scholarly journals Effects of individualized high positive end-expiratory pressure and crystalloid administration on postoperative pulmonary function in patients undergoing robotic-assisted radical prostatectomy: a prospective randomized single-blinded pilot study 

2021 ◽  
Author(s):  
Sebastian Blecha ◽  
Anna Hager ◽  
Verena Gross ◽  
Timo Seyfried ◽  
Florian Zeman ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Blood Oxygenation ◽  
Lung Protective Ventilation ◽  
P Value ◽  
High Peep ◽  
Positive End Expiratory Pressure ◽  
Robotic Assisted ◽  
Postoperative Pulmonary Function ◽  
Crystalloid Infusion ◽  
Crystalloid Administration

Abstract Background Robotic-assisted laparoscopic prostatectomy (RALP) using a combination of capnoperitoneum and steep Trendelenburg positioning (STP) results in important pathophysiological pulmonary changes. The aim of the study was to evaluate if restrictive crystalloid administration and individual management of positive end-expiratory pressure (PEEP) improve peri- and postoperative pulmonary function in patients undergoing RALP in permanent 45 degree STP.Methods 98 patients undergoing RALP under standardized anesthesia were either allocated to a standard PEEP (5 mmHg) group or an individualized high PEEP group. Furthermore, each group was divided into a liberal vs restrictive crystalloid group (30 ml vs 15 ml per kg predicted body weight). Individualized PEEP levels were determined by means of preoperative PEEP titration in STP. In each of the four study groups following intraoperative parameters were analyzed: ventilation setting (PIP, driving pressure [Pdriv], lung compliance [LC], mechanical power [MP]), and postoperative pulmonary function (bed-side spirometry). The following spirometric parameters were measured pre- and postoperatively: the Tiffeneau index (FEV1/FVC ratio) and mean forced expiratory flow (FEF25 − 75). Data are shown as mean ± standard deviation (SD), and groups were compared with ANOVA. A P-value of < 0.05 was considered significant.Results The two individualized high PEEP groups (mean PEEP 15.5 [± 1.71 cmH2O]) showed significantly higher PIP and MP levels but significantly decreased Pdriv and increased LC. On the first and second postoperative day, patients with individualized higher PEEP levels had a significantly higher mean Tiffeneau index (day 1: 77.6% (± 6.6) vs 73.6% (± 8.8), P = 0.014; day 2: 76.5% (± 6.1) vs 72.7% (± 9.3), P = 0.021) and FEF25 − 75 (day 1: 2.41 liter/sec (± 0.9) vs 1.95 liter/sec (± 0.8), P = 0.009; day 2: 2.45 liter/sec (± 0.9) vs 2.07 liter/sec (± 0.8), P = 0.033). Perioperative oxygenation and postoperative spirometric parameters were not influenced by restrictive or liberal crystalloid infusion in either of the two PEEP groups.Conclusions Higher individualized PEEP levels during RALP improved blood oxygenation, lung-protective ventilation, and postoperative pulmonary function up to 48 hours after surgery. Restrictive crystalloid infusion during RALP seemed to have no effect on peri- and postoperative oxygenation and pulmonary function.

scholarly journals High Intraoperative Inspired Oxygen Does Not Increase Postoperative Supplemental Oxygen Requirements

2012 ◽  
Vol 117 (2) ◽  
pp. 271-279 ◽  
Author(s):  
Natalie Mackintosh ◽  
Matthew C. Gertsch ◽  
Harriet W. Hopf ◽  
Nathan L. Pace ◽  
Julia White ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Oxygen Saturation ◽  
Supplemental Oxygen ◽  
Arterial Oxygen ◽  
Postanesthesia Care Unit ◽  
Positive End Expiratory Pressure ◽  
Oxygen Requirement ◽  
Postoperative Pulmonary Function ◽  
Oxygen Requirements ◽  
Inspired Oxygen

Background Although a high fraction of inspired oxygen (FIO2) could reduce surgical site infection, there is concern it could increase postoperative pulmonary complications, including hypoxemia. Intraoperative positive end-expiratory pressure can improve postoperative pulmonary function. A practical measure of postoperative pulmonary function and the degree of hypoxemia is supplemental oxygen requirement. We performed a double-blind randomized 2 × 2 factorial study on the effects of intraoperative FIO2 0.3 versus more than 0.9 with and without positive end-expiratory pressure on the primary outcome of postoperative supplemental oxygen requirements in patients undergoing lower risk surgery. Methods After Institutional Review Board approval and consent, 100 subjects were randomized using computer-generated lists into four treatment groups (intraoperative FIO2 0.3 vs. more than 0.9, with and without 3-5 cm H2O positive end-expiratory pressure). Thirty minutes and 24 h after extubation, supplemental oxygen was discontinued. Arterial oxygen saturation by pulse oximetry was recorded 15 min later. If oxygen saturation decreased to less than 90%, supplemental oxygen was added incrementally to maintain saturation more than 90%. Results Nearly all subjects required supplemental oxygen in the postanesthesia care unit. Nonparametric Wilcoxon rank sum test demonstrated no statistically significant difference between groups in supplemental oxygen requirements at 45 min and 24 h after tracheal extubation (P = 0.56 and 0.98, respectively). Conclusions Use of intraoperative FIO2 more than 0.9 was not associated with increased oxygen requirement, suggesting it does not induce postoperative hypoxemia beyond anesthetic induction and surgery. Therefore, it may be reasonable to use high inspired oxygen in surgical patients with relatively normal pulmonary function.

