BibTex RIS Kaynak Göster

The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations

Yıl 2014, Cilt: 5 Sayı: 3, 397 - 402, 01.09.2014
https://doi.org/10.5799/ahinjs.01.2014.03.0427

Öz

Objective: The effects of 10cmH2O Positive End-expiratory Pressure (PEEP) on respiratory mechanics, arterial oxygenation and hemodynamics in laparoscopic cholecystectomy operation were investigated. Methods: The study was planned on ASA I-II, 18-65 years old, forty patients scheduled for laparoscopic cholecystectomy under general anesthesia. The patients were divided into two groups which PEEP implemented Group 0 and 10 cmH2O PEEP applied Group P (Group 0, n=20; Group P, n=20). Heart rate, Mean arterial blood pressure, arterial oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PEtCO2), Peak inspiratory pressure (PİP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2 ) values were evaluated at 5 minutes after induction, 5 minutes after CO2 insufflation, after the head-up position and the right side in the 10th and 30th minutes, After 10 minutes desufflation and in the recovery room. The Alveolar–arterial oxygen pressure gradient (P(A-a) O2), the ratio of physiologic dead space over tidal volume (VD/VT), Arterial to End Tidal CO2 gradient (P(a-et) CO2), static compliance (CS), dynamic compliance (CD) were assessed same times. Results: The assessment between the groups, there were not statistical differences about mean blood pressure, heart rate, SpO2, PetCO2, PaO2, plateau pressure, and P (A-a) values (p>0.05). Peak inspiratory pressure was higher in Group P (p

Kaynakça

  • Himal HS. Minimally invasive (laparoscopic) surgery. Surg Endosc 2002;8:265-270.
  • Hardacre JM, Talamini MA. Pulmonary and hemody- namic changes during laparoscopy-Are they impor- tant? Surgery 2000:127;241-244.
  • Marini JJ, Hotchkiss Jr JR. PEEP in Prone position: reversing the perfusion imbalance. Crit Care Med 1999;27:1-2.
  • Halbertsma FJ, van der Hoeven JG. Lung Recruitment during mechanical positive pressure ventilation in the PICU: What can be learned from the literature? An- aesthesia 2005;60:779-790.
  • Gander S, Frascarolo P, Suter M, et al. Positive end- expiratory pressure during induction of general anes- thesia increases time of apnea before peripheral de- saturation in morbidly obese patients. Anesthesiology 2003;99:1515.
  • Yao and Artusio’s Anesthesiology: Problem-Oriented Patient Management, Lippincott, 2008, Sixth Edition, 854-855.
  • Tyagi A, Kumar R, Sethi AK, Mohta M. A comparison of pressure-controlled and volume-controlled ventila- tion for laparoscopic cholecystectomy. Anaesthesia 2011;66:503-508.
  • Kim JY, Shin CS, Kim HS, et al. Positive end-expiratory pressure in pressure-controlled ventilation improves ventilatory and oxygenation parameters during laparo- scopic cholecystectomy. Surg Endosc 2010:24:1099- 103.
  • Brezo DB, Ezquerro C, Alsina E, et al. Anesthesia ventilation strategy in general surgery with low tidal volume and positive pressure at the end of expiration (PEEP) is associated with higher arterial oxygen pres- sure than ventilation with high tidal volume without PEEP. Anesthesiology 2003;99: A1516 .
  • Neumann P, Rothen HU, Berglund JE, et al. Positive end-expiratory pressure prevents atelectasis during general anaesthesia even in the presence of a high inspired oxygen concentration. Acta Anaesth Scand 1999;43:295-301.
  • İdem N, Şen Ö, Bican G. Prone pozisyonunda uygu- lanan perkütan nefrolitotomi cerrahisinde genel anes- tezi sirasinda iki farkli peep düzeyinin hemodinamik parametrelere, solunum mekaniğine ve arteriyel ok- sijenizasyona olan etkilerinin karşilaştirilmasi. GKD Anest Yoğ Bak Dern Derg 2009;15:45-52.
  • Wolf JS. Pathophysiologic Effects of prolonged lapa- roscopic operation. Sem Surg Oncol 1996;12:86-95.
  • Sood J, Kurma VP. Anaesthesia for laparoscopic sur- gery. Indian J Surg 2003;65:232-240.
  • Beştaş A, Bayar MK, Erhan ÖL, et al. Genel anestezi esnasında PEEP uygulamasının arteriyel oksijenizas- yona etkileri. Anestezi Dergisi 2002;10:83-88.
  • Rauh R, Hemmerling TM, Rist M, Jacobi KE. Influ- ence of pneumoperitoneum and patient position- ing on respiratory system compliance. J Clin Anesth 2001;13:361-365.
  • Sharma KC, Brandstetter RD, Brensilver JM, Jung LD. Cardiopulmonary physiology and pathophysiol- ogy as a consequence of laparoscopic surgery. Chest 1996;110:810-815.
  • Acar C, Toktaş C. Laparoskopik cerrahinin temel fizyo- lojik etkileri. Türk Üroloji Seminerleri 2010;1:119-125.
  • Kraut EJ, Anderson JT, Safwat A, et al. Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure. Arch Surg 1999:134;76-80.
  • Hirvonen EA, Poikolainen EO, Paakkönen ME, Nuutinen LS. The adverse haemodynamic effects of anaesthesia, head-up tilt and carbondioxide pneu- moperitoneum during laparoscopic cholecystectomy. Surg Endosc 2000;14:272-277.
  • Kararmaz A, Kaya S, Turhanoğlu S, Özyılmaz MA. La- paroskopi sonrasında uygulanan rekruitment manev- rasının arteryel oksijenasyon ve akciğer kompliyansı- na etkileri. Türk Anest Rean Der 2004;32:113-119.

