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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 1 - 13 (13page)
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Background: Protective mechanical ventilation using low tidal volume has been introduced to surgical patients to reduce the incidence of postoperative pulmonary complications. We investigated the effects of protective ventilation (PV) techniques on anesthesia-induced atelectasis identified via lung ultrasonography in patients undergoing abdominal surgery. Methods: A total of 42 adult patients who were scheduled for open abdominal surgery with an expected duration > 2 hours were included in the study. Patients were randomized to receive either conventional ventilation (CV; tidal volume of 9–10 mL/kg predicted body weight [PBW] with no positive end-expiratory pressure [PEEP]) or PV (tidal volume of 6–8 mL/kg PBW and 5 cmH2O PEEP) via pressure-controlled ventilation with volume guaranteed. Lung ultrasonography was performed at four predefined time points to assess perioperative atelectasis by dividing each hemithorax into six quadrants based on a modified lung ultrasound (LUS) scoring system. Results: The tidal volume delivered to patients was 9.65 ± 1.65 mL/kg PBW in the CV group and 6.31 ± 0.62 mL/kg PBW in the PV group. Ventilation using low tidal volume led to similar LUS scores in all lung areas and at all time points compared to ventilation using high tidal volume. There was no significant difference between the groups in the number of patients requiring recruitment maneuvers at the end of surgery. Conclusion: Ventilation with low tidal volume combined with 5 cmH2O PEEP did not cause further loss of aeration compared to ventilation with high tidal volume. Low tidal volume ventilation can be used in patients without lung injury based on lung assessment by bedside lung ultrasonography.
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참고문헌 (28)
참고문헌 신청
Cai H / 2007 / Effect of low tidal volume ventilation on atelectasis in patients during general anesthesia : a computed tomographic scan / J Clin Anesth 19(2):125~129
Lundquist H / 1995 / CT-assessment of dependent lung densities in man during general anaesthesia / Acta Radiol 36(6):626~632
Putensen C / 2009 / Meta-analysis : ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury / Ann Intern Med 151(8):566~576
Bendixen HH / 1963 / Impaired oxygenation in surgical patients during general anesthesia with controlled ventilation. a concept of atelectasis / N Engl J Med 269(19):991~996
Güldner A / 2015 / Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications : a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers / Anesthesiology 123(3):692~713
Lundquist H / 1995 / CT-assessment of dependent lung densities in man during general anaesthesia / Acta Radiol 36(6):626~632
Putensen C / 2009 / Meta-analysis : ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury / Ann Intern Med 151(8):566~576
Bendixen HH / 1963 / Impaired oxygenation in surgical patients during general anesthesia with controlled ventilation. a concept of atelectasis / N Engl J Med 269(19):991~996
Güldner A / 2015 / Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications : a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers / Anesthesiology 123(3):692~713
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