| Ventilatory responses after major surgery and high dependency care. | |
| | |
MedLine Citation:
|
PMID: 22369766 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Disturbed breathing during sleep, with episodic upper airway obstruction, is frequent after major surgery. Ventilatory responses to hypercapnia and hypoxia during episodes of airway obstruction are difficult to investigate because the usual measure, that of ventilation, has been attenuated by the obstruction. We simulated the blood gas stimulus associated with obstruction to allow investigation of the responses. METHODS: To assess ventilatory responses, we studied 19 patients, mean age 59 (19-79), first at discharge from high dependency care after major abdominal surgery and then at surgical review, ~6 weeks later. Exhaled gas was analysed and inspired gas adjusted to simulate changes that would occur during airway obstruction. Changes in ventilation were measured over the following 45-70 s. Studies were done from air breathing if possible, and also from an increased inspired oxygen concentration. RESULTS: During simulated obstruction, hypercapnia developed similarly in all the test conditions. Arterial oxygen saturation decreased significantly more rapidly when the test was started from air breathing. The mean ventilatory response was 5.8 litre min(-2) starting from air breathing and 4.5 litre min(-2) with oxygen breathing. The values 6 weeks later were 5.9 and 4.3 litre min(-2), respectively (P=0.05, analysis of variance). There was no statistical difference between the responses starting from air and those on oxygen. CONCLUSIONS: After major surgery, ventilatory responses to hypercapnia and hypoxaemia associated with airway obstruction are small and do not improve after 6 weeks. With air breathing, arterial oxygen desaturation during simulated rebreathing is substantial. |
| | |
Authors:
|
D Nieuwenhuijs; J Bruce; G B Drummond; P M Warren; P K Wraith; A Dahan |
Related Documents
:
|
831666 - Walter j. zeiter lecture: pathokinesiology of duchenne muscular dystrophy: implications... 18400876 - Drinking policies and exercise-associated hyponatraemia: is anyone still promoting over... 21707016 - Central retinal vein occlusion after intense exercise: response to intravitreal bevaciz... 21210856 - Anaerobic contribution during maximal anaerobic running test: correlation with maximal ... 12355146 - Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowi... 8761346 - Plasma protein-bound sulfhydryl group oxidation in humans following a full marathon race. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2012-02-26 |
Journal Detail:
|
Title: British journal of anaesthesia Volume: 108 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2012 May |
Date Detail:
|
Created Date: 2012-04-13 Completed Date: 2012-06-05 Revised Date: 2013-05-02 |
Medline Journal Info:
|
Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
|
Languages: eng Pagination: 864-71 Citation Subset: IM |
Affiliation:
|
St Antonius Ziekenhuis, Nieuwegein, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abdomen
/
surgery Adult Aged Airway Obstruction / blood, physiopathology* Analgesics, Opioid / blood Anoxia / blood, physiopathology Female Follow-Up Studies Humans Hypercapnia / blood, physiopathology Intensive Care / methods* Male Middle Aged Morphine / blood Oxygen / blood Postoperative Care / methods* Postoperative Complications / blood, physiopathology* Respiratory Mechanics / physiology Young Adult |
| Grant Support | |
ID/Acronym/Agency:
|
051229/Z/97/Z//Wellcome Trust |
| Chemical | |
Reg. No./Substance:
|
0/Analgesics, Opioid; 57-27-2/Morphine; 7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
|
Br J Anaesth. 2013 Feb;110(2):311-2
[PMID:
23319669
]
Br J Anaesth. 2013 Feb;110(2):311 [PMID: 23319670 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Short-acting P2Y12 blockade to reduce platelet dysfunction and coagulopathy during experimental extr...
Next Document: Effect of pain on autonomic nervous system indices derived from photoplethysmography in healthy volu...