Effect of general anesthesia and controlled mechanical ventilation on pulmonary ventilation distribution assessed by electrical impedance tomography in healthy children

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art_NASCIMENTO_Effect_of_general_anesthesia_and_controlled_mechanical_ventilation_2023.PDF (1.02 MB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
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Editora
PUBLIC LIBRARY SCIENCE
Autores
NASCIMENTO, Milena
REBELLO, Celso
CORREA, Leticia
ALCALA, Glasiele
ROSSI, Felipe
LAURENTI, Eliana
CAMARA, Mauro
IASI, Marcelo
Citação
PLOS ONE, v.18, n.3, 2023
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
IntroductionGeneral anesthesia is associated with the development of atelectasis, which may affect lung ventilation. Electrical impedance tomography (EIT) is a noninvasive imaging tool that allows monitoring in real time the topographical changes in aeration and ventilation. ObjectiveTo evaluate the pattern of distribution of pulmonary ventilation through EIT before and after anesthesia induction in pediatric patients without lung disease undergoing nonthoracic surgery. MethodsThis was a prospective observational study including healthy children younger than 5 years who underwent nonthoracic surgery. Monitoring was performed continuously before and throughout the surgical period. Data analysis was divided into 5 periods: induction (spontaneous breathing, SB), ventilation-5min, ventilation-30min, ventilation-late and recovery-SB. In addition to demographic data, mechanical ventilation parameters were also collected. Ventilation impedance (Delta Z) and pulmonary ventilation distribution were analyzed cycle by cycle at the 5 periods. ResultsTwenty patients were included, and redistribution of ventilation from the posterior to the anterior region was observed with the beginning of mechanical ventilation: on average, the percentage ventilation distribution in the dorsal region decreased from 54%(IC95%:49-60%) to 49%(IC95%:44-54%). With the restoration of spontaneous breathing, ventilation in the posterior region was restored. ConclusionThere were significant pulmonary changes observed during anesthesia and controlled mechanical ventilation in children younger than 5 years, mirroring the findings previously described adults. Monitoring these changes may contribute to guiding the individualized settings of the mechanical ventilator with the goal to prevent postoperative complications.
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https://observatorio.fm.usp.br/handle/OPI/53845
Referências
  1. BARBER DC, 1984, J PHYS E SCI INSTRUM, V17, P723, DOI 10.1088/0022-3735/17/9/002
  2. Bauer M, 2019, BMC ANESTHESIOL, V19, DOI 10.1186/s12871-019-0805-8
  3. Bikker IG, 2009, INTENS CARE MED, V35, P1362, DOI 10.1007/s00134-009-1512-6
  4. Brochard L, 2020, AM J RESP CRIT CARE, V201, P388, DOI 10.1164/rccm.201908-1645LE
  5. Dmytrowich J, 2018, J CLIN MONIT COMPUT, V32, P503, DOI 10.1007/s10877-017-0048-5
  6. Durlak Wojciech, 2013, ISRN Pediatr, V2013, P529038, DOI 10.1155/2013/529038
  7. Faraway J.J., 2006, C&H TEXT STAT SCI
  8. Frerichs I, 1998, ACTA ANAESTH SCAND, V42, P721, DOI 10.1111/j.1399-6576.1998.tb05308.x
  9. Frerichs I, 2003, INTENS CARE MED, V29, P2312, DOI 10.1007/s00134-003-2029-z
  10. Frerichs I, 2001, INTENS CARE MED, V27, P1385, DOI 10.1007/s001340101021
  11. HACHENBERG T, 1993, ACTA ANAESTH SCAND, V37, P549, DOI 10.1111/j.1399-6576.1993.tb03763.x
  12. HEAF DP, 1983, NEW ENGL J MED, V308, P1505, DOI 10.1056/NEJM198306233082505
  13. Hedenstierna G, 2006, MINERVA ANESTESIOL, V72, P183
  14. Hedenstierna G, 2003, CLIN PHYSIOL FUNCT I, V23, P123, DOI 10.1046/j.1475-097X.2003.00483.x
  15. Hedenstierna G, 2015, BEST PRACT RES-CLIN, V29, P273, DOI 10.1016/j.bpa.2015.08.008
  16. Humphreys S, 2011, PEDIATR ANESTH, V21, P887, DOI 10.1111/j.1460-9592.2011.03547.x
  17. Inany HS, 2020, RESP CARE, V65, P590, DOI 10.4187/respcare.07076
  18. Lupton-Smith AR, 2014, PEDIATR PULM, V49, P764, DOI 10.1002/ppul.22893
  19. Nascimento MS, 2022, ANESTHESIOLOGY, V137, P648, DOI 10.1097/ALN.0000000000004321
  20. Neto AS, 2015, BEST PRAC RES-CL ANA, V29, P331, DOI 10.1016/j.bpa.2015.09.002
  21. Pereira SM, 2018, ANESTHESIOLOGY, V129, P1070, DOI 10.1097/ALN.0000000000002435
  22. Pham TMT, 2011, EUR RESPIR J, V37, P919, DOI 10.1183/09031936.00034310
  23. Putensen C, 2006, CURR OPIN CRIT CARE, V12, P13, DOI 10.1097/01.ccx.0000198994.37319.60
  24. Radke OC, 2012, ANESTHESIOLOGY, V116, P1227, DOI 10.1097/ALN.0b013e318256ee08
  25. Reber A, 1998, ANAESTHESIA, V53, P1054, DOI 10.1046/j.1365-2044.1998.00569.x
  26. WAHBA RWM, 1991, CAN J ANAESTH, V38, P384, DOI 10.1007/BF03007630
  27. Wolf GK, 2012, PEDIATR CRIT CARE ME, V13, P509, DOI 10.1097/PCC.0b013e318245579c
  28. Yoshida T, 2019, AM J RESP CRIT CARE, V200, P933, DOI 10.1164/rccm.201904-0797LE

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/09
Artigos e Materiais de Revistas Científicas - ODS/03