Safety and efficacy of lung recruitment maneuvers in pediatric post-operative cardiac patients
| Autor: | John J. Nigro, Chasity Wellnitz, Renee Devor, Harjot Bassi, Christine Tenaglia, Brigham C. Willis, Paul Kang, Kristi Richardson, Tiffany Morandi |
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| Rok vydání: | 2020 |
| Předmět: |
ventilator
lcsh:R5-130.5 business.industry positive-pressure respiration lcsh:Medical emergencies. Critical care. Intensive care. First aid lcsh:RC86-88.9 hemodynamics congenital heart defects lung recruitment compliance Lung recruitment Anesthesia respiratory insufficiency atelectasis lung compliance Medicine artificial respiration Post operative business lcsh:General works |
| Zdroj: | Southwest Journal of Pulmonary and Critical Care, Vol 20, Iss 1, Pp 16-28 (2020) |
| ISSN: | 2160-6773 |
| Popis: | Background: Recruitment maneuvers are a dynamic process of transient increases in transpulmonary pressure intended to open unstable airless alveoli. Due to concerns regarding the hemodynamic consequences of recruitment maneuvers in children with heart disease, these maneuvers have not been widely utilized in this population. The objective of this study was to demonstrate the safety and efficacy of lung recruitment maneuvers in post-operative pediatric cardiac patients. We hypothesized that multiple recruitment maneuvers are physiologically beneficial and hemodynamically tolerated in children with congenital cardiac disease. Methods: Retrospective chart review was conducted of post-operative cardiac surgical subjects who received recruitment maneuvers, as well as a matched control group who did not, at a Cardiac ICU in a quaternary care free-standing children’s hospital. Repetitive lung recruitment maneuvers using incremental positive end-expiratory pressure were performed. Hemodynamic and respiratory physiologic variables were recorded. Results: Sixty-one post-operative cardiac subjects had a total of 435 lung recruitment maneuvers. Assessment of hemodynamic tolerability demonstrated no change in MAP, HR, or CVP during or after the maneuvers. There was a 28% increase in dynamic compliance following recruitment maneuvers (p |
| Databáze: | OpenAIRE |
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