Journals / Marmara Medical Journal / 2013 / Cilt: 26 - Sayı: 3

-

Pron pozisyonda PEEP uygulamasının solunum mekaniği ve arteriyel oksijenizasyon üzerine etkileri

Pages
146–150
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Results: Mean blood pressure was statistically low in PEEP 10 group at the prone positioning, compared to the other periods (p

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives: To evaluate the changes in arterial oxygenation and vital parameters by applying 10cm HO positive end-expiratory pressure (PEEP) to patients undergoing lumbar spine surgery in the prone position.
📊
Key Findings & Data:Patients and Method: According to The American Society of Anesthesiologists (ASA) status I-II, 40 patients, scheduled for lumbar discectomy in the prone position were enrolled in the study.
💡
Conclusion & Impact:Results: Mean blood pressure was statistically low in PEEP 10 group at the prone positioning, compared to the other periods (p
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:PEEP · Pron pozisyon · Solunum mekaniği

Abstract

Objectives: To evaluate the changes in arterial oxygenation and vital parameters by applying 10cm HO positive end-expiratory pressure (PEEP) to patients undergoing lumbar spine surgery in the prone position. Patients and Method: According to The American Society of Anesthesiologists (ASA) status I-II, 40 patients, scheduled for lumbar discectomy in the prone position were enrolled in the study. During the anesthesia induction and after intubation they were ventilated with intermittent positive pressure ventilation (IPPV) mode, 60%NO-40%O, 4L.min flow and 0.7-1.0 minumum alveolar concentration (MAC) sevoflurane. The patients were randomized into 2 groups. PEEP value was set at 0 cm HO in PEEP 0 group and at 10 cm HO in PEEP 10 group. Respiratory rate 10/min, inspiration-expiration ratio 1:2 and tidal volume 8ml.kgwere kept constant. Blood gas samples were obtained 10 min after induction and 15-30-45-60-75-90 min after prone positioning. Vital parameters, dynamic compliance and side effects were recorded. Results: Mean blood pressure was statistically low in PEEP 10 group at the prone positioning, compared to the other periods (p

Özet

Amaç: Çalışmamızın amacı pron pozisyonda cerrahi girişim geçirecek lumber diskopatili hastalarda 10cm H2 O ekspirasyon sonu pozitif basınç (positive end-expiratory pressure (PEEP)) uygulamasının arteriyel oksijenizasyon, solunum mekaniği ve dolaşım sistemi üzerindeki etkilerini araştırmaktır. Hastalar ve Yöntem: Pron pozisyonda lumber diskektomi operasyonu geçirecek Amerikan Anesteziyoloji Derneği (The American Society of Anesthesiologists (ASA)) kriterlerine göre I-II sınıf, 40 hasta çalışmaya alındı. Anestezi indüksiyonu ve endotrakeal entübasyondan sonra hastalar aralıklı pozitif basınçlı ventilasyon (intermittent positive pressure ventilation (IPPV)) modunda %60 N2 O-%40 O2 , akım 4L.dk-1 ve sevoflurane 0.7- 1.0 minimum alveolar konsantrasyon (MAK) olacak şekilde ventile edildi. Hastalar randomize edilerek 2 gruba ayrıldı. PEEP 0 grubunda, PEEP 0 cm H2 O, PEEP 10 grubunda, PEEP 10 cm H2 O olarak ayarlandı. Solunum sayısı 10 soluk/dk, inspirasyonekspirasyon oranı 1:2, tidal volüm 8ml.kg-1 olacak şekilde sabit tutuldu. İndüksiyondan 10 dk, pron pozisyona döndükten sonra 15-30-45-60-75-90. dakikalarda kan gazı örnekleri alındı. Vital parametreler, dinamik kompliyans değerleri ve yan etkiler kaydedildi. Bulgular: Ortalama kan basıncı değerleri PEEP 10 grubunda pron dönemde diğer dönemlere göre istatistiksel olarak düşük bulundu (p

🔖

Cite This Article

ÇORMAN, P. D., ÜNSEL, M., YUMRU, C. (2013). -. Marmara Medical Journal, Cilt: 26 - Sayı: 3, 146–150. https://ajindex.com/articles/283917

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (15)

  1. Hedenstierna G, Rothen HU. Atelectasis formation during anesthesia: causes and measures to prevent it. J Clin Monit Comput 2000
  2. doi: 10.1023/A:1011491231934 2. Hedenstierna G, Edmark L. Mechanisms of atelectasis in the perioperative period. Best Pract Res Clin Anaesthesiol 2010
  3. Tusman G, Böhm SH, Warner DO, Sprung J. Atelectasis and perioperative pulmonary complications in high-risk patients. Curr Opin Anaesthesiol 2012
  4. doi: 10.1097/ACO.0b013e32834dd1eb 4. Marini JJ, Hotchkiss Jr JR. PEEP in Prone position: reversing the perfusion imbalance. Crit Care Med 1999
  5. Satoh D, Kurosawa S, Kirino W, et al. Impact of changes of positive end-expiratory pressure on functional resudual capacity at low tidal volume ventilation during general anesthesia. J Anesth 2012
  6. doi: 10.1007/s00540-012-1411-9. 6. Karsten J, Heinze H, Meier T. Impact of PEEP during laparoscopic surgery on early postoperative ventilation distribution visualised by electrical impedance tomography. Minerva Anestesiol 2013
  7. [Epub ahead of print] 7. Gattinoni L, Tognoni G, Pesenti A, et al. Prone-Supine Study Group. Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med 2001
  8. doi: 10.1056/ NEJMoa010043 8. Soo Hoo GW. In prone ventilation, one good turn deserves another. N Engl J Med 2013
  9. doi: 10.1056/NEJMe1304349. Epub 2013 May 20. 9. Pullen RL Jr. Performing a modified Allen test. Nursing 2005
  10. Ruengsakulrach P, Brooks M, Hare DL, Gordon I, Buxton BF. Preoperative assessment of hand circulation by mean of Doppler ultrasonography and the modified Allen test. J Thorac Cardiovasc Surg 2001
  11. doi: 10.1067/mtc.2001.112468 11. Pelosi P, Croci M, Calappi E, et al. Prone position improves pulmonary function in obese patients during general anesthesia. Anesth Analg 1996
  12. Pelosi P, Ravagnan I, Giurati G, et al. Positive end-expiratory pressure improves respiratory function in obese but not in normal subjects during anesthesia and paralysis. Anesthesiology 1999
  13. Pelosi P, Caironi P, Taccone P, Brazzi L Pathophysiology of prone positioning in the healthy lung and in ALI/ARDS. Minerva Anestesiol 2001
  14. Kraut EJ, Amira S, Ronald B, Bruce MW. Impairment of cardiac performance by laparoscopy in patients receiving positive endexpiratory pressure. Arch Surg 1999
  15. doi:10.1001/ archsurg.134.1.76 15. Kararmaz A,