Alveolar recruitment improves ventilation during thoracic surgery: a randomized controlled trial.
Br J Anaesth
; 108(3): 517-24, 2012 Mar.
Article
de En
| MEDLINE
| ID: mdl-22201185
ABSTRACT
BACKGROUND:
This study was conducted to determine whether an alveolar recruitment strategy (ARS) applied during two-lung ventilation (TLV) just before starting one-lung ventilation (OLV) improves ventilatory efficiency.METHODS:
Subjects were randomly allocated to two groups (i) control group ventilation with tidal volume (VT) of 8 or 6 ml kg(-1) for TLV and OLV, respectively, and (ii) ARS group same ventilatory pattern with ARS consisting of 10 consecutive breaths at a plateau pressure of 40 and 20 cm H(2)O PEEP applied immediately before and after OLV. Volumetric capnography and arterial blood samples were recorded 5 min (baseline) and 20 min into TLV, at 20 and 40 min during OLV, and finally 10 min after re-establishing TLV.RESULTS:
Twenty subjects were included in each group. In all subjects, the airway component of dead space remained constant during the study. Compared with baseline, the alveolar dead space ratio (VD(alv)/VT(alv)) increased throughout the protocol in the control but decreased in the ARS group. Differences in VD(alv)/VT(alv) between groups were significant (P<0.001). Except for baseline, all values in kPa (sd) were higher in the ARS than in the control group (P<0.001), respectively [70 (7) and 55 (9); 33 (9) and 24 (10); 33 (8) and 22 (10); 70 (7) and 55 (10)].CONCLUSIONS:
Recruitment of both lungs before instituting OLV not only decreased alveolar dead space but also improved arterial oxygenation and the efficiency of ventilation.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Alvéoles pulmonaires
/
Ventilation à pression positive
/
Procédures de chirurgie thoracique
Type d'étude:
Clinical_trials
Limites:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Br J Anaesth
Année:
2012
Type de document:
Article
Pays d'affiliation:
Espagne