uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Lung recruitment improves right ventricular performance after cardiopulmonary bypass A randomised controlled trial
Hosp Privado Univ Cordoba, Dept Anesthesia, Cordoba, Argentina..
Hosp Privado Comunidad Mar Del Plata, Dept Anesthesia, Mar Del Plata, Buenos Aires, Argentina..
Hosp Privado Univ Cordoba, Dept Cardiovasc Surg, Cordoba, Argentina..
Show others and affiliations
2017 (English)In: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 34, no 2, 66-74 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND Atelectasis after cardiopulmonary bypass (CPB) can affect right ventricular (RV) performance by increasing its outflow impedance. OBJECTIVE The aim of this study was to determine whether a lung recruitment manoeuvre improves RV function by re-aerating the lung after CPB. DESIGN Randomised controlled study. SETTING Single-institution study, community hospital, Cordoba, Argentina. PATIENTS Forty anaesthetised patients with New York Heart Association class I or II, preoperative left ventricular ejection fraction at least 50% and Euroscore 6 or less scheduled for cardiac surgery with CPB. INTERVENTIONS Patients were assigned to receive either standard ventilation with 6 cmH(2)O of positive end-expiratory pressure (PEEP; group C, n = 20) or standard ventilation with a recruitment manoeuvre and 10 cmH(2)O of PEEP after surgery (group RM, n = 20). RV function, left ventricular cardiac index (CI) and lung aeration were assessed by transoesophageal echocardiography (TOE) before, at the end of surgery and 30 min after surgery. MAIN OUTCOME MEASURES RV function parameters and atelectasis assessed by TOE. RESULTS Haemodynamic data and atelectasis were similar between groups before surgery. At the end of surgery, CI had decreased from 2.9 +/- 1.1 to 2.6 +/- 0.9 l min(-1) m(-2) in group C (P = 0.24) and from 2.8 +/- 1.0 to 2.6 +/- 0.8 l min(-1) m +/- 2 in group RM (P = 0.32). TOE-derived RV function parameters confirmed a mild decrease in RV performance in 95% of patients, without significant differences between groups (multivariate Hotelling t-test P = 0.16). Atelectasis was present in 18 patients in group C and 19 patients in group RM (P = 0.88). After surgery, CI decreased further from 2.6 to 2.4 l min(-)1 m(-2) in group C (P = 0.17) but increased from 2.6 to 3.7 l min(-1) m(-2) in group RM (P<0.001). TOE-derived RV function parameters improved only in group RM (Hotelling t-test P<0.001). Atelectasis was present in 100% of patients in group C but only in 10% of those in group RM (P<0.001). CONCLUSION Atelectasis after CPB impairs RV function but this can be resolved by lung recruitment using 10 cm H2O of PEEP.

Place, publisher, year, edition, pages
2017. Vol. 34, no 2, 66-74 p.
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:uu:diva-316013DOI: 10.1097/EJA.0000000000000559ISI: 000392170300004PubMedID: 27861261OAI: oai:DiVA.org:uu-316013DiVA: diva2:1076973
Available from: 2017-02-24 Created: 2017-02-24 Last updated: 2017-02-24Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Suarez-Sipmann, Fernando
By organisation
Hedenstierna laboratoryAnaesthesiology and Intensive Care
In the same journal
European Journal of Anaesthesiology
Anesthesiology and Intensive Care

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 123 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf