Abstract:
BACKGROUND:Pulmonary function is impaired during pneumoperitoneum mainly as a result of atelectasis formation. We studied the effects of 10 cm H2O of positive end-expiratory pressure (PEEP) and PEEP followed by a recruitment maneuver (PEEP+RM) on end-expiratory lung volume (EELV), oxygenation and respiratory mechanics in patients undergoing laparoscopic surgery. METHODS:Sixty consecutive adult patients (30 obese, 30 healthy weight) in reverse Trendelenburg position were prospectively studied. EELV, static elastance of the respiratory system, dead space, and gas exchange were measured before and after pneumoperitoneum insufflation with zero end-expiratory pressure, with PEEP alone, and with PEEP+RM. Results are presented as mean ± SD. RESULTS:Pneumoperitoneum reduced EELV (healthy weight, 1195 ± 405 vs. 1724 ± 774 ml; obese, 751 ± 258 vs. 886 ± 284 ml) and worsened static elastance and dead space in both groups (in all P < 0.01 vs. zero-end expiratory pressure before pneumoperitoneum) whereas oxygenation was unaffected. PEEP increased EELV (healthy weight, 570 ml, P < 0.01; obese, 364 ml, P < 0.01) with no effect on oxygenation. Compared with PEEP alone, EELV and static elastance were further improved after RM in both groups (P < 0.05), as was oxygenation (P < 0.01). In all patients, RM-induced change in EELV was 16% (P = 0.04). These improvements were maintained 30 min after RM. RM-induced changes in EELV correlated with change in oxygenation (r = 0.42, P < 0.01). CONCLUSION:RM combined with 10 cm H2O of PEEP improved EELV, respiratory mechanics, and oxygenation during pneumoperitoneum whereas PEEP alone did not.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Futier E,Constantin JM,Pelosi P,Chanques G,Kwiatkoskwi F,Jaber S,Bazin JEdoi
10.1097/ALN.0b013e3181fc640asubject
Has Abstractpub_date
2010-12-01 00:00:00pages
1310-9issue
6eissn
0003-3022issn
1528-1175journal_volume
113pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract::A constantly coupled bigeminal arrhythmia was induced in dogs anesthetized with thiopental-halothane by infusion of epinephrine (1 microgram.kg-1.min-1). The site of origin of the abnormal beat was localized to the interventricular septum by bipolar recordings from the left and right ventricular epicardium and two sit...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198208000-00006
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Lamotrigine is a sodium channel blocker that inhibits the neuronal release of glutamate. Systemic administration of lamotrigine induces analgesia in short- and long-term models of hyperalgesia in rats. Considering the key role of N-methyl-D-aspartate receptors in the sensitization of dorsal horn neurons that...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199802000-00028
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) requires early diagnosis and adequate antibiotic therapy. The aim of this prospective postmortem study was to assess the accuracy of direct examination and quantification of intracellular organisms (ICO) for the diagnosis of VAP. METHODS:Total and differential cell coun...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199708000-00013
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Up to 84% of women who undergo operative vaginal delivery receive neuraxial analgesia. However, little is known about the association between neuraxial analgesia and neonatal morbidity in women who undergo operative vaginal delivery. The authors hypothesized that neuraxial analgesia is associated with a redu...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003589
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Drugs that block spinal excitatory amino acid receptor activation may prevent pain after surgery. The authors previously studied the effect of excitatory amino acid receptor antagonists after incision. In the present study, we examined the role of N-methyl-d-aspartate (NMDA), non-NMDA, and metabotropic gluta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00029
更新日期:2000-08-01 00:00:00
abstract::Propofol is a potent lipophilic anesthetic that was initially formulated in Cremophor El for human use. Because of the occurrence of Cremophor EL anaphylaxis and improvements in the quality of lipid emulsions, it was ultimately brought to market as 1% propofol formulated in 10% soybean oil emulsion. Emulsions represen...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00000542-200510000-00026
更新日期:2005-10-01 00:00:00
abstract::The effects of vasopressor therapy on intracranial pressure (ICP) during hypotension were evaluated in 45 adult cats anesthetized with pentobarbital and hyperventilated via an endotracheal tube with nitrous oxide, 70 per cent, and oxygen, 30 per cent, to maintain Paco2 25 plus or minus 5 torr. Hypotension was induced ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197504000-00011
更新日期:1975-04-01 00:00:00
abstract:BACKGROUND:Anesthetic drugs administered to immature animals may cause neurohistopathologic changes and alterations in behavior. The authors studied association between anesthetic exposure before age 4 yr and the development of reading, written language, and math learning disabilities (LD). METHODS:This was a populati...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.anes.0000344728.34332.5d
更新日期:2009-04-01 00:00:00
abstract::To determine the correlation between the partial pressures of anesthetics in venous and arterial blood (Pv and Pa), and to assess whether this correlation was better than that between the partial pressure of anesthetic in alveolar gas (PA) and Pa, isoflurane (n = 4) or halothane (n = 4) was administered to eight patie...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198904000-00014
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Massive release of central excitatory neurotransmitters is an important initial step in ischemic neuronal injury, and modification of this process may provide neuroprotection. We studied the protective effects of the voltage-dependent sodium channel antagonist riluzole and the N-methyl-d-aspartate receptor a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200011000-00025
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:It is not always possible to predict when tracheal intubation will be difficult or impossible. The authors wanted to determine whether indirect laryngoscopy could identify patients in whom intubation was difficult. METHODS:Indirect laryngoscopy was done in 2,504 patients. The Wilson risk sum score and the m...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199702000-00007
更新日期:1997-02-01 00:00:00
abstract::It is now well established that the pathophysiology of the malignant hyperthermia (MH) syndrome is related to a malfunction of intracellular calcium homeostasis. Magnesium plays important roles in the basic contractile properties of muscle, and many of its actions are antagonistic to those of calcium. The aim of this ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199007000-00016
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Halothane and isoflurane have been shown to differentially effect mechanisms of contraction in working myocardial fibers. The aim of this study was to compare effects of halothane and isoflurane on contractile force (CF) and Ca2+ transients in canine cardiac Purkinje fiber preparations. METHODS:Fiber prepar...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199406000-00024
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:Patients with initial mild acute respiratory distress syndrome are often underrecognized and mistakenly considered to have low disease severity and favorable outcomes. They represent a relatively poorly characterized population that was only classified as having acute respiratory distress syndrome in the mos...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0000000000002508
更新日期:2019-02-01 00:00:00
abstract::Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. By Audrey Shafer, Van A. Doze, Steven L. Shafer, and Paul F. White. Anesthesiology 1988; 69:348-56. Reprinted with permission.The pharmacokinetic and pharmacodynamic properties of propofol (Diprivan) were studied in 50 elective surg...
journal_title:Anesthesiology
pub_type: 古典文章,评论,杂志文章
doi:10.1097/ALN.0b013e31818ddba8
更新日期:2008-12-01 00:00:00
abstract::The cerebral and systemic hemodynamic and metabolic effects of hypotension induced with desflurane were examined in 11 dogs. During a steady-state baseline period under 1 MAC desflurane (7.2%), the following were measured or derived: arterial, pulmonary artery, and pulmonary artery occlusion pressures; arterial, mixed...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199103000-00021
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Electroconvulsion therapy is likely to serve as an effective preconditioning stimulus for inducing tolerance to ischemic brain injury. The current study examines whether electrical stimuli on the spinal cord is also capable of inducing tolerance to ischemic spinal cord injury by transient aortic occlusion. ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200507000-00015
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Animal models of ventilator-associated pneumonia (VAP) in primates, sheep, and pigs differ in the underlying pulmonary injury, etiology, bacterial inoculation methods, and time to onset. The most common ovine and porcine models do not reproduce the primary pathogenic mechanism of the disease, through the asp...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000222
更新日期:2014-05-01 00:00:00
abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:Cardiac surgery is associated with cognitive decline and postoperative delirium. The relationship between postoperative delirium and cognitive decline after cardiac surgery is unclear WHAT THIS ARTICLE TELLS US THAT IS NEW:The development of postoperative delirium is associated wi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002253
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:High-frequency oscillatory ventilation (HFOV) at higher frequencies minimizes the tidal volume. However, whether increased frequencies during HFOV can reduce ventilator-induced lung injury remains unknown. METHODS:After the induction of acute respiratory distress syndrome in the model by repeated lavages, 2...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31829419a6
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Anesthetic preconditioning (APC) with sevoflurane reduces myocardial ischemia-reperfusion injury. The authors tested whether two brief exposures to sevoflurane would lead to a better preconditioning state than would a single longer exposure and whether dual exposure to a lower (L) concentration of sevofluran...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200403000-00016
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:In an effort to measure and improve the quality of perioperative care, the Surgical Care Improvement Project (SCIP) was introduced in 2003. The SCIP guidelines are evidence-based process measures designed to reduce preventable morbidity, but it remains to be determined whether SCIP-measure compliance is asso...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000681
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Differentiating drug-related changes and state-related changes on the electroencephalogram during anesthetic-induced unconsciousness has remained a challenge. To distinguish these, we designed a rigorous experimental protocol with two drugs known to have distinct molecular mechanisms of action. We hypothesiz...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000002192
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The design of an endotracheal tube has been shown to influence the passage of the tube through the glottis during fiberoptic intubation. Difficulty in passing the endotracheal tube can occur if the aryepiglottic folds obstruct the passage of the bevel. The relevant aspects of endotracheal tube design include...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200105000-00007
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that desflurane and isoflurane produce similar hemodynamic actions. This investigation examined the cardiovascular effects of desflurane and isoflurane in the presence or absence of dexmedetomidine, a highly selective alpha 2-adrenergic agonist that may be clinically useful as a p...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199311000-00021
更新日期:1993-11-01 00:00:00
abstract::Anesthetized, prone dogs were intubated with a double-lumen endobronchial tube, and the lungs were ventilated independently. Three methods of recording differential blood flow were compared during unilateral lung hypoxia: electromagnetic flow measurement, flow probes being fitted onto each main pulmonary artery after ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198708000-00015
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Uptake of a second gas of a delivered gas mixture decreases the amount of carrier gas and potent inhaled anesthetic leaving the circle system through the pop-off valve. The authors hypothesized that the vaporizer settings required to maintain constant end-expired sevoflurane concentration (Etsevo) during min...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200208000-00017
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Initial anesthetic-induced hypothermia results largely from core-to-peripheral redistribution of heat. Nifedipine administration may minimize hypothermia by inducing vasodilation well before induction of anesthesia. Although vasodilation would redistribute heat to peripheral tissues, thermoregulatory respons...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199401000-00019
更新日期:1994-01-01 00:00:00
abstract::The occurrence of fasciculations following administration of agents is a well-known pharmacologic phenomenon. Using the cat soleus nerve-muscle preparation, intravenous neostigmine doses between 20-200 micrograms/kg evoked fasciculations in a dose-related manner. The data demonstrate that the fasciculations were the r...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198712000-00011
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:We examined the effects of different anesthetics on cerebral oxygenation and systemic hemodynamics in patients undergoing surgery in beach chair position (BCP). Jugular venous bulb oxygen saturation (SjvO2) and regional cerebral tissue oxygen saturation (SctO2) were determined while patients were placed from...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e31825154d2
更新日期:2012-05-01 00:00:00