Document Detail


Comparison of Respiratory Mechanics in Adult Patients Undergoing Minimally Invasive Repair of the Pectus Excavatum and Removal of a Pectus Bar.
MedLine Citation:
PMID:  23140756     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to compare the respiratory mechanics and gas exchange in adult patients undergoing minimally invasive repair of the pectus excavatum (MIRPE group) and removal of a pectus bar (bar removal group). DESIGN: A prospective observational study. SETTING: A tertiary university hospital. PARTICIPANTS: Thirty-two patients scheduled for elective MIRPE or removal of a pectus bar. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Spirometry was used to measure the peak inspiratory airway pressure (PIP), static compliance, and respiratory resistance. The measurements were recorded at 1 minute after beginning mechanical ventilation (T0), 15 minutes after beginning sevoflurane inhalation (T1), and after the insertion (or removal) of a pectus bar through the chest wall (T2). Pulmonary gas exchange was assessed by calculating the alveolar arterial oxygen tension difference (AaDO(2)) before surgical incision and after insertion (or removal) of the pectus bar. In the MIRPE group, static compliance was decreased significantly (p < 0.001), and PIP was increased significantly (p < 0.001) after insertion of the pectus bar (T2) compared with baseline. In contrast, the bar removal group showed the opposite results. There were significant differences in static compliance and PIP at T2 between the groups (p = 0.002 and 0.026, respectively). AaDO(2) was increased significantly in the MIRPE group compared with the bar removal group (p = 0.012). CONCLUSIONS: Insertion of the pectus bar through the chest wall results in significant changes in respiratory mechanics and gas exchange. Therefore, close attention to pulmonary function is required during and after these surgical procedures.
Authors:
Young Eun Moon; Jeong Eun Kim; Hyung Joo Park
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-6
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  -     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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