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- Title
Impact of changes of positive end-expiratory pressure on functional residual capacity at low tidal volume ventilation during general anesthesia.
- Authors
Satoh, Daizoh; Kurosawa, Shin; Kirino, Wakaba; Wagatsuma, Toshihiro; Ejima, Yutaka; Yoshida, Akiko; Toyama, Hiroaki; Nagaya, Kei
- Abstract
Purpose: Several reports in the literature have described the effects of positive end-expiratory pressure (PEEP) level upon functional residual capacity (FRC) in ventilated patients during general anesthesia. This study compares FRC in mechanically low tidal volume ventilation with different PEEP levels during upper abdominal surgery. Methods: Before induction of anesthesia (awake) for nine patients with upper abdominal surgery, a tight-seal facemask was applied with 2 cmHO pressure support ventilation and 100 % O during FRC measurements conducted on patients in a supine position. After tracheal intubation, lungs were ventilated with bilevel airway pressure with a volume guarantee (7 ml/kg predicted body weight) and with an inspired oxygen fraction (FIO) of 0.4. PEEP levels of 0, 5, and 10 cmHO were used. Each level of 5 and 10 cmHO PEEP was maintained for 2 h. FRC was measured at each PEEP level. Results: FRC awake was significantly higher than that at PEEP 0 cmHO ( P < 0.01). FRC at PEEP 0 cmHO was significantly lower than that at 10 cmHO ( P < 0.01). PaO/FIO awake was significantly higher than that for PEEP 0 cmHO ( P < 0.01). PaO/FIO at PEEP 0 cmHO was significantly lower than that for PEEP 5 cmHO or PEEP 10 cmHO ( P < 0.01). Furthermore, PEEP 0 cmHO, PEEP 5 cmHO after 2 h, and PEEP 10 cmHO after 2 h were correlated with FRC ( R = 0.671, P < 0.01) and PaO/FIO ( R = 0.642, P < 0.01). Conclusions: Results suggest that PEEP at 10 cmHO is necessary to maintain lung function if low tidal volume ventilation is used during upper abdominal surgery.
- Subjects
PULMONARY gas exchange; GENERAL anesthesia; FUNCTIONAL residual capacity (Respiration); ARTIFICIAL respiration; ABDOMINAL surgery; PREOPERATIVE care
- Publication
Journal of Anesthesia, 2012, Vol 26, Issue 5, p664
- ISSN
0913-8668
- Publication type
Article
- DOI
10.1007/s00540-012-1411-9