Effects of split torso positioning and laparoscopic surgery for donor nephrectomy on respiratory mechanics

Journal of Clinical Anesthesia
B G FahyP A Delaney

Abstract

To test whether split torso positioning, abdominal insufflation, and other procedures performed during laparoscopic nephrectomy would affect mechanical impedances to inflation [i.e., elastance (E) and resistance (R) of the total respiratory system (Ers, and Rrs), lungs (EL and RL), and chest wall (Ecw and Rcw)] differently from previously studied laparoscopic procedures. Unblinded study, each patient serving as own control. University hospital. 12 ASA physical status I and II patients scheduled for laparoscopic donor nephrectomy, all without cardiopulmonary disease. Patients were anesthetized and paralyzed, tracheally intubated and mechanically ventilated at 10, 20, and 30 breaths/minute and at tidal volumes of 250, 500, and 800 ml. Measurements were made in the following positions: supine, split torso, abdominal insufflation (Pab = 15 mmHg), and supine after deflation. Airway flow and pressure and esophageal pressure were measured. Discrete Fourier transformation was used to calculate E and R. These were analyzed with repeated measures, linear multiple regression with accepted level of significance at p < 0.05. Ers, Ecw, and Rcw increased (p < 0.05) while EL decreased (p < 0.05) when patients changed from supine to split torso...Continue Reading

References

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Citations

Oct 2, 2001·Journal of Clinical Anesthesia·G NataliniA Bernardini
Jan 20, 1999·Journal of Clinical Laser Medicine & Surgery
Aug 7, 2002·Surgical Endoscopy·F J BerendsJ N M IJzermans
Oct 17, 2009·Journal of Clinical Anesthesia·Ozlem S CakmakkayaBirsel Ekici
Sep 25, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Brendan ParentStephen P Wall
Mar 22, 2000·Current Opinion in Urology·S C JacobsE Cho
Dec 10, 1998·Journal of Endourology

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