THE EFFECT OF UPPER ABDOMINAL SURGERY ON THE RELATIONSHIP OF AIRWAY CLOSING POINT TO END TIDAL POSITION

1973 ◽  
Vol 17 (5) ◽  
pp. 461
Author(s):  
J. I. ALEXANDER ◽  
P. W. HORTON ◽  
W. T. MILLAR ◽  
R. K. PARIKH ◽  
A. A. SPENCE
1972 ◽  
Vol 43 (2) ◽  
pp. 137-141 ◽  
Author(s):  
J. I. Alexander ◽  
P. W. Horton ◽  
W. T. Millar ◽  
R. K. Parikh ◽  
A. A. Spence

1. The relationship between end tidal position (ETP) and the point of lung emptying at which there is significant airways closure (CP) has been investigated before and after upper abdominal surgery in thirty-one patients. 2. A significant negative correlation between the index (ETP-CP) and the alveolar-arterial Po2 difference (A-ado2) was found. 3. Nineteen of these patients had a vagotomy and drainage operation and, in this group, there was a greater fall in ETP than in CP in the first and second postoperative days. 4. It is suggested that airway closure is a contributory factor to the known hypoxaemia following abdominal surgery.


2020 ◽  
Vol 72 (5) ◽  
Author(s):  
Mariaclelia La Russa ◽  
Chrysoula G. Liakou ◽  
Nikolaos Akrivos ◽  
Hilary L. Turnbull ◽  
Timothy J. Duncan ◽  
...  

Respiration ◽  
2021 ◽  
pp. 1-14
Author(s):  
Kerrie A. Sullivan ◽  
Isabella F. Churchill ◽  
Danielle A. Hylton ◽  
Waël C. Hanna

<b><i>Background:</i></b> Currently, consensus on the effectiveness of incentive spirometry (IS) following cardiac, thoracic, and upper abdominal surgery has been based on randomized controlled trials (RCTs) and systematic reviews of lower methodological quality. To improve the quality of the research and to account for the effects of IS following thoracic surgery, in addition to cardiac and upper abdominal surgery, we performed a meta-analysis with thorough application of the Grading of Recommendations Assessment, Development and Evaluation scoring system and extensive reference to the Cochrane Handbook for Systematic Reviews of Interventions. <b><i>Objective:</i></b> The objective of this study was to determine, with rigorous methodology, whether IS for adult patients (18 years of age or older) undergoing cardiac, thoracic, or upper abdominal surgery significantly reduces30-day post-operative pulmonary complications (PPCs), 30-day mortality, and length of hospital stay (LHS) when compared to other rehabilitation strategies. <b><i>Methods:</i></b> The literature was searched using Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Web of Science for RCTs between the databases’ inception and March 2019. A random-effect model was selected to calculate risk ratios (RRs) with 95% confidence intervals (CIs). <b><i>Results:</i></b> Thirty-one RCTs involving 3,776 adults undergoing cardiac, thoracic, or upper abdominal surgery were included. By comparing the use of IS to other chest rehabilitation strategies, we found that IS alone did not significantly reduce 30-day PPCs (RR = 1.00, 95% CI: 0.88–1.13) or 30-day mortality (RR = 0.73, 95% CI: 0.42–1.25). Likewise, there was no difference in LHS (mean difference = −0.17,95% CI: −0.65 to 0.30) between IS and the other rehabilitation strategies. None of the included trials significantly impacted the sensitivity analysis and publication bias was not detected. <b><i>Conclusions:</i></b> This meta-analysis showed that IS alone likely results in little to no reduction in the number of adult patients with PPCs, in mortality, or in the LHS, following cardiac, thoracic, and upper abdominal surgery.


2021 ◽  
Vol 10 (4) ◽  
pp. 561
Author(s):  
Aliyah Snyder ◽  
Christopher Sheridan ◽  
Alexandra Tanner ◽  
Kevin Bickart ◽  
Molly Sullan ◽  
...  

Dysregulation of the autonomic nervous system (ANS) may play an important role in the development and maintenance of persistent post-concussive symptoms (PPCS). Post-injury breathing dysfunction, which is influenced by the ANS, has not been well-studied in youth. This study evaluated cardiorespiratory functioning at baseline in youth patients with PPCS and examined the relationship of cardiorespiratory variables with neurobehavioral outcomes. Participants were between the ages of 13–25 in two groups: (1) Patients with PPCS (concussion within the past 2–16 months; n = 13) and (2) non-injured controls (n = 12). Capnometry was used to obtain end-tidal CO2 (EtCO2), oxygen saturation (SaO2), respiration rate (RR), and pulse rate (PR) at seated rest. PPCS participants exhibited a reduced mean value of EtCO2 in exhaled breath (M = 36.3 mmHg, SD = 2.86 mmHg) and an altered inter-correlation between EtCO2 and RR compared to controls. Neurobehavioral outcomes including depression, severity of self-reported concussion symptoms, cognitive catastrophizing, and psychomotor processing speed were correlated with cardiorespiratory variables when the groups were combined. Overall, results from this study suggest that breathing dynamics may be altered in youth with PPCS and that cardiorespiratory outcomes could be related to a dimension of neurobehavioral outcomes associated with poorer recovery from concussion.


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