Document Detail


Factors determining end-expiratory alveolar pressure after cardiac surgery.
MedLine Citation:
PMID:  10434169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intrinsic positive end-expiratory pressure can occur when the sternum is closed following cardiac surgery, causing anaesthetic and surgical problems. We measured intrinsic positive end-expiratory pressure after sternal closure in two studies of patients undergoing coronary artery bypass grafting with the same anaesthetic regime. In one, patients were ventilated at 10 breaths min-1, in the other they were randomized to be ventilated at 10 or 20 breaths min-1. After sternal closure, intrinsic positive end-expiratory pressure increased significantly, especially in patients in whom it had been present before sternotomy. Multiple linear regressions with the pooled data from the studies showed that intrinsic positive end-expiratory pressure was positively correlated with ventilatory rate (P < 0.005), age (P < 0.005) and Body Mass Index (P < 0.0005), and negatively with FEV1, as percentage of predicted (P < 0.01). There was no correlation between intrinsic positive end-expiratory pressure and a history of smoking. As there was no difference in expiratory resistance between patients ventilated at the two different rates, any effect on intrinsic positive end-expiratory pressure of the higher ventilatory rates could have been due only to the shorter expiratory time.
Authors:
R Fletcher; P Foster; S Thornton
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  16     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-09-17     Completed Date:  1999-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  396-9     Citation Subset:  IM    
Affiliation:
Central Manchester Hospitals NHS Trust, Manchester, UK.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Airway Resistance
Body Mass Index
Coronary Artery Bypass*
Female
Forced Expiratory Volume
Humans
Linear Models
Male
Middle Aged
Positive-Pressure Respiration, Intrinsic / etiology*
Postoperative Complications*
Respiration, Artificial / methods
Risk Factors
Sternum / surgery

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


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