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The effect of lung expansion and positive end-expiratory pressure on anesthetized children
dc.creator | Kaditis, A. G. | en |
dc.creator | Motoyama, E. K. | en |
dc.creator | Zin, W. | en |
dc.creator | Maekawa, N. O. | en |
dc.creator | Nishio, I. | en |
dc.creator | Imai, T. | en |
dc.creator | Milic-Emili, J. | en |
dc.date.accessioned | 2015-11-23T10:30:45Z | |
dc.date.available | 2015-11-23T10:30:45Z | |
dc.date.issued | 2008 | |
dc.identifier | 10.1213/ane.0b013e318162c20a | |
dc.identifier.issn | 0003-2999 | |
dc.identifier.uri | http://hdl.handle.net/11615/28698 | |
dc.description.abstract | BACKGROUND: Imaging studies have shown that general anesthesia in children results in atelectasis. Lung recruitment total lung capacity (TLC) maneuvers plus positive end-expiratory pressure (PEEP) are effective in preventing atelectasis. However, physiological changes in children during general anesthesia have not been elucidated. METHODS: In eight anesthetized and mechanically ventilated children (median age: 3.5 years; range: 2.3-6.5), we measured static respiratory system elastance (E,,), flow resistance (R-int), and elastance and resistance components resulting from tissue viscoelasticity (Delta E and Delta R, respectively) using the constant inflow, end-inspiratory occlusion method preceded by TLC maneuvers, both with zero PEEP (ZEEP) and PEEP (5 cm H,C) for comparison. RESULTS: With constant inspiratory flow (VI) and ZEEP, increases in end-inspiratory lung volume above relaxation volume (tidal volume V) from 8 to 20 mL.kg(-1),, resulted in decreases in E,, from 1.06 to 0.82 cm H2O.mL(-1).kg, Delta E from 0.16 to 0.09, and Rint from 0.13 to 0.11 cm H2O.mL(-1).s.kg, whereas Delta R increased from 0.08 to 0.12 (P < 0.05). Similar relationships were found with PEEP. Increases in V, (8 to 26 mL.s(-1).kg) with constant V-T and ZEEP resulted in decreases in E-st from 1.09 to 0.9 and Delta R from 0.17 to 0.06 (P < 0.01), whereas Delta E and R-int did not change. There was a similar flow and volume dependence of elastance and resistance with PEEP. CONCLUSIONS: The observed steady decreases in E-st with increasing V, (up to 16 mL/kg with PEEP) indicate marked reductions in end-expiratory relaxation volume (functional residual capacity) even with PEEP. Similarity in results with ZEEP and PEEP suggests that TLC-maneuvers and O-2-N-2 ventilation prevented airway closure throughout the study. | en |
dc.source.uri | <Go to ISI>://WOS:000253393900014 | |
dc.subject | FUNCTIONAL RESIDUAL CAPACITY | en |
dc.subject | RESPIRATORY MECHANICS | en |
dc.subject | GENERAL-ANESTHESIA | en |
dc.subject | PARALYZED HUMANS | en |
dc.subject | MUSCLE PARALYSIS | en |
dc.subject | AIRWAY-CLOSURE | en |
dc.subject | ARDS PATIENTS | en |
dc.subject | GAS-EXCHANGE | en |
dc.subject | ATELECTASIS | en |
dc.subject | VOLUME | en |
dc.subject | Anesthesiology | en |
dc.title | The effect of lung expansion and positive end-expiratory pressure on anesthetized children | en |
dc.type | journalArticle | en |
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