Annals of translational medicine
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We previously used a pig model to demonstrate that noninvasive positive pressure ventilation (NPPV) may be a safe alternative to endotracheal intubation (ET). We sought to validate our model by quantifying the pressure threshold of esophageal anastomoses in human cadavers as a step before a clinical trial. ⋯ We created a human cadaveric model that in conjunction with our porcine data demonstrates that a human esophageal anastomosis can tolerate manifold higher pressures than are delivered to the esophagus by NPPV. This is the final step before a trial of NPPV in patients following esophagectomy.
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On June 14, 2015, Ladha and colleagues published an article in the BMJ entitled "Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study", which investigated the effects of intraoperative protective ventilation on major postoperative respiratory complications. This study used data of over 69,265 patients in order to investigate patients over the age of 18 who underwent a non-cardiac surgical procedure between January 2007 and August 2014 and required general anesthesia with endotracheal intubation. The investigators found that intraoperative protective ventilation was associated with a decreased risk of postoperative respiratory complications. This study raises important questions about the ventilatory management of surgical patients.