QRS-activated ventilation during general anesthesia for extracorporeal shock wave lithotripsy.

Abstract:

:High frequency ventilation has been claimed to improve the efficiency of extracorporeal shock wave lithotripsy (ESWL) by minimizing the movement of urinary stones during the procedure. A ventilatory mode, QRS-activated ventilation, was developed in which the stones remain motionless during the delivery of shock waves. As the shock wave is triggered to occur approximately 20 milliseconds after the R wave of the QRS complex, the mechanical breath was synchronized to occur approximately 150 ms later. QRS-activated ventilation is used in 16 patients undergoing ESWL under general anesthesia. Tidal volume was set at 3 ml/kg (234 +/- 36 ml; mean +/- SD) at a rate that equaled the heart rate (71 +/- 9 beats/min). The time between the R wave and the initiation of mechanical breath (T1) was 124 +/- 25 ms, time of mechanical breath itself (T2) was 431 +/- 67 ms, and time between end of T2 and next R wave (T3) was 264 +/- 84 ms. End-tidal CO2 measured by the large breath technique was 28.1 +/- 4.8 mmHg. During the clinical use of QRS-activated ventilation and during earlier studies using an EKG simulator and a test lung, the shock wave occurred invariably at end-expiration even at high heart rates.

journal_name

J Clin Anesth

authors

Perel A,Segal E,Pizov R,Lenkovskey Z,Mahler Y

doi

10.1016/0952-8180(89)90025-1

subject

Has Abstract

pub_date

1989-01-01 00:00:00

pages

268-71

issue

4

eissn

0952-8180

issn

1873-4529

pii

0952-8180(89)90025-1

journal_volume

1

pub_type

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