Impaired Oxygenation in Surgical Patients during General Anesthesia with Controlled Ventilation

Bendixen, Henrik H.; Hedley-Whyte, John; Laver, Myron B.

doi:10.1056/nejm196311072691901

Cited by 659 publications

(196 citation statements)

References 16 publications

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“…In the very young patient, closing volume tends to increase and functional residual capacity decrease during general anesthesia due to cephalad displacement of the most dorsal part of the diaphragm, with impaired ventilation of the inferior and dependent parts of the lungs resulting in atelectasis [3]. Bendixen and colleagues [4] showed that spontaneous breathing without periodic deep breaths can lead to progressive atelectasis, with increased shunting and decreased pulmonary compliance, and these changes were reversible by lung hyperinflation.…”

Section: Anesthetic Concernsmentioning

confidence: 99%

“…Bendixen et al [4] and later Rothen et al [7] showed that this pressure is approximately 40 cm H 2 O. Lachmann et al [8] recommended opening collapsed lungs by applying sufficient levels of peak inspiratory pressure and maintaining alveoli open by using sufficient levels of positive end-expiratory pressure (PEEP). This recruitment maneuver has been shown to improve arterial oxygenation and lung compliance [9].…”

Section: Anesthetic Concernsmentioning

confidence: 99%

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CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

2014

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Section: Anesthetic Concernsmentioning

confidence: 99%

Section: Anesthetic Concernsmentioning

confidence: 99%

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

2014

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“…Manual sighs (i.e., HI) and large tidal volumes were first advocated by Bendixen et al 9 to improve oxygenation during anaesthesia. Manual sighs have been shown to restore oxygenation and compliance temporarily, but must be repeated frequently.…”

Section: Qs/qtmentioning

confidence: 99%

Large tidal volume ventilation improves pulmonary gas exchange during lower abdominal surgery in Trendelenburg’s position

et al. 1991

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“…Periodic sighs increase lung compliance as shown in dogs by Mead and Collier 5 and in humans by Bendixen et al 6 However, Nunn et al 7 and Douglas et al s were unable to confirm the increase in compliance with sighs. The differences in their results may be due to different protocols for sigh frequency, duration and plateau pressure attained.…”

mentioning

confidence: 92%

Cardiopulmonary effects of the volume recruitment manoeuvre in infant swine

et al. 1989

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The volume recruitment manoeuvre is a non-invasive et al.3 found that the decrease in FRC leads to a decrease in lung compliance and proposed that elevating lung volume would restore compliance towards its pre-anaesthetic level. It has been suggested that positive airway pressure might counter the decrease in FRC during anaesthesia. However, positive endexpiratory pressure (PEEP) in anaesthetized subjects with normal cardiorespiratory function decreases cardiac output. 2 As well, PEEP applied to dogs decreased static and dynamic lung compliance in spite of an increase in lung volume.* This decrease in compliance was reversible by the application of sighs. As a result of these considerations, positive airway pressure has not found wide application in anaesthesia.Periodic sighs increase lung compliance as shown in dogs by Mead and Collier 5 and in humans by Bendixen et al. 6 However, Nunn et al. 7 and Douglas et al. s were unable to confirm the increase in compliance with sighs. The differences in their results may be due to different protocols for sigh frequency, duration and plateau pressure attained. Even if periodic sighing were proved to be effective, this modality would be restricted to intubated subjects because sighs require high airway pressures.A new, non-invasive technique which we termed "volume recruitment" has been introduced for measuring respiratory mechanics in spontaneously breathing animals and infants. 9 In this technique lung volume increases during spontaneous inspiration while expiration is occluded for three or four breaths. It offers the advantage that it may be performed by either mask or tracheal tube. Although this technique has been applied to neonates with and without lung disease with no apparent deleterious effects, 9 the changes in FRC, compliance, gas exchange and cardiac output have not been reported. We therefore applied the volume recruitment manoeuvre to seven anaesthetized infant swine in order to investigate its cardiopulmonary effects. CAN J ANAESTH 1989 / 36:5 / pp533-53S

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Impaired Oxygenation in Surgical Patients during General Anesthesia with Controlled Ventilation

Cited by 659 publications

References 16 publications

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

Large tidal volume ventilation improves pulmonary gas exchange during lower abdominal surgery in Trendelenburg’s position

Cardiopulmonary effects of the volume recruitment manoeuvre in infant swine

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