On-line expiratory flow-volume curves during thoracic surgery: occurrence of auto-PEEP.
نویسندگان
چکیده
Flow-volume loops were monitored continuously in 39 patients undergoing thoracic surgery requiring one-lung ventilation. In 26 of the 39 patients (67%), auto-positive end-expiratory pressure (auto-PEEP) was seen on the flow-volume curves during both two-lung and one-lung ventilation. Eighty-seven percent of the patients whose trachea was intubated with a smaller size (35- and 37-French gauge) double-lumen tracheal tube exhibited auto-PEEP, compared with patients in whom the tube used was larger (39- or 41-French gauge: 54% and 50%, respectively). Before operation, mean airway resistance was significantly greater in patients who exhibited auto-PEEP during anaesthesia (2.4 cm H2O litre-1 s) than in patients without auto-PEEP (1.7 cm H2O litre-1 s).
منابع مشابه
Assessment of Factors Related to Auto-PEEP.
BACKGROUND Previous physiological studies have identified factors that are involved in auto-PEEP generation. In our study, we examined how much auto-PEEP is generated from factors that are involved in its development. METHODS One hundred eighty-six subjects undergoing controlled mechanical ventilation with persistent expiratory flow at the beginning of each inspiration were enrolled in the st...
متن کاملIt's Time to Reappraise the Impact of Auto-PEEP.
Since Pepe and Marini1 first used the term auto-PEEP in 1982, many studies have been conducted in this field.2-5 For patients receiving mechanical ventilation, auto-PEEP is a common problem during the weaning process.2-4 Even in the acute stage of acute respiratory failure, patients may suffer from the detrimental effects of auto-PEEP.4,5 By definition, auto-PEEP occurs when air flow does not r...
متن کاملEffects of PEEP on respiratory mechanics in patients with COPD on mechanical ventilation.
We studied the effects of positive end-expiratory pressure (PEEP) applied by the ventilator on respiratory mechanics in ventilated patients with chronic obstructive pulmonary disease (COPD). Airway pressures, relaxed expiratory flow-volume curves and end-expiratory volumes (EEV) were measured. In all patients investigated without PEEP applied by the ventilator, an intrinsic PEEP level (PEEPi) a...
متن کاملMeasurement of air trapping, intrinsic positive end-expiratory pressure, and dynamic hyperinflation in mechanically ventilated patients.
Severe airflow obstruction is a common cause of acute respiratory failure. Dynamic hyperinflation affects tidal ventilation, increases airways resistance, and causes intrinsic positive end-expiratory pressure (auto-PEEP). Most patients with asthma and chronic obstructive pulmonary disease have dynamic hyperinflation and auto-PEEP during mechanical ventilation, which can cause hemodynamic compro...
متن کاملEffect of external PEEP in patients under controlled mechanical ventilation with an auto-PEEP of 5 cmH2O or higher
BACKGROUND In some patients with auto-positive end-expiratory pressure (auto-PEEP), application of PEEP lower than auto-PEEP maintains a constant total PEEP, therefore reducing the inspiratory threshold load without detrimental cardiovascular or respiratory effects. We refer to these patients as "complete PEEP-absorbers." Conversely, adverse effects of PEEP application could occur in patients w...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- British journal of anaesthesia
دوره 72 1 شماره
صفحات -
تاریخ انتشار 1994