Effects of pneumoperitoneal pressure and position changes on respiratory mechanics during laparoscopic colectomy / 대한마취과학회지
Korean Journal of Anesthesiology
; : 419-424, 2012.
Article
Dans En
| WPRIM
| ID: wpr-227541
Responsable en Bibliothèque :
WPRO
ABSTRACT
BACKGROUND:
This study was designed to assess the effects of pneumoperitoneal pressure (PP) and positional changes on the respiratory mechanics during laparoscopy assisted colectomy.METHODS:
Peak inspiratory pressure, plateau pressure, lung compliance, and airway resistance were recorded in PP of 10 mmHg and 15 mmHg, with the position change in 5steps:
head-down at 20degrees, head-down at 10degrees, neutral position, head-up at 10degrees and head-up at 20degrees.RESULTS:
When the patient was placed head-down, the position change accentuated the effects of pneumoperitoneum on respiratory mechanics. However, when the patient was placed in a head-up position during pneumoperitoneum the results showed no pattern. In the 20degrees head-up position with the PP being 10 mmHg, the compliance increased from 30.6 to 32.6 ml/cmH2O compared with neutral position (P = 0.002). However with the PP being 15 mmHg, the compliance had not changed compared with neutral position (P = 0.989). In 20degrees head-down position with the PP of 10 mmHg, the compliance was measured as 24.2 ml/cmH2O. This was higher than that for patients in the 10degrees head-down position with a PP of 15 mmHg, which was recorded as 21.2 ml/cmH2O. Also in the airway resistance, the patient in the 20degrees head-down position with the PP of 10 mmHg showed 15.8 cmH2O/L/sec, while the patient in the 10degrees head-down position with the PP of 15 mmHg showed 16.2 cmH2O/L/sec of airway resistance. These results were not statistically significant but still suggested that the head-down position accentuated the effects of pneumoperitoneum on respiratory mechanics.CONCLUSIONS:
Our results suggest that respiratory mechanics are affected by the patient position and the level of PP - the latter having greater effect.
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Pneumopéritoine
/
Mécanique respiratoire
/
Résistance des voies aériennes
/
Compliance pulmonaire
/
Laparoscopie
/
Colectomie
/
Compliance
Limites du sujet:
Humans
langue:
En
Texte intégral:
Korean Journal of Anesthesiology
Année:
2012
Type:
Article