| Assessing the impact of lung hyperinflation maneuver on systemic inflammatory response and lung collapse in patients undergoing surgeries under spontaneous ventilation. | |
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MedLine Citation:
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PMID: 20682157 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Lung hyperinflation maneuvers (LHM) reverse intraoperative atelectasis; however, they can lead to pulmonary-induced systemic inflammatory response. The objective of this study was to determine the impact of LHM on systemic inflammatory response and lung structure in patients undergoing subarachnoid block. METHODS: After approval by the Ethics Committee of the institution and signing the informed consent, 20 patients undergoing small and medium surgical procedures were randomly separated into two groups: 1) control (CG), and 2) LHM (LHMG). One hour after the spinal anesthesia, LHM was performed in LHMG by applying bilevel positive pressure in the airways (BIPAP) with an expiratory pressure of 20 cmH(2)O and inspiratory pressure of 20 cmH(2)O for 1 to 2 minutes. Blood levels of TNFalpha, IL-1, IL-6, IL-8, IL-10, and IL-12 were determined by flow cytometry at baseline and at 90, 180, and 780 minutes. Lung volumes and weights were determined using CT scans obtained immediately after the surgery. RESULTS: The use of LHM resulted in a reduction in the fraction of non-aerated pulmonary parenchyma (7.5 +/- 4.3%, in the Control Group, vs. 4 +/- 2.1%, in the LHM Group, p = 0.02) without changing pulmonary volumes. A progressive increase in plasma levels of IL-1, IL-6, IL-8, and IL-10, similar in both groups, was observed. Plasma levels of TNFalpha and IL-12 were undetectable during the study. CONCLUSIONS: The use of LHM reduced the incidence of atelectasis, but it did not amplify the inflammatory response in patients with normal lungs undergoing small and medium surgeries under subarachnoid block. |
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Authors:
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Luiz Marcelo Sá Malbouisson; Elton Lúcio Silva de Souza; Larissa Barbalho; Cristina de Oliveira Massoco; Maria José Carvalho Carmona; José Otávio Costa Auler |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Revista brasileira de anestesiologia Volume: 60 ISSN: 1806-907X ISO Abbreviation: Rev Bras Anestesiol Publication Date: 2010 May-Jun |
Date Detail:
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Created Date: 2010-08-04 Completed Date: 2011-01-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401316 Medline TA: Rev Bras Anestesiol Country: Brazil |
Other Details:
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Languages: eng Pagination: 247-58 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Editora Ltda. All rights reserved. |
Affiliation:
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Hospital das Clínicas (HC) of the Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil. malbouisson@hcnet.usp.br |
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, Spinal* Female Humans Inflammation / blood, etiology*, pathology Intraoperative Complications / therapy* Male Middle Aged Pulmonary Atelectasis / blood, pathology, therapy* Respiratory Therapy / adverse effects* Surgical Procedures, Operative |
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