Document Detail


Alveolar recruitment improves ventilatory efficiency of the lungs during anesthesia.
MedLine Citation:
PMID:  15310643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The goal of this study was to analyze the effect of positive end-expiratory pressure (PEEP), with and without a lung recruitment maneuver, on dead space. METHODS: 16 anesthetized patients were sequentially studied in three steps: 1) without PEEP (ZEEP), 2) with 5 cm H(2)O of PEEP and 3) with 5 cm H(2)O of PEEP after an alveolar recruitment strategy (ARS). Ventilation was maintained constant. The single breath test of CO(2) (SBT-CO(2)), arterial oxygenation, end-expiratory lung volume (EELV) and respiratory compliance were recorded every 30 min. RESULTS: Physiological dead space to tidal volume decreased after ARS (0.45 +/- 0.01) compared with ZEEP (0.50 +/- 0.07, P < 0.05) and PEEP (0.51 +/- 0.06, P < 0.05). The elimination of CO(2) per breath increased during PEEP (25 +/- 3.3 mL.min(-1)) and ARS (27 +/- 3.2 mL.min(-1)) compared to ZEEP (23 +/- 2.6 mL.min(-1), P < 0.05), although ARS showed larger values than PEEP (P < 0.05). Pa-etCO(2) difference was lower after recruitment (0.9 +/- 0.5 kPa, P < 0.05) compared to ZEEP (1.1 +/- 0.5 kPa) and PEEP (1.2 +/- 0.5 kPa). Slope II increased after ARS (63 +/- 11%/L, P < 0.05) compared with ZEEP (46 +/- 7.7%/L) and PEEP (56 +/- 10%/L). Slope III decreased significantly after recruitment (0.13 +/- 0.07 1/L) compared with ZEEP (0.21 +/- 0.11 1/L) and PEEP (0.18 +/- 0.10 1/L). The angle between slope II and III decreased only after ARS. After lung recruitment, PaO(2), EELV, and compliance increased significantly compared with ZEEP and PEEP. CONCLUSION: Lung recruitment improved the efficiency of ventilation in anesthetized patients.
Authors:
Gerardo Tusman; Stephan H Böhm; Fernando Suarez-Sipmann; Elsio Turchetto
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  51     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:    2004 Aug-Sep
Date Detail:
Created Date:  2004-08-16     Completed Date:  2005-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  723-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Hospital Privado de Comunidad, Mar del Plata, Argentina. gtusman@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery
Aged
Aged, 80 and over
Anesthesia, General / adverse effects*
Carbon Dioxide / metabolism
Female
Humans
Lung / drug effects,  physiopathology*
Lung Volume Measurements / methods
Male
Oxygen / blood
Positive-Pressure Respiration / methods*
Prospective Studies
Pulmonary Alveoli / physiology*
Pulmonary Gas Exchange / drug effects
Pulmonary Ventilation / physiology*
Respiration, Artificial / methods*
Respiratory Dead Space / physiology
Vital Capacity / physiology
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Can J Anaesth. 2004 Aug-Sep;51(7):649-53   [PMID:  15310630 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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