Right Middle Lobe Transposition after Upper Lobectomy: Influence on Postoperative Pulmonary Function

2012 ◽  
Vol 61 (02) ◽  
pp. 138-143
Author(s):  
Toshiki Tanaka ◽  
Masataro Hayashi ◽  
Nobuyuki Tanaka ◽  
Tao-Sheng Li ◽  
Kimikazu Hamano ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Middle Lobe ◽  
Postoperative Pulmonary Function ◽  
Right Middle Lobe

COMPARATIVE EVALUATION OF SPIROMETRY PARAMETERS IN HEALTHY YOUNG AND ELDERLY ADULTS POPULATION IN PUNJAB, INDIA

2021 ◽  
pp. 1-3
Author(s):  
Ajay Pal Singh ◽  
Kailash Meena ◽  
Surinder Pal Singh ◽  
Avnish Kumar ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Tertiary Care ◽  
P Value ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Age Group ◽  
Elderly Adults ◽  
Elderly Age ◽  
Cross Sectional ◽  
Age Related

INTRODUCTION: Spirometry is a vital tool for the assessment of pulmonary function status. Spirometry can be used to demonstrate the age-related decline in pulmonary function. The spirometry values can be used as reference values for a particular age group. The aims of our study was to compare spirometry values between the young and elderly groups and evaluate age-related changes in both groups. MATERIAL AND METHODS: A cross-sectional study was conducted on 600 adults, which divided into two healthy groups: one was of young adults (18-35 years), and other was of elderly adults (>60 years) of 300 persons, each taken over a period of one year, in the Department of pulmonary medicine, a tertiary care hospital, Punjab. We conducted spirometry in both age group. Spirometry values were measured FVC, FEV1, FVC/FEV1, PEFR, and FEF25- 75 % of each groups.The subjects were selected based on random sampling RESULT: Spirometry values compared between young and elderly adults. Mean BMI in young and elderly groups was 25.09±2.87 and 25.82±2.45, respectively. Spirometry values in FVC , FEV1, FEV1/FVC , PEFR and FEF25-75% in young was 4.31± 0.18 , 3.84,± 0.88± 0.02, 9.87± 0.38 and 3.75 ±0.26 and elderly age group 3.01±, 2.60 ±0.85± 0.02, 7.70± 0.30 and 2.82 ± 0.26. On statistical analysis, p value <0.001 in all spirometry parameters. CONCLUSION: The study shows that there was a decline in spirometry parameters of healthy adults with the increase in age. This decline was signicant in all spirometric parameters (FVC, FEV1, FEV1/FVC, PEFR, FEF25–75%) measured in the present study

Surgical stabilization of flail chest: the impact on postoperative pulmonary function

2013 ◽  
Vol 40 (4) ◽  
pp. 501-505 ◽  
Author(s):  
S. M. Said ◽  
N. Goussous ◽  
M. D. Zielinski ◽  
H. J. Schiller ◽  
B. D. Kim
Keyword(s):  
Pulmonary Function ◽  
Flail Chest ◽  
Postoperative Pulmonary Function ◽  
The Impact

scholarly journals The Effect of Incentive Spirometry on Postoperative Pulmonary Function Following Laparotomy

JAMA Surgery ◽  
2015 ◽  
Vol 150 (3) ◽  
pp. 229 ◽  
Author(s):  
Anna F. Tyson ◽  
Claire E. Kendig ◽  
Charles Mabedi ◽  
Bruce A. Cairns ◽  
Anthony G. Charles
Keyword(s):  
Pulmonary Function ◽  
Postoperative Pulmonary Function ◽  
Incentive Spirometry

Modified Ultrafiltration May Improve Postoperative Pulmonary Function in Children with a Ventricular Septal Defect

Surgery Today ◽  
2001 ◽  
Vol 31 (7) ◽  
pp. 586-590 ◽  
Author(s):  
Masahiko Onoe ◽  
Hidetaka Oku ◽  
Hitoshi Kitayama ◽  
Terufumi Matsumoto ◽  
Toshio Kaneda
Keyword(s):  
Ventricular Septal Defect ◽  
Pulmonary Function ◽  
Septal Defect ◽  
Postoperative Pulmonary Function

scholarly journals Post-Cholecystectomy Pulmonary Function following Interpleural Bupivacaine and Intramuscular Pethidine

1989 ◽  
Vol 17 (4) ◽  
pp. 440-443 ◽  
Author(s):  
D. C. Oxorn ◽  
G. S. Whatley
Keyword(s):  
Postoperative Pain ◽  
Pulmonary Function ◽  
Postoperative Analgesia ◽  
The Other ◽  
Pulmonary Mechanics ◽  
Postoperative Pulmonary Function ◽  
Pain Scores ◽  
Significant Difference ◽  
Group A ◽  
To Receive

Twenty-four patients who were to undergo cholecystectomy were randomised into two groups, one to receive postoperative analgesia with interpleural bupivacaine, 20 ml of a 0.5% solution with adrenaline 5 μg/ml, and the other to receive intramuscular pethidine, 1 mg/kg. Preoperative and postoperative pulmonary function, postoperative pain scores, and days from operation to hospital discharge were recorded and statistically compared. There was no significant difference in pain scores, nor in days to discharge; however, postoperative pulmonary mechanics were significantly poorer in the interpleural group. A hypothesis to explain the differences is offered.

Sign in / Sign up

Export Citation Format

Share Document