PNL is the preferred treatment method for kidney stones larger than 2 cm, multiple kidney
stones and staghorn stones. With new developments in the field of medicine, PNL has
become a minimally invasive method and is preferred to open surgery in the treatment of
kidney stones. Alternative types of anesthesia and various patient positions have been
described in PNL.
Mechanical power of ventilation (MP) is the amount of energy transferred from the
mechanical ventilator to the respiratory system per unit time. Although this energy is
primarily used to overcome airway resistance and respiratory system compliance, some of
it acts directly on lung tissue, potentially causing ventilator-induced lung injury
(VILI).
Mechanical power during ventilation estimates the energy delivered to the respiratory
system by integrating inspiratory pressures, tidal volume and respiratory rate into a
single value. It allows physicians to evaluate adjustments made to mechanical ventilation
by calculating a single value. High mechanical power value is associated with a high
incidence of postoperative pulmonary complications and mortality . In short, the energy
distributed to the respiratory system consists of the static composite (PEEP), the
dynamic composite (driving pressure and tidal volume) and the resistive composite (the
pressure required for gas flow). Because energy is equal to the pressure that causes a
change in volume. The equation is as follows: MP= 0.098 × respiratory rate × tidal volume
× (PEEP + ½(plateau-peep)+ (peak-plateau)). These parameters are monitored on the monitor
while the patient is mechanically ventilated and placed into the equation.
After general anesthesia, some postoperative pulmonary complications may be encountered.
Exposure to high mechanical force in ventilated patients during surgery has been found to
be associated with an increase in postoperative pulmonary complications and acute
respiratory failure. This increases the length of hospital stay and mortality. In order
to prevent ventilator-related lung damage, the mechanical ventilator must be adjusted to
transfer the least amount of energy per unit time to the respiratory system for each
patient.
Early recognition of postoperative pulmonary complications that are likely to occur after
surgery is important for rapid initiation of treatment. Incentive spirometry (triflo) can
be used to make a rapid assessment of the respiratory capacity of patients. An incentive
spirometer is a device that measures the volume of air drawn into the lungs during
inspiration. As you breathe through an incentive spirometer, a piston inside the device
rises and measures the volume of inhaled air. 1 ball is considered as 600ml, 2 balls as
900ml, and 3 balls as 1200ml flow.]