Positive end-expiratory pressure improves end-expiratory lung volume but not oxygenation after induction of anaesthesia
Positive end-expiratory pressure improves end-expiratory lung volume but not oxygenation after induction of anaesthesia
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DOI：
10.1097/eja.0b013e3283398806
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发表时间：
2010-06-01
影响因子：
3.6
通讯作者：
Bazin, Jean-Etienne
中科院分区：
文献类型：
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作者：
Futier, Emmanuel;Constantin, Jean-Michel;Bazin, Jean-Etienne
背景与目的麻醉诱导促进肥胖和非肥胖患者依赖性肺区域的塌陷。我们假设，呼气末肺容积（EELV）可能比氧合更敏感，以评估麻醉诱导后呼气末正压（PEEP）的影响。方法40例患者（20例非肥胖患者和20例肥胖患者）进行了前瞻性研究。麻醉诱导后，逐步调整PEEP [零呼气末压（ZEEP）、PEEP 5 cmH（2）O和PEEP 10 cmH（2）O]。在每一步中，我们测量了EELV、静弹性、气体交换和死腔。结果麻醉诱导和ZEEP均使非肥胖患者EELV降低39%，肥胖患者EELV降低59%（均P
Background and objective Induction of anaesthesia promotes collapse of dependent lung regions in both obese and nonobese patients. We hypothesized that end-expiratory lung volume (EELV) may be more sensitive than oxygenation to evaluate the effects of positive end-expiratory pressure (PEEP) after anaesthesia induction.Methods Forty patients (20 nonobese patients and 20 obese patients) were prospectively studied. After anaesthesia induction, PEEP was adjusted in a stepwise fashion [zero end-expiratory pressure (ZEEP), PEEP 5 cmH(2)O and PEEP 10 cmH(2)O]. At each step, we measured EELV, static elastance, gas exchange and dead space. Other than changing PEEP, respiratory settings were kept constant throughout.Results Anaesthesia induction and ZEEP both lowered EELV by 39% in nonobese patients and 59% in obese patients (both P