Titre
Use of a vital capacity maneuver to prevent atelectasis after cardiopulmonary bypass: an experimental study
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Magnusson, L.
Auteure/Auteur
Zemgulis, V.
Auteure/Auteur
Tenling, A.
Auteure/Auteur
Wernlund, J.
Auteure/Auteur
Tyden, H.
Auteure/Auteur
Thelin, S.
Auteure/Auteur
Hedenstierna, G.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0003-3022
Statut éditorial
Publié
Date de publication
1998-01
Volume
88
Numéro
1
Première page
134
Dernière page/numéro d’article
42
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jan
Research Support, Non-U.S. Gov't --- Old month value: Jan
Résumé
BACKGROUND: Respiratory failure secondary to cardiopulmonary bypass (CPB) remains a major complication after cardiac surgery. The authors previously found that the increase in intrapulmonary shunt was well correlated with the amount of atelectasis. They tested the hypothesis that post-CPB atelectasis can be prevented by a vital capacity maneuver (VCM) performed before termination of the bypass. METHODS: Eighteen pigs received standard hypothermic CPB (no ventilation during bypass). The VCM was performed in two groups and consisted of inflating the lungs during 15 s to 40 cmH2O at the end of the bypass. In one group, the inspired oxygen fraction (FIO2) was then increased to 1.0. In the second group, the FIO2 was left at 0.4. In the third group, no VCM was performed (control group). Ventilation-perfusion distribution was measured with the inert gas technique and atelectasis by computed tomographic scanning. RESULTS: Intrapulmonary shunt increased after bypass in the control group (from 4.9 +/- 4% to 20.8 +/- 11.7%; P < 0.05) and was also increased in the vital capacity group ventilated with 100% oxygen (from 2.2 +/- 1.3% to 6.9 +/- 2.9%; P < 0.01) but was unaffected in the vital capacity group ventilated with 40% oxygen. The control pigs showed extensive atelectasis (21.3 +/- 15.8% of total lung area), which was significantly larger (P < 0.01) than the proportion of atelectasis found in the two vital capacity groups (5.7 +/- 5.7% for the vital capacity group ventilated with 100% oxygen and 2.3 +/- 2.1% for the vital capacity group ventilated with 40% oxygen. CONCLUSION: In this pig model, postcardiopulmonary bypass atelectasis was effectively prevented by a VCM.
Sujets
PID Serval
serval:BIB_FC81916E2473
PMID
Date de création
2008-01-28T09:52:02.987Z
Date de création dans IRIS
2025-05-21T07:23:08Z