The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations

Yıl 2014, Cilt: 5 Sayı: 3, 397 - 402, 01.09.2014
https://doi.org/10.5799/ahinjs.01.2014.03.0427

Öz

Amaç: Laparoskopik kolesistektomi operasyonlarında hastalarda uygulanan 10 cmH2O PEEP\'in solunum mekaniği, arteriyel oksijenizasyon ve hemodinami üzerine olan etkilerinin araştırılması. Yöntemler: Araştırma genel anesteziyle laparoskopik kolesistektomi ameliyatı geçirecek ASA I–II grubu 18-65 yaş arasında 40 hasta üzerinde planlandı. Hastalar PEEP uygulanmayan Grup 0 ve 10 cmH2O PEEP uygulanan Grup P olarak ikiye ayrıldı. Kalp atım hızı (KAH), ortalama kan basıncı (OAB), arteriyel oksijen satürasyonu (SpO2), end-tidal karbondioksit parsiyel basıncı (PEtCO2), tepe inspiratuar basınç (PİP), plato basıncı (Pplato), arteriyel kanda parsiyel oksijen basıncı (PaO2), arteriyel parsiyel karbondioksit basıncı (PaCO2) değerleri indüksiyondan sonra 5. dakikada, CO2 insüflasyonu sonrası 5. dakika, başyukarı ve sağ yan pozisyondan sonra 10. ve 30. dakikalarda, desüflasyon sonrası 10. dakika ve derlenme odasında alınarak kaydedildi. Aynı zamanlarda alveolo-arteriyel oksijen basınç gradiyenti (P(A-a) O2), ölü boşluk değişiklikleri (VD/VT), arter ve end tidal parsiyel karbondioksit basıncı farkı (P(a-et) CO2), statik kompliyans (CS), dinamik kompliyans (CD) hesaplanarak yazıldı. Bulgular: Gruplar arası değerlendirmede, KAH, OAB, SpO2, PetCO2, PaO2, plato basıncı ve P(A-a)O2 değerleri arasında istatistiksel fark görülmedi (p>0,05). Pik inspiratuvar basınç Grup P de daha yüksek idi (p

Kaynakça

  • Himal HS. Minimally invasive (laparoscopic) surgery. Surg Endosc 2002;8:265-270.
  • Hardacre JM, Talamini MA. Pulmonary and hemody- namic changes during laparoscopy-Are they impor- tant? Surgery 2000:127;241-244.
  • Marini JJ, Hotchkiss Jr JR. PEEP in Prone position: reversing the perfusion imbalance. Crit Care Med 1999;27:1-2.
  • Halbertsma FJ, van der Hoeven JG. Lung Recruitment during mechanical positive pressure ventilation in the PICU: What can be learned from the literature? An- aesthesia 2005;60:779-790.
  • Gander S, Frascarolo P, Suter M, et al. Positive end- expiratory pressure during induction of general anes- thesia increases time of apnea before peripheral de- saturation in morbidly obese patients. Anesthesiology 2003;99:1515.
  • Yao and Artusio’s Anesthesiology: Problem-Oriented Patient Management, Lippincott, 2008, Sixth Edition, 854-855.
  • Tyagi A, Kumar R, Sethi AK, Mohta M. A comparison of pressure-controlled and volume-controlled ventila- tion for laparoscopic cholecystectomy. Anaesthesia 2011;66:503-508.
  • Kim JY, Shin CS, Kim HS, et al. Positive end-expiratory pressure in pressure-controlled ventilation improves ventilatory and oxygenation parameters during laparo- scopic cholecystectomy. Surg Endosc 2010:24:1099- 103.
  • Brezo DB, Ezquerro C, Alsina E, et al. Anesthesia ventilation strategy in general surgery with low tidal volume and positive pressure at the end of expiration (PEEP) is associated with higher arterial oxygen pres- sure than ventilation with high tidal volume without PEEP. Anesthesiology 2003;99: A1516 .
  • Neumann P, Rothen HU, Berglund JE, et al. Positive end-expiratory pressure prevents atelectasis during general anaesthesia even in the presence of a high inspired oxygen concentration. Acta Anaesth Scand 1999;43:295-301.
  • İdem N, Şen Ö, Bican G. Prone pozisyonunda uygu- lanan perkütan nefrolitotomi cerrahisinde genel anes- tezi sirasinda iki farkli peep düzeyinin hemodinamik parametrelere, solunum mekaniğine ve arteriyel ok- sijenizasyona olan etkilerinin karşilaştirilmasi. GKD Anest Yoğ Bak Dern Derg 2009;15:45-52.
  • Wolf JS. Pathophysiologic Effects of prolonged lapa- roscopic operation. Sem Surg Oncol 1996;12:86-95.
  • Sood J, Kurma VP. Anaesthesia for laparoscopic sur- gery. Indian J Surg 2003;65:232-240.
  • Beştaş A, Bayar MK, Erhan ÖL, et al. Genel anestezi esnasında PEEP uygulamasının arteriyel oksijenizas- yona etkileri. Anestezi Dergisi 2002;10:83-88.
  • Rauh R, Hemmerling TM, Rist M, Jacobi KE. Influ- ence of pneumoperitoneum and patient position- ing on respiratory system compliance. J Clin Anesth 2001;13:361-365.
  • Sharma KC, Brandstetter RD, Brensilver JM, Jung LD. Cardiopulmonary physiology and pathophysiol- ogy as a consequence of laparoscopic surgery. Chest 1996;110:810-815.
  • Acar C, Toktaş C. Laparoskopik cerrahinin temel fizyo- lojik etkileri. Türk Üroloji Seminerleri 2010;1:119-125.
  • Kraut EJ, Anderson JT, Safwat A, et al. Impairment of cardiac performance by laparoscopy in patients receiving positive end-expiratory pressure. Arch Surg 1999:134;76-80.
  • Hirvonen EA, Poikolainen EO, Paakkönen ME, Nuutinen LS. The adverse haemodynamic effects of anaesthesia, head-up tilt and carbondioxide pneu- moperitoneum during laparoscopic cholecystectomy. Surg Endosc 2000;14:272-277.
  • Kararmaz A, Kaya S, Turhanoğlu S, Özyılmaz MA. La- paroskopi sonrasında uygulanan rekruitment manev- rasının arteryel oksijenasyon ve akciğer kompliyansı- na etkileri. Türk Anest Rean Der 2004;32:113-119.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Yazısı
Yazarlar

