| Sitting posture decreases collapsibility of the passive pharynx in anesthetized paralyzed patients with obstructive sleep apnea. | |
| | |
MedLine Citation:
|
PMID: 20823756 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Obstructive sleep apnea (OSA) is an independent risk factor for difficult and/or impossible mask ventilation during anesthesia induction. Postural change from supine to sitting improves nocturnal breathing in patients with OSA. The purpose of this study was to evaluate the effect of patient position on collapsibility of the pharyngeal airway in anesthetized and paralyzed patients with OSA. The authors tested the hypothesis that the passive pharynx is structurally less collapsible during sitting than during supine posture. METHOD: Total muscle paralysis was induced with general anesthesia in nine patients with OSA, eliminating neuromuscular factors contributing to pharyngeal patency. The cross-sectional area of the pharynx was measured endoscopically at different static airway pressures. Comparison of static pressure-area plots between the supine and sitting (62° head-up) allowed assessment of the postural differences of the mechanical properties of the pharynx. RESULTS:: Maximum cross-sectional area was greater during sitting than during supine posture at both retropalatal (median (10th-90th percentile): 1.91 (1.52-3.40) versus 1.25 (0.65-1.97) cm) and retroglossal (2.42 (1.72-3.84) versus 1.75 (0.47-2.35) cm) airways. Closing pressure of the passive pharynx was significantly lower during sitting than supine posture. Differences of the closing pressures between the postures are 5.89 (3.73-11.6) and 6.74 (4.16-9.87) cm H2O, at retropalatal and retroglossal airways, respectively, and did not differ between the pharyngeal segments. CONCLUSIONS: Postural change from supine to sitting significantly improves collapsibility of pharyngeal airway in anesthetized and paralyzed patients with OSA. |
| | |
Authors:
|
Yugo Tagaito; Shiroh Isono; Atsuko Tanaka; Teruhiko Ishikawa; Takashi Nishino |
Related Documents
:
|
2857276 - An evaluation of the efficiency of face masks in the resuscitation of newborn infants. 46446 - Effect of continuous positive airway pressure on breathing pattern of infants with resp... 14509556 - The effect of treatment on diaphragm contractility in obstructive sleep apnea syndrome. 3980366 - Factors influencing regional patency and configuration of the human infant upper airway. 1273986 - Closed-system habitat for high pressure exposures of animal colonies. 19189836 - Hypertension and epidemiological factors among tribal labour population in gujarat. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Anesthesiology Volume: 113 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-24 Completed Date: 2010-10-13 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
|
Languages: eng Pagination: 812-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesiology, Teikyo University Chiba Medical Center, Ichihara, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Anatomy, Cross-Sectional Anesthesia, General* Biomechanics Humans Male Middle Aged Palate / surgery Paralysis / chemically induced, physiopathology Pharynx / anatomy & histology*, surgery Posture / physiology* Pressure Sleep Apnea, Obstructive / physiopathology*, surgery* Uvula / surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Anesthesia Literature Review.
Next Document: Isoflurane preconditioning elicits competent endogenous mechanisms of protection from oxidative stre...