on-line in the magazine Critical Care.
The research led by Belda and Ferrando has used the pioneering way of stress index. “When artificial breathing is applied there are two parameters to avoid damaging the lung: the amount of gas volume (oxygen plus air), and positive pressure applied to prevent this body from collapsing and, so far, this indicator is only used to the pressure that prevented the collapse”, Belda argues. However, as Ferrando points out, “we have verified that it is much more efficient to regulate positive pressure with other parameters of respiratory mechanics and reserve the stress index to indicate the necessary volume of gas that prevents the lung is injured”.
This work has been carried over a period of two years experimenting with animals in the laboratories of the Faculty of Medicine and Dentistry of the Universitat de València. Furthermore, recently, researchers have also carried tests of this new use of the stress index in healthy patients during surgical operations.
Scientific literature shows that lung complications, more or less severe, occur in up to 30-40% of patients who have been given artificial ventilation. “While these often have no impact on long-term patient if it can lead to increased hospitalization days, use of resources and therefore an increase in health spending”, Carlos Ferrando said.
Meanwhile, the research coordinator of the Anaesthesiology Service at the Clinical Hospital, Marina Soro, says these results “culminate developing an experimental work that we started over ten years ago, a period in which our laboratory at the Mixed Unit of Research has established to study any model, from cells to large animals”.
Francisco Javier Belda is a professor of Anaesthesiology at the Department of Surgery of Universitat de València and Chief Department of Anaesthesia and Intensive Care at the Clinical University Hospital of Valencia. As a teacher, he has directed 16 doctoral theses, all with the highest rating, and has been director of many courses, including the Mechanical Ventilation having the highest recognition in Spain and now in its twentieth edition.
As a clinical, Belda has devoted his life mainly to the management of Critical Care patients, with special attention to ventilation strategies for lung injury and hemodynamic monitoring and management. The reanimation Unit of the Clinical Hospital where he works has an average of 1,200 hospitalisations per year. Belda has worked recently in cardiac anaesthesia with inhalational agents. He is also a specialist in anaesthetic circuits and anaesthetic gases (including Xenon). His research highlights on the administration of supplemental oxygen to reduce surgical infection, worldwide reference published in JAMA 2005.
Meanwhile, Carlos Ferrando is anesthesiologist Clinical University Hospital of Valencia since 2010. His priority research line is respiratory, especially related to artificial ventilation, which recently won a grant from the Social Fund (FIS) of the Carlos III Health Institute and the European Young Researchers’ Award, given by the European Society of Anaesthesiology.
Adjusting tidal volume to stress index in an open lung condition optimizes ventilation and prevents overdistension in an experimental model of lung injury and reduced chest wall compliance, Ferrando C, Suárez-Sipmann F, Gutierrez A, Tusman G, Carbonell J, García M, Piqueras L, Compañ D, Flores S, Soro M, Llombart A, Belda F. Critical Care, doi:10.1186/s13054-014-0726-3, published 13 January 2015.
Source: RUVID Association