| Autor: |
Aditianingsih, Dita, Madjid, Amir S., Rahmawati, Vera |
| Předmět: |
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| Zdroj: |
Anaesthesiology & Rescue Medicine / Anestezjologia i Ratownictwo; 2018, Vol. 12 Issue 1, p5-17, 13p |
| Abstrakt: |
Background. Atelectasis is one of the most common perioperative respiratory complications seen in the first 24 hours postoperatively and it can actually persist for several days afterwards. Application of Positive End-Expiratory Pressure (PEEP) can prevent postoperative alveolar collapse which is behind atelectasis. The study compares the influence of PEEP either 5 cmH2O (PEEP-5) or 10 cmH2O (PEEP-10) on the distribution of ventilation in postoperative patients using Electrical Impedance Tomography (EIT). Material and methods. A single-blind randomized clinical trial was conducted in the Intensive Care Unit of University Hospital upon 35 patients. The subjects were randomized into two groups: either postoperative mechanical ventilation with PEEP-5 or with PEEP-10. The patients were monitored with EIT PulmoVista 500® with values of the following parameters being taken: global Tidal Impedance Variation (gTIV), regional Tidal Impedance Variation (rTIV) for both anterior and posterior parts of the lungs, global End-Expiratory Lung Impedance (gEELI), regional End-Expiratory Lung Impedance (rEELI) for both anterior and posterior parts of the lungs, Regional Dynamic Compliance Change (RC) for both anterior and posterior parts of the lungs. Then the calculated parameters and their relationship were analyzed for PEEP-5 and PEEP-10 group over time points taken (0-20-40-60 min) and lung regions (anterior/posterior). Results. Analysis of rTIV and gTIV values in PEEP-5 and PEEP-10 group have shown statistically significant difference in measurements taken at the 20th minute (p<0.05) of the study. The analysis of gEELI and rEELI values taken at both anterior and posterior parts of the lungs in PEEP-5 and PEEP-10 group have shown statistically significant difference in every measurement taken (p < 0.05). ΔRC difference values (ΔRC) at both anterior and posterior parts of the lungs between PEEP-5 and PEEP-10 group were statistically significantly different (p < 0.05) in every measurement taken. There were no differences between two groups in terms of PaO2/FiO2 ratio, the length of intubation and the duration of hospitalization. Conclusions. Despite statistically significant differences in pulmonary parameters (TIV, EELI, RC) measured between PEEP-5 and PEEP-10 groups short term patients' outcome defined by PaO2/FiO2 ratio, the length of intubation and the duration of hospitalization did not differ between both groups. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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