What is the Effect of Positive End-expiratory Pressure (PEEP) on Postoperative Pulmonary Complications and Mortality During General Anaesthesia?

Çelebioğlu, Bilge

doi:10.5222/jtaics.2011.106

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Atelectasis resulting from general anaesthesia leads to hyperventilation during spontaneous breathing, which consequently causes hypercapnia, hypoxemia and impaired acid-base balance (Sereno 2006;Haskins 2007;Cecen et al 2009;Celebioglu 2011;Guzel et al 2013b). Blood gas analyses are important in determining a patient's ventilation and oxygenation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the cardiorespiratory effects of the alpha-2 adrenoceptor agonists xylazine, medetomidine and dexmedetomidine in combination with ketamine in dogs

Güzel¹,

Kaya²,

Altunatmaz³

et al. 2018

Vet. Med. - Czech

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In this study, we compared the effects of xylazine, medetomidine and dexmedetomidine in combination with ketamine on heart rate, respiratory rate, blood gas values, temperature and sedation scores. A total of 30 dogs were evaluated. The dogs were randomly allocated into three anaesthesia groups, each of which included ten dogs. The first group, denoted the xylazine/ketamine group, intravenously received xylazine (0.5 mg/kg) for premedication and ketamine (5 mg/kg) for induction. The second group, the medetomidine/ketamine group, intravenously received medetomidine (10 µg/kg) followed by ketamine (5 mg/kg). The third group received the dexmedetomidine/ketamine combination. This group intravenously received dexmedetomidine (3 µg/kg) for premedication and ketamine (5 mg/kg). Heart rate, respiratory rate, oxygen saturation, blood gas parameters and temperature were recorded for all patients immediately before sedation onset (T0), five minutes after sedation onset (T1) and five minutes after endotracheal intubation following ketamine injection (T2). The end tidal carbon dioxide level was recorded at T2. A significant decrease in heart rate occurred following premedication in all groups. However, the decrease was most marked in the medetomidine/ketamine group. An increase was observed in venous partial pressure of carbon dioxide values at T2 in the xylazine/ketamine group compared to the medetomidine/ketamine and dexmedetomidine/ketamine groups. The end tidal carbon dioxide levels were higher in the medetomidine/ketamine group than in the other two groups, and oxygen saturation of haemoglobin levels in the same group were found to be lower than in the others. It was determined that none of α2-agonists, namely xylazine, medetomidine or dexmedetomidine, had superior properties over the others. If medetomidine is used, special care should be taken because of the rapid decrease in heart rate.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the cardiorespiratory effects of the alpha-2 adrenoceptor agonists xylazine, medetomidine and dexmedetomidine in combination with ketamine in dogs

Güzel¹,

Kaya²,

Altunatmaz³

et al. 2018

Vet. Med. - Czech

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“…In obese patients, the decrease in FRC is greater during anesthesia, and there is a linear relationship between Body Mass Index (BMI) and FRC. Obese patients are more vulnerable to atelectasis (3). A lung protective ventilation strategy consisting of low tidal volume and positive end-expiratory pressure (PEEP) ventilation is known to evolve postoperative respiratory outcomes in patients at high surgical risk, including patients undergoing laparoscopic surgery (4).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effect of Different Peep Applications on Optic Nerve Sheath Diameter in Obese Patients Undergoing Laparoscopic Surgery

Sert,

Doğan Bakı,

Akıcı

et al. 2024

Kocatepe Tıp Dergisi

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OBJECTIVE: Positive end-expiratory pressure (PEEP) application, which is used to improve oxygenation by keeping the alveoli open, may cause an additional increase in intracranial pressure (ICP) during pneumoperitoneum in obese patients. In this study, the effect of different PEEP applications on the optic nerve sheath diameter (ONSD) in obese patients undergoing laparoscopic surgery was evaluated. MATERIAL AND METHODS: The study included 26 patients with a Body Mass Index (BMI) of ≥ 30 and the American Society of Anesthesiologists (ASA) I-II status undergoing laparoscopic surgery in the reverse Trendelenburg position. After anesthesia induction, the patients were randomly allocated to either the PEEP 5 group or the PEEP 8 group. The patients were compared with respect to age, gender, BMI, ASA status, operations performed, and the hemodynamic data and ONSD values recorded intraoperatively at regular intervals. RESULTS: 22 patients completed the study. Except for gender (p=0.020), there was no difference in demographic and hemodynamic data between the groups. No difference was observed between the groups in respect of ONSD measurements at all times. In the intra-group comparisons, there was no difference in the ONSD values within the PEEP 5 group, whereas in the PEEP 8 group, the measurements at 5 minutes (T2) and 30 minutes (T3) after pneumoperitoneum, and at the end of surgery (T4) were significantly higher than the basal measurements (T1) (p=0.010, p=0.003, p=0.012). CONCLUSIONS: Although PEEP 8 and PEEP 5 applications have similar effects to ICP increase, we thought that it would be safer to apply PEEP increments by measuring ONSD via ultrasonography.

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“…With positive pressure ventilation, gas flow is achieved through the airway to the lungs by creating positive pressure against atmospheric pressure in the airway. Expiration takes place passively in both respiration types 1 …”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Spontaneous and Mechanical Ventilation on Blood Gases During General Anaesthesia in Dogs

Güzel¹,

Yıldar²,

Karabağli³

et al. 2013

Kafkas Univ Vet Fak Derg

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SummarySpontaneous ventilation during general anaesthesia leads to respiratory depression and atelectasis. Mechanical ventilation increases tidal volume and eliminates atelectasis. The study material consisted of a total of 20 dogs of different breed, age and gender. Dogs were divided into two groups, consisted of 10 dogs. The first group was established as the spontaneous ventilation (SV) group, while the second group was the mechanical ventilation (MV) group. For induction of anaesthesia, propofol was administered to both groups via intravenous injection at a dose of 6 mg/kg. Blood samples were collected from all dogs in 5 minutes after propofol administration. This period was determined as Minute 0 (T 0 ). In both groups, inhalation anaesthesia was continued with isoflurane. Venous blood samples were collected from dogs in the SV and MV groups at 15 (T 15 ), 30 (T 30 ) and 60 (T 60 ) minutes. Heart rate, respiratory rate, SpO 2 , body temperature and blood gases were monitored. Statistical evaluation of the study was carried out using the Repeated Measures Analysis of Variance method. The results obtained showed that there was no statistically significant difference between the SV and MV groups regarding the examined parameters. However, in the assessments within the group, results obtained from the dogs in the MV group were more reliable from the point of view of the patients remaining stable throughout anaesthesia. Keywords: Spontaneous ventilation, Mechanical ventilation, Blood gases, Dog Köpeklerde Genel Anestezi Sürecinde Spontan ve Mekanik Ventilasyonun Kan Gazları Üzerine Etkilerinin Karşılaştırılması ÖzetGenel anestezide spontan ventilasyon, solunumun baskılanmasına ve atelektaziye yol açar. Mekanik ventilasyon tidal volümü artırır ve atelektaziyi giderir. Çalışma materyalini, farklı ırk, yaş ve cinsiyetteki toplam 20 köpek oluşturdu. Olgular, her grupta 10 köpek olacak şekilde 2'ye ayrıldı. İlk grup spontan ventilasyon (SV), ikinci grup mekanik ventilasyon (MV) grubu olarak belirlendi. Anestezi indüksiyonunda her iki gruba, propofol 6 mg/kg'dan intravenöz enjeksiyonla verildi. Tüm köpeklerden, propofol enjeksiyonunu takip eden 5. dakikada kan örnekleri alındı. Bu süre 0. dakika (T 0 ) olarak değerlendirildi. Her iki grubun inhalasyon anestezisi izofloranla sürdürüldü. SV ve MV grubundaki olgulardan 15. dakika (T 15 ), 30. dakika (T 30 ) ve 60. dakika (T 60 )'larda venöz kan örnekleri alındı. Kalp atım sayısı, solunum sayısı, SpO 2 , vücut ısısı ve kan gazları monitörize edildi. Çalışmanın istatistiki değerlendirmesi Tekrarlı Ölçüm Varyans Analizi metodu ile yapıldı. Elde edilen bulgular, incelenen parametreler yönünden SV ve MV grupları arasında istatistiki anlamda önemli bir fark olmadığını gösterdi. Ancak grup içi değerlendirmelerde, MV grubundaki köpeklerden elde edilen sonuçların, hastaların anestezi süresince stabil kalmaları açısından daha güvenilir olduğu sonucuna ulaşıldı.

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What is the Effect of Positive End-expiratory Pressure (PEEP) on Postoperative Pulmonary Complications and Mortality During General Anaesthesia?

Cited by 3 publications

References 22 publications

Evaluation of the cardiorespiratory effects of the alpha-2 adrenoceptor agonists xylazine, medetomidine and dexmedetomidine in combination with ketamine in dogs

Evaluation of the cardiorespiratory effects of the alpha-2 adrenoceptor agonists xylazine, medetomidine and dexmedetomidine in combination with ketamine in dogs

Evaluation of the Effect of Different Peep Applications on Optic Nerve Sheath Diameter in Obese Patients Undergoing Laparoscopic Surgery

Comparison of the Effects of Spontaneous and Mechanical Ventilation on Blood Gases During General Anaesthesia in Dogs

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