• citations in SCIndeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[]
  • visits in previous 30 days:5
  • full-text downloads in 30 days:3


article: 2 from 21  
Back back to result list
2015, vol. 44, iss. 3, pp. 23-28
Comparative analysis of parameters of oxygenation, ventilation and acid-base status during intraoperative application of conventional and protective lung ventilation
aUniversity of Priština - Kosovska Mitrovica, Faculty of Medicine, Serbia + KBC Priština, Gračanica
bOdeljenje neonatologije, OB Leskovac
Keywords: Conventional and protective lung ventilation; oxygenation; ventilation; acid-base status
The aim of this study was to perform a comparative analysis applied conventional (traditional) and protective mechanical lung ventilation in clinical conditions with regard to intraoperative parameters changes of oxygenation, ventilation and acid-base status. This was a prospective study that included 240 patients. All patients underwent the same elective surgery (classic cholecystectomy). Patients were divided into two groups of 120 patients, A and B. In group A during the operation had received conventional lung ventilation with tidal volume of 10-15 ml/kg body weight, respiratory rate 12/min. and a PEEP zero. In group B was applied protective lung ventilation with a tidal volume of 6-8 ml/kg body weight, respiratory rate 12/min. and a PEEP of 7 mbar. Monitoring of oxygenation included the monitoring SaO2 and PaO2. Monitoring of ventilation included the determination of the value of tidal volume and minute volume ventilation, peak inspiratory pressure (Ppeak), medium pressure in the airway (Paw.mean), PEEP, PaCO2 and EtCO2. Monitoring of acid-base status was performed via determination of the pH values of arterial blood. Monitoring was carried out in four intervals: T1 - 5-10 minutes after the establishment of the airway, T2 - after opening peritoneum, T3 - after removal of the gallbladder, T4 - after the closure of the abdominal wall. All monitoring results are presented as mean. The statistical significance of differences in mean values was tested by t - test mean values in the case of two independent samples. As a statistical significance test taken as standard values p <0.01 and p <0.001. Comparative analysis of the value of SaO2, PaO2, Ppeak did not reach statistical significance. Statistical significance there is in the analysis of values of tidal volume and Paw.mean (p <0.001). Analysis of PaCO2 and pH of arterial blood showed no statistical significance in the first interval measurements but did interval T2-T4 (p <0.001). Based on the results of this study, it can be concluded that the applied types of mechanical ventilation of lungs during the performance of surgical procedures of medium duration, have not led to significant changes in terms of maintaining the parameters of oxygenation, ventilation and acid-base status, and they stayed in normal, physiological range.
*** (2000) Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress Syndrome. New England Journal of Medicine, 342(18): 1301-1308
Amato, M.B., Barbas, C.S., Medeiros, D.M., Magaldi, R.B., Schettino, G.P., Lorenzi-Filho, G., Kairalla, R.A., Deheinzelin, D., Munoz, C., Oliveira, R., Takagaki, T.Y., Carvalho, C.R. (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. New England journal of medicine, 338(6): 347-54
Bendixen, H.H., Hedley-Whyte, J., Laver, M.B. (1963) Impaired oxygenation in surgical patients during general anesthesia with controlled ventilation. A concept of atelectasis. N Engl J Med, 269: 991-6
