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Atelectasis after anaesthesia: a randomised trial of positive airway pressure and low oxygen
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
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2013 (English)Article in journal (Other academic) Submitted
Abstract [en]

Background:

Atelectasis is common during and after general anaesthesia. We hypothesized that a ventilation strategy with a combination of 1) continuous positive airway pressure (CPAP) or positive end-expiratory pressure (PEEP) and 2) a reduced end-expiratory oxygen fraction (FETO2) before extubation would reduce postoperative atelectasis.

Methods:

Sixty patients were randomized into two groups. During anaesthesia induction, inspiratory oxygen fractions (FIO2) were 1.0, and depending on weight, CPAP 6–8 cm H2O was applied in both groups via face mask. During maintenance of anaesthesia, a laryngeal mask airway was used, and depending on weight, PEEP was 6–8 cm H2O in both groups. Before extubation, FIO2 was set to 0.3 in the intervention groups and 1.0 in the control group. Atelectasis was studied by computed tomography approximately 13 min postoperatively.

Results:

The area of atelectasis was 5.5, 0–16.9 cm2 (median and range), and 6.8, 0–27.5 cm2 in the groups given FIO2 0.3 or FIO2 1.0 before extubation, a difference that was not statistically significant.

Conclusion:

Inducing anaesthesia with CPAP/PEEP and FIO2 1.0 and deliberately reducing FIO2 before extubation did not reduce postoperative atelectasis compared with FIO2 1.0 before extubation.

Place, publisher, year, edition, pages
2013.
Keyword [en]
Atelectasis, CPAP, PEEP, Oxygen fraction, Smoking, ASA, Postoperative complications
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology; Clinical Physiology
Identifiers
URN: urn:nbn:se:uu:diva-209736OAI: oai:DiVA.org:uu-209736DiVA: diva2:660142
Available from: 2013-10-29 Created: 2013-10-25 Last updated: 2013-11-04Bibliographically approved

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Edmark, LennartLindbäck, JohanEnlund, MatsHedenstierna, Göran

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Centre for Clinical Research, County of VästmanlandClinical PhysiologyDepartment of Medical SciencesUCR-Uppsala Clinical Research CenterAnaesthesiology and Intensive Care
Anesthesiology and Intensive Care

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