Abstract
Background. General anesthesia could imply that the closing capacity exceed the functional residual capacity. This phenomenon, associated with a reduction of maximal expiratory flow, could lead to expiratory flow limitation (EFL). The aim of our study was to verify 1) a new method of determining EFL during anesthesia (PEEP test); 2) if anesthesia could be associated with the development of EFL; 3) if the use a small amount of PEEP is able to reverse the possible negative effects of low lung volume ventilation. Methods. Fifty two patients scheduled for abdominal surgery were prospectively randomized in: 1) group ZEEP, ventilated at PEEP 0 H2O and 2) group PEEP ventilated at PEEP 5 cm H2O. The presence of EFL was determined by the negative expiratory pressure (NEP) test the day before surgery and by the PEEP test during surgery. Data of respiratory mechanics were calculated at the beginning and at the end of anesthesia. Results. 1) The PEEP test allows the detection of EFL; 2) anesthesia was associated with EFL: 8 patients developed EFL after induction. At the end of surgery, 7 more patients became flow limited in the group ZEEP, while only 1 in the group PEEP. The group ZEEP exhibited a marked decrease of expiratory flow and a worsening of respiratory mechanics at the end of surgery. Conclusion. The PEEP test allowed to verify that EFL during anesthesia is a valuable phenomenon. The use of 5 cmH2O of PEEP was helpful to prevent the deterioration of lung mechanics that occurs during surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 1205-1214 |
| Number of pages | 10 |
| Journal | Minerva Anestesiologica |
| Volume | 78 |
| Issue number | 11 |
| Publication status | Published - Nov 2012 |
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Keywords
- Anesthesia, general
- Positive-pressure respiration
- Respiratory mechanics
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Respiratory mechanics at different PEEP levels during general anesthesia in the elderly : A pilot study. / Marangoni, E.; Alvisi, V.; Ragazzi, R.; Mojoli, F.; Alvisi, R.; Caramori, G.; Astolfi, L.; Volta, C. A.
In: Minerva Anestesiologica, Vol. 78, No. 11, 11.2012, p. 1205-1214.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Respiratory mechanics at different PEEP levels during general anesthesia in the elderly
T2 - A pilot study
AU - Marangoni, E.
AU - Alvisi, V.
AU - Ragazzi, R.
AU - Mojoli, F.
AU - Alvisi, R.
AU - Caramori, G.
AU - Astolfi, L.
AU - Volta, C. A.
PY - 2012/11
Y1 - 2012/11
N2 - Background. General anesthesia could imply that the closing capacity exceed the functional residual capacity. This phenomenon, associated with a reduction of maximal expiratory flow, could lead to expiratory flow limitation (EFL). The aim of our study was to verify 1) a new method of determining EFL during anesthesia (PEEP test); 2) if anesthesia could be associated with the development of EFL; 3) if the use a small amount of PEEP is able to reverse the possible negative effects of low lung volume ventilation. Methods. Fifty two patients scheduled for abdominal surgery were prospectively randomized in: 1) group ZEEP, ventilated at PEEP 0 H2O and 2) group PEEP ventilated at PEEP 5 cm H2O. The presence of EFL was determined by the negative expiratory pressure (NEP) test the day before surgery and by the PEEP test during surgery. Data of respiratory mechanics were calculated at the beginning and at the end of anesthesia. Results. 1) The PEEP test allows the detection of EFL; 2) anesthesia was associated with EFL: 8 patients developed EFL after induction. At the end of surgery, 7 more patients became flow limited in the group ZEEP, while only 1 in the group PEEP. The group ZEEP exhibited a marked decrease of expiratory flow and a worsening of respiratory mechanics at the end of surgery. Conclusion. The PEEP test allowed to verify that EFL during anesthesia is a valuable phenomenon. The use of 5 cmH2O of PEEP was helpful to prevent the deterioration of lung mechanics that occurs during surgery.
AB - Background. General anesthesia could imply that the closing capacity exceed the functional residual capacity. This phenomenon, associated with a reduction of maximal expiratory flow, could lead to expiratory flow limitation (EFL). The aim of our study was to verify 1) a new method of determining EFL during anesthesia (PEEP test); 2) if anesthesia could be associated with the development of EFL; 3) if the use a small amount of PEEP is able to reverse the possible negative effects of low lung volume ventilation. Methods. Fifty two patients scheduled for abdominal surgery were prospectively randomized in: 1) group ZEEP, ventilated at PEEP 0 H2O and 2) group PEEP ventilated at PEEP 5 cm H2O. The presence of EFL was determined by the negative expiratory pressure (NEP) test the day before surgery and by the PEEP test during surgery. Data of respiratory mechanics were calculated at the beginning and at the end of anesthesia. Results. 1) The PEEP test allows the detection of EFL; 2) anesthesia was associated with EFL: 8 patients developed EFL after induction. At the end of surgery, 7 more patients became flow limited in the group ZEEP, while only 1 in the group PEEP. The group ZEEP exhibited a marked decrease of expiratory flow and a worsening of respiratory mechanics at the end of surgery. Conclusion. The PEEP test allowed to verify that EFL during anesthesia is a valuable phenomenon. The use of 5 cmH2O of PEEP was helpful to prevent the deterioration of lung mechanics that occurs during surgery.
KW - Anesthesia, general
KW - Positive-pressure respiration
KW - Respiratory mechanics
UR - http://www.scopus.com/inward/record.url?scp=84871325394&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871325394&partnerID=8YFLogxK
M3 - Article
C2 - 22772859
AN - SCOPUS:84871325394
VL - 78
SP - 1205
EP - 1214
JO - Minerva Anestesiologica
JF - Minerva Anestesiologica
SN - 0375-9393
IS - 11
ER -