Fatma Çiçek Bu kişi benim

Canan Ün Bu kişi benim

Oya Kılcı Bu kişi benim

Mehmet Gamlı Bu kişi benim

Dilşen Örnek Bu kişi benim

Derya Türkaslan Bu kişi benim

Bayazit Dikmen Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 5 Sayı: 3

Kaynak Göster

APA Çiçek, F., Ün, C., Kılcı, O., Gamlı, M., vd. (2014). The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations. Journal of Clinical and Experimental Investigations, 5(3), 397-402. https://doi.org/10.5799/ahinjs.01.2014.03.0427
AMA Çiçek F, Ün C, Kılcı O, Gamlı M, Örnek D, Türkaslan D, Dikmen B. The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations. J Clin Exp Invest. Eylül 2014;5(3):397-402. doi:10.5799/ahinjs.01.2014.03.0427
Chicago Çiçek, Fatma, Canan Ün, Oya Kılcı, Mehmet Gamlı, Dilşen Örnek, Derya Türkaslan, ve Bayazit Dikmen. “The Effects of 10 CmH 2 O Positive End-Expiratory Pressure on Arterial Oxygenation, Respiratory Mechanics and Hemodynamic Parameters in Laparoscopic Cholecystectomy Operations”. Journal of Clinical and Experimental Investigations 5, sy. 3 (Eylül 2014): 397-402. https://doi.org/10.5799/ahinjs.01.2014.03.0427.
EndNote Çiçek F, Ün C, Kılcı O, Gamlı M, Örnek D, Türkaslan D, Dikmen B (01 Eylül 2014) The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations. Journal of Clinical and Experimental Investigations 5 3 397–402.
IEEE F. Çiçek, C. Ün, O. Kılcı, M. Gamlı, D. Örnek, D. Türkaslan, ve B. Dikmen, “The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations”, J Clin Exp Invest, c. 5, sy. 3, ss. 397–402, 2014, doi: 10.5799/ahinjs.01.2014.03.0427.
ISNAD Çiçek, Fatma vd. “The Effects of 10 CmH 2 O Positive End-Expiratory Pressure on Arterial Oxygenation, Respiratory Mechanics and Hemodynamic Parameters in Laparoscopic Cholecystectomy Operations”. Journal of Clinical and Experimental Investigations 5/3 (Eylül 2014), 397-402. https://doi.org/10.5799/ahinjs.01.2014.03.0427.
JAMA Çiçek F, Ün C, Kılcı O, Gamlı M, Örnek D, Türkaslan D, Dikmen B. The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations. J Clin Exp Invest. 2014;5:397–402.
MLA Çiçek, Fatma vd. “The Effects of 10 CmH 2 O Positive End-Expiratory Pressure on Arterial Oxygenation, Respiratory Mechanics and Hemodynamic Parameters in Laparoscopic Cholecystectomy Operations”. Journal of Clinical and Experