Comparison of two ventilatory strategies in elderly patients undergoing major abdominal surgery

British Journal of Anaesthesia
T N WeingartenJ Sprung

Abstract

'Open lung' ventilation is commonly used in patients with acute lung injury and has been shown to improve intraoperative oxygenation in obese patients undergoing laparoscopic surgery. The feasibility of an 'open lung' ventilatory strategy in elderly patients under general anaesthesia has not previously been assessed. 'Open lung' ventilation (recruitment manoeuvres, tidal volume 6 ml kg(-1) predicted body weight, and 12 cm H(2)O PEEP) (RM group) was compared with conventional ventilation (no recruitment manoeuvres, tidal volume 10 ml kg(-1) predicted body weight, and zero end-expiratory pressure) in elderly patients (>65 yr) undergoing major open abdominal surgery with regard to oxygenation, respiratory system mechanics, and haemodynamic stability. We also monitored the serum levels of the interleukins (IL)-6 and IL-8 before and after surgery to determine whether the systemic inflammatory response to surgery depends on the ventilatory strategy used. Twenty patients were included in each group. The RM group tolerated open lung ventilation without significant haemodynamic instability. Intraoperative Pa(o(2)) improved in the RM group (P<0.01) and deteriorated in controls (P=0.01), but postoperative Pa(o(2)) was similar in both grou...Continue Reading

References

Jan 1, 1992·Intensive Care Medicine·B Lachmann
Apr 1, 1991·British Journal of Anaesthesia·L GunnarssonG Hedenstierna
Oct 1, 1982·Acta Anaesthesiologica Scandinavica·J Hovorka
Mar 1, 1997·The Journal of Clinical Investigation·L TremblayA S Slutsky
Sep 25, 1997·Archives of Surgery·D B AllenT K Hunt
Feb 5, 1998·The New England Journal of Medicine·M B AmatoC R Carvalho
May 18, 1999·British Journal of Anaesthesia·G TusmanB Lachmann
Jan 20, 2000·The New England Journal of Medicine·R GreifUNKNOWN Outcomes Research Group
Dec 28, 2002·Anesthesiology·Lennart EdmarkGöran Hedenstierna
Mar 29, 2003·American Journal of Respiratory and Critical Care Medicine·Michelle DugganBrian P Kavanagh
Dec 5, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Juraj SprungDavid O Warner
Oct 11, 2007·Chest·Daniel TalmorAtul Malhotra
Dec 20, 2008·Anesthesia and Analgesia·Juraj SprungDavid O Warner

❮ Previous
Next ❯

Citations

Nov 19, 2013·Revista española de anestesiología y reanimación·D ChiumelloS Froio
Apr 26, 2014·Critical Care : the Official Journal of the Critical Care Forum·Yuda SutherasanPaolo Pelosi
Jul 17, 2014·Critical Care : the Official Journal of the Critical Care Forum·Silvia CoppolaDavide Chiumello
Oct 11, 2014·BMC Anesthesiology·Dharshi KaralapillaiRinaldo Bellomo
Oct 31, 2012·Intensive Care Medicine·Francois Lellouche, Jed Lipes
Feb 13, 2016·British Journal of Anaesthesia·S HemmesM Schultz
Feb 13, 2015·Critical Care : the Official Journal of the Critical Care Forum·Namita Gupta, Sachin Yende
Jul 12, 2011·Critical Care Clinics·Adrian A Maung, Lewis J Kaplan
Dec 9, 2015·Best Practice & Research. Clinical Anaesthesiology·Pedro Leme SilvaPatricia Rieken Macêdo Rocco
Jun 16, 2016·Frontiers in Medicine·Satoshi KimuraDavid L Stahl
May 18, 2016·Iranian Journal of Nursing and Midwifery Research·Farkhondeh Yousefnia-DarziMalahat Khalili
Oct 22, 2016·JACC. Cardiovascular Interventions·Nicolas DebryThomas Modine
Apr 25, 2017·Expert Review of Respiratory Medicine·Lígia de Albuquerque MaiaPatricia Rieken Macedo Rocco
Feb 12, 2017·British Journal of Anaesthesia·A Miskovic, A B Lumb
Feb 12, 2017·European Journal of Anaesthesiology·Ary Serpa NetoUNKNOWN PROVE Network Investigators
Jun 13, 2014·The Cochrane Database of Systematic Reviews·Fabiano T BarbosaCélio F de Sousa-Rodrigues
Jul 8, 2011·Current Opinion in Critical Care·D C Johnson, L J Kaplan
Sep 18, 2018·Anesthesia and Analgesia·Maximilian S SchaeferTanja Astrid Meyer-Treschan
May 16, 2015·Anesthesiology·Ary Serpa NetoUNKNOWN PROVE Network Investigators
Nov 25, 2011·Current Opinion in Anaesthesiology·Gerardo TusmanJuraj Sprung
Oct 18, 2016·Anesthesiology·Göran Hedenstierna, Lennart Edmark
Feb 7, 2013·Current Opinion in Anaesthesiology·Sabrine N T HemmesMarcus J Schultz
Dec 7, 2010·Expert Review of Respiratory Medicine·Joseph E Levitt, Michael A Matthay
Dec 1, 2011·Journal of Robotic Surgery·Mohamed BadawyWalter H Gotlieb

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.