Document Detail

Pressure-controlled inverse ratio ventilation using laryngeal mask airway in gynecological laparoscopy.
MedLine Citation:
PMID:  22869939     Owner:  NLM     Status:  PubMed-not-MEDLINE    
BACKGROUND: It is well documented that pressure-controlled ventilation (PCV) improves oxygenation and ventilation compared to volume-controlled ventilation and reduces peak airway pressure in gynecological laparoscopy. PCV with moderately inversed inspiratory-expiratory (I: E) ratio can successfully recruit collapsed alveoli and has been proved to be beneficial in intensive care. We tested the hypothesis that altering the I: E ratio to 1.5:1 in PCV improves ventilation during gynecological laparoscopy using laryngeal mask airway (LMA).
OBJECTIVE: To study pressure-controlled inverse ratio ventilation (PCIRV) with I: E ratio 1.5:1 as against PCV with I: E ratio 1:2 in gynecological laparoscopy with LMA using noninvasive parameters.
MATERIALS AND METHODS: Intraoperative hemodynamics and side-stream spirometry recordings were noted in 20 consecutive patients undergoing major gynecological laparoscopy with LMA. Flexible LMA or LMA supreme were used depending on normal body mass index (BMI) or high BMI, respectively.
RESULTS: REVERSING THE I: E ratio to 1.5:1 increased the tidal volume, mean airway pressures, and dynamic lung compliance significantly, all indicating better oxygenation at comparable peak airway pressures as against PCV with I: E ratio 1:2. There was no change in the end-tidal carbon dioxide. There was no auto-positive end expiratory pressure (PEEP) or change in the hemodynamics.
CONCLUSION: REVERSAL OF I: E ratio with PCV can be beneficially used with LMA in laparoscopy.
Manju Sinha; Sheetal Chiplonkar; Rishita Ghanshani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of anaesthesiology, clinical pharmacology     Volume:  28     ISSN:  2231-2730     ISO Abbreviation:  J Anaesthesiol Clin Pharmacol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-08-07     Completed Date:  2012-10-02     Revised Date:  2014-01-24    
Medline Journal Info:
Nlm Unique ID:  9516972     Medline TA:  J Anaesthesiol Clin Pharmacol     Country:  India    
Other Details:
Languages:  eng     Pagination:  330-3     Citation Subset:  -    
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