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- Title
Alveolar recruitment strategy and PEEP improve oxygenation, dynamic compliance of respiratory system and end-expiratory lung volume in pediatric patients undergoing cardiac surgery for congenital heart disease.
- Authors
SCOHY, THIERRY V.; BIKKER, IDO G.; HOFLAND, JAN; de JONG, PETER L.; BOGERS, AD J.J.C.; GOMMERS, DIEDERIK
- Abstract
Objective: Optimizing alveolar recruitment by alveolar recruitment strategy (ARS) and maintaining lung volume with adequate positive end-expiratory pressure (PEEP) allow preventing ventilator-induced lung injury (VILI). Knowing that PEEP has its most beneficial effects when dynamic compliance of respiratory system (Crs) is maximized, we hypothesize that the use of 8 cm H2O PEEP with ARS results in an increase in Crs and end-expiratory lung volume (EELV) compared to 8 cm H2O PEEP without ARS and to zero PEEP in pediatric patients undergoing cardiac surgery for congenital heart disease. Methods: Twenty consecutive children were studied. Three different ventilation strategies were applied to each patient in the following order: 0 cm H2O PEEP, 8 cm H2O PEEP without an ARS, and 8 cm H2O PEEP with a standardized ARS. At the end of each ventilation strategy, Crs, EELV, and arterial blood gases were measured. Results: EELV, Crs, and PaO2/FiO2 ratio changed significantly ( P < 0.001) with the application of 8 cm H2O + ARS. Mean PaCO2– PETCO2 difference between 0 PEEP and 8 cm H2O PEEP + ARS was also significant ( P < 0.05). Conclusion: An alveolar recruitment strategy with relative high PEEP significantly improves Crs, oxygenation, PaCO2– PETCO2 difference, and EELV in pediatric patients undergoing cardiac surgery for congenital heart disease.
- Subjects
CONGENITAL heart disease in children; CARDIAC surgery; RESPIRATORY organ surgery; PEDIATRIC cardiology; JUVENILE diseases
- Publication
Pediatric Anesthesia, 2009, Vol 19, Issue 12, p1207
- ISSN
1155-5645
- Publication type
Article
- DOI
10.1111/j.1460-9592.2009.03177.x