Abstract:
BACKGROUND:Although the mechanical status of the lungs affects the shape of the capnogram, the relations between the capnographic parameters and those reflecting the airway and lung tissue mechanics have not been established in mechanically ventilated patients. We, therefore, set out to characterize how the mechanical properties of the airways and lung tissues modify the indices obtained from the different phases of the time and volumetric capnograms and how the lung mechanical changes are reflected in the altered capnographic parameters after a cardiopulmonary bypass (CPB). METHODS:Anesthetized, mechanically ventilated patients (n = 101) undergoing heart surgery were studied in a prospective consecutive cross-sectional study under the open-chest condition before and 5 minutes after CPB. Forced oscillation technique was applied to measure airway resistance (Raw), tissue damping (G), and elastance (H). Time and volumetric capnography were performed to assess parameters reflecting the phase II (SII) and phase III slopes (SIII), their transition (D2min), the dead-space indices according to Fowler, Bohr, and Enghoff and the intrapulmonary shunt. RESULTS:Before CPB, SII and D2min exhibited the closest (P = 0.006) associations with H (0.65 and -0.57; P < 0.0001, respectively), whereas SIII correlated most strongly (P < 0.0001) with Raw (r = 0.63; P < 0.0001). CPB induced significant elevations in Raw and G and H (P < 0.0001). These adverse mechanical changes were reflected consistently in SII, SIII, and D2min, with weaker correlations with the dead-space indices (P < 0.0001). The intrapulmonary shunt expressed as the difference between the Enghoff and Bohr dead-space parameters was increased after CPB (95% ± 5% [SEM] vs 143% ± 6%; P < 0.001). CONCLUSIONS:In mechanically ventilated patients, the capnographic parameters from the early phase of expiration (SII and D2min) are linked to the pulmonary elastic recoil, whereas the effect of airway patency on SIII dominates over the lung tissue stiffness. However, severe deterioration in lung resistance or elastance affects both capnogram slopes.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Csorba Z,Petak F,Nevery K,Tolnai J,Balogh AL,Rarosi F,Fodor GH,Babik Bdoi
10.1213/ANE.0000000000001185subject
Has Abstractpub_date
2016-05-01 00:00:00pages
1412-20issue
5eissn
0003-2999issn
1526-7598journal_volume
122pub_type
杂志文章abstract::We designed a randomized, double-blind study to assess the analgesic efficacy and safety of perioperative ketorolac infusion in 95 patients undergoing cholecystectomy. The ketorolac group (n = 48) received premedication, combined with ketorolac 30 mg intramuscularly (IM), followed by a ketorolac continuous infusion (2...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Thoracic aorta dissection is an acute critical condition associated with shock-induced endotheliopathy, coagulopathy, massive bleeding, and significant morbidity and mortality. Our aim was to compare the effect of coagulation support with solvent/detergent-treated pooled plasma (OctaplasLG) versus standard f...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
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doi:10.1213/ANE.0000000000001674
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e318229d450
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
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journal_title:Anesthesia and analgesia
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
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更新日期:2013-05-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
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journal_title:Anesthesia and analgesia
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-08-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000156579.11254.D1
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doi:10.1213/01.ANE.0000139651.82022.1D
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pub_type: 杂志文章
doi:10.1097/00000539-200206000-00009
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003340
更新日期:2019-06-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199304000-00020
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1999-02-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199309000-00028
更新日期:1993-09-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199804000-00028
更新日期:1998-04-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199006000-00013
更新日期:1990-06-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
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更新日期:2000-02-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
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更新日期:2012-01-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
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更新日期:2012-11-01 00:00:00