scholarly journals Lung Ultrasonography in the Monitoring of Intraoperative Recruitment Maneuvers

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 276
Author(s):  
Jolanta Cylwik ◽  
Natalia Buda
Keyword(s):  
General Anesthesia ◽  
Peak Pressure ◽  
Perioperative Complications ◽  
Lung Compliance ◽  
Chest Ultrasonography ◽  
Simultaneous Reduction ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Recruitment Maneuvers ◽  
Ventilated Patients

Introduction: Postoperative respiratory failure is a serious problem in patients who undergo general anesthesia. Approximately 90% of mechanically ventilated patients during the surgery may develop atelectasis that leads to perioperative complications. Aim: The aim of this study is to determine whether it is possible to optimize recruitment maneuvers with the use of chest ultrasonography, thus limiting the risk of respiratory complications in patients who undergo general anesthesia. Methodology: The method of incremental increases in positive end-expiratory pressure (PEEP) values with simultaneous continuous ultrasound assessments was employed in mechanically ventilated patients. Results: The study group comprised 100 patients. The employed method allowed for atelectasis reduction in 91.9% of patients. The PEEP necessary to reverse areas of atelectasis averaged 17cmH2O, with an average peak pressure of 29cmH2O. The average PEEP that prevented repeat atelectasis was 9cmH2O. A significant improvement in lung compliance and saturation was obtained. Conclusions: Ultrasound-guided recruitment maneuvers facilitate the patient-based adjustment of the process. Consequently, the reduction in ventilation pressures necessary to aerate intraoperative atelectasis is possible, with the simultaneous reduction in the risk of procedure-related complications.

Detection of Tidal Recruitment/Overdistension in Lung-Healthy Mechanically Ventilated Patients Under General Anesthesia

2013 ◽  
Vol 116 (3) ◽  
pp. 677-684 ◽  
Author(s):  
Alysson Roncally Carvalho ◽  
Sergio A. Pacheco ◽  
Patricia Vieira de Souza Rocha ◽  
Bruno Curty Bergamini ◽  
Luís Felipe Paula ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Tidal Recruitment ◽  
Ventilated Patients

scholarly journals The effects of manual hyperflation using self-inflating manual resuscitation bags on arterial oxygen tensions and lung compliance - Ameta-analysis of the literature

2000 ◽  
Vol 56 (1) ◽  
pp. 7-16 ◽  
Author(s):  
M. Barker ◽  
C. J. Eales
Keyword(s):  
Meta Analysis ◽  
Lung Compliance ◽  
Arterial Oxygen ◽  
Mean Values ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Therapeutic Value ◽  
The Mean ◽  
Oxygen Tensions ◽  
Ventilated Patients

The self-inflating manual resuscitation bag (MRB) is a modality which is commonly used by physiotherapists to manually hyperinflate the lungs of mechanically ventilated patients. There is limited scientific evidence to support its therapeutic use and the literature is not in agreement as to the effects of manual hyperinflation. A meta-analysis of the current research on humans has been conducted to investigate the effects of this modality on arterial oxygen tensions and lung compliance. All published studies evaluating the effects of manual hyperinflation (or bagging) on arterial oxygen tensions and/or lung compliance on mechanically ventilated patients have been retrieved. Only studies which reported results in terms of mean values and standard deviation or standard error of the mean could be used in this analysis. Eleven studies were identified between the time period 1968 -1995. Seven of these studies fitted the inclusion criteria. The mean and standard error of the mean values for arterial oxygen tensions (Pa02) and lung compliance (CL) have been used to calculate the 95% confidence intervals and these results were plotted on a graph. A comparative analysis has been performed on the results of the seven studies. A generally non-significant association between bagging and the Pa02 and CL values was demonstrated. Great discrepancies were identified in the designs of the seven included studies. Since the seven studies included in this meta-analysis show an overall non-significant association, it is reasonable to assume that the therapeutic value of the self-inflating manual resuscitation bag is questionable. The studies presented such divergent designs that they do not offer conclusive evidence. More standardized, multi-centre studies are required to clarify the therapeutic value of this modality. Other methods of recruiting the lungs of critically ill patients during and after physiotherapy intervention, need to be explored.

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