Interrupted expiratory flow on automatically constructed flow-volume curves may determine the presence of intrinsic positive end-expiratory pressure during one-lung ventilation

Anesthesia and Analgesia
G I BardoczkyJ C Yernault

Abstract

We studied patients undergoing elective pulmonary surgery to establish whether observing interrupted expiratory flow (IEF) on the flow-volume curves constructed by the Ultima SV respiratory monitor is a reliable way to identify patients with dynamic pulmonary hyperinflation and intrinsic positive end-expiratory pressure (PEEPi). Patients' tracheas were intubated with a double-lumen endotracheal tube and ventilated with a Siemens 900C constant flow ventilator. In 30 patients, PEEPi was determined by the end-expiratory occlusion (EEO) method during the periods of two-lung and one-lung ventilation in the lateral position. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of the IEF method were calculated. From the 122 measurement pairs, PEEPi was identified with the EEO method in 65 occasions. The mean level of PEEPi was 4.4 cm H2O. During one-lung ventilation, the level of PEEPi and the number of true-positive findings was significantly higher (PEEPi = 4.7 cm H2O and 32 episodes) than during two-lung ventilation (2.9 cm H2O and 19 episodes). When the level of PEEPi was higher than 5 cm H2O, the predictive value of IEF was 100%. The overall sensitivity of the IEF method was 0.78, its specif...Continue Reading

References

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Citations

Nov 18, 2008·Journal of Anesthesia·Yuhji SaitohYoshinori Nakata
May 23, 2012·Pulmonary Pharmacology & Therapeutics·Sriram MahadevCheryl M Salome
Sep 27, 2001·Anesthesiology Clinics of North America·L L Szegedi
Jun 27, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Katherine P Grichnik, Steven E Hill
Nov 12, 2002·Respiratory Physiology & Neurobiology·Guilherme M Sant'Anna, Jacopo P Mortola
Oct 14, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Claude S Farah, Cheryl M Salome
Nov 2, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Stephen W Littleton
Nov 5, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Ahmed S Bahammam, Suhaila E Al-Jawder
Nov 30, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Jean-Christian BorelJean-Louis Pepin
Jan 4, 2012·Respirology : Official Journal of the Asian Pacific Society of Respirology·Ching-Kai Lin, Ching-Chi Lin
Oct 24, 2012·Anesthesiology Clinics·Jens Lohser
Dec 18, 2015·British Journal of Anaesthesia·J SpaethT Loop
May 6, 2008·Anesthesiology Clinics·Jens Lohser
Sep 29, 2007·Critical Care Clinics·Jonathan M Siner, Constantine A Manthous
Feb 15, 2005·Thoracic Surgery Clinics·Katherine P Grichnik, Jeffrey A Clark
Jan 16, 2008·Current Opinion in Anaesthesiology·Andrew Ian LevinAndre Coetzee
May 7, 2009·Anesthesiology·Waheedullah Karzai, Konrad Schwarzkopf
Mar 21, 2000·International Anesthesiology Clinics·P W SeigneS C Body
Mar 21, 2000·International Anesthesiology Clinics·P F Dunn

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