Brochard, L., Roudot-Thoraval, F., Roupie, E., Delclaux, C., Chastre, J., Fernandez-Mondéjar, E., Clémenti, E., Mancebo, J., Factor, P., Matamis, D., Ranieri, M., Blanch, L., Rodi, G., Mentec, H., Dreyfuss, D., Ferrer, M., Brun-Buisson, C., Tobin, M., Lemaire, F. (1998) Tidal volume reduction for prevention of ventilator-induced lung injury in acute respiratory distress syndrome. The Multicenter Trail Group on Tidal Volume reduction in ARDS. American Journal of Respiratory and Critical Care Medicine, 158(6): 1831-8
Chaney, M.A., Nikolov, M.P., Blakeman, B.P., Bakhos, M. (2000) Protective ventilation attenuates postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass. Journal of cardiothoracic and vascular anesthesia, 14(5): 514-8
Eichacker, P.Q., Gerstenberger, E.P., i dr. (2002) A metaanalysis of ALI and ARDS trials testing low tidal volumes. Am J Respir Crit Care Med, 28: (43); 28
Esteban, A., Frutos-Vivar, F., Muriel, A., Ferguson, N.D., Peñuelas, O., Abraira, V., Raymondos, K., Rios, F., Nin, N., Apezteguía, C., Violi, D.A., Thille, A.W., Brochard, L., González, M. (2013) Evolution of mortality over time in patients receiving mechanical ventilation. American Journal of Respiratory and Critical Care Medicine, 188(2): 220-30
Fan, E., Needham, D.M., Stewart, T.E. (2005) Ventilatory management of acute lung injury and acute respiratory distress syndrome. JAMA, 294(22): 2889-96
Hager, D.N., Krishnan, J.A., Hayden, DL., Brower, R.G. (2005) Tidal Volume Reduction in Patients with Acute Lung Injury When Plateau Pressures Are Not High. American Journal of Respiratory and Critical Care Medicine, 172(10): 1241-1245
Imai, Y., Parodo, J., Kajikawa, O., i dr. (2003) Injurious Mechanical Ventilation and End-Organ Epithelial Cell Apoptosis and Organ Dysfunction in an Experimental Model of Acute Respiratory Distress Syndrome. JAMA, 289(16): 2104
Lellouche, F., Dionne, S., Simard, S., Bussières, J., Dagenais, F. (2012) High tidal volumes in mechanically ventilated patients increase organ dysfunction after cardiac surgery. Anesthesiology, 116(5): 1072-82
Oeckler, R.A., Hubmayr, R.D. (2007) Ventilator-associated lung injury: a search for better therapeutic targets. European respiratory journal, 30(6): 1216-26
Pingleton, S.K. (1988) Complications of acute respiratory failure. American review of respiratory disease, 137(6): 1463-93
Serpa, N.A., Cardoso, S.O., Manetta, J.A., i dr. (2012) Association Between Use of Lung-Protective Ventilation With Lower Tidal Volumes and Clinical Outcomes Among Patients Without Acute Respiratory Distress Syndrome. JAMA, 308(16): 1651
Severgnini, P., Selmo, G., Lanza, C., Chiesa, A., Frigerio, A., Bacuzzi, A., Dionigi, G., Novario, R., Gregoretti, C., de Abreu, M.G., Schultz, M.J., Jaber, S., Futier, E. (2013) Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function. Anesthesiology, 118(6): 1307-21
Stewart, T.E., Meade, M.O., Cook, D.J., i dr. (1998) Evaluation of a Ventilation Strategy to Prevent Barotrauma in Patients at High Risk for Acute Respiratory Distress Syndrome. New England Journal of Medicine, 338(6): 355-361
Sutherasan, Y., Vargas, M., Pelosi, P. (2014) Protective mechanical ventilation in the non-injured lung: review and meta-analysis. Critical care, 18(2): 211
The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. New England journal of medicine, 342(18): 1301-8
Treschan, T.A., Kaisers, W., Schaefer, M.S., Bastin, B., Schmalz, U., Wania, V., Eisenberger, C.F., Saleh, A., Weiss, M., Schmitz, A., Kienbaum, P., Sessler, D.I., Pannen, B., Beiderlinden, M. (2012) Ventilation with low tidal volumes during upper abdominal surgery does not improve postoperative lung function. British journal of anaesthesia, 109(2): 263-71
Videnović, N. (2012) Oštećenja pluća izazvana mehaničkom ventilacijom. Kosovska Mitrovica: Medicinski fakultet Priština, Doktorska disertacija


article language: Serbian
document type: Professional Paper
DOI: 10.5937/pramed1503023v
published in SCIndeks: 05/01/2016

Related records

No related records