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Evaluation of alveolar recruitment maneuver on respiratory resistance during general anesthesia: a prospective observational study
- Source :
- BMC Anesthesiology, Vol 20, Iss 1, Pp 1-7 (2020), BMC Anesthesiology
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- BackgroundAlveolar recruitment maneuvers enable easily reopening nonaerated lung regions via a transient elevation in transpulmonary pressure. To evaluate the effect of these maneuvers on respiratory resistance, we used an oscillatory technique during mechanical ventilation. This study was conducted to assess the effect of the alveolar recruitment maneuvers on respiratory resistance under routine anesthesia. We hypothesized that respiratory resistance at 5 Hz (R5) after the maneuver would be decreased after the lung aeration.MethodsAfter receiving the ethics committee’s approval, we enrolled 33 patients who were classified with an American Society of Anesthesiologists physical status of 1, 2 or 3 and were undergoing general anesthesia for transurethral resection of a bladder tumor within a 12-month period from 2017 to 2018. The recruitment maneuver was performed 30 min after endotracheal intubation. The maneuver consisted of sustained manual inflation of the anesthesia reservoir bag to a peak inspiratory pressure of 40 cmH2O for 15 s, including 5 s of gradually increasing the peak inspiratory pressure. Respiratory resistance was measured using the forced oscillation technique before and after the maneuver, and the mean R5 was calculated during the expiratory phase. The respiratory resistance and ventilator parameter results were analyzed using paired Student’st-tests, andp ResultsWe analyzed 31 patients (25 men and 6 women). R5 was 7.3 ± 1.6 cmH2O/L/sec before the recruitment maneuver during mechanical ventilation and was significantly decreased to 6.4 ± 1.7 cmH2O/L/sec after the maneuver. Peak inspiratory pressure and plateau pressure were significantly decreased, and pulmonary compliance was increased, although the values were not clinically relevant.ConclusionThe recruitment maneuver decreased respiratory resistance and increased lung compliance during mechanical ventilation.Trial registrationName of registry: Japan Medical Association Center for Clinical Trials.Trial registration number: reference JMA-IIA00136.Date of registration: 2 September 2013.URL of trial registry record:https://dbcentre3.jmacct.med.or.jp/JMACTR/App/JMACTRE02_04/JMACTRE02_04.aspx?kbn=3&seqno=3582
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Peak inspiratory pressure
Anesthesia, General
Pulmonary compliance
Positive-Pressure Respiration
lcsh:RD78.3-87.3
03 medical and health sciences
Plateau pressure
0302 clinical medicine
030202 anesthesiology
Anesthesiology
Alveolar recruitment maneuver
medicine
Humans
Prospective Studies
030212 general & internal medicine
Respiratory system
Lung Compliance
Aged
Mechanical ventilation
Lung
business.industry
Airway Resistance
Middle Aged
Respiratory resistance
Pulmonary Alveoli
Forced oscillation technique
Anesthesiology and Pain Medicine
medicine.anatomical_structure
lcsh:Anesthesiology
Anesthesia
Female
business
Research Article
Transpulmonary pressure
Subjects
Details
- ISSN :
- 14712253
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Anesthesiology
- Accession number :
- edsair.doi.dedup.....83abd359c422237df1d70f0796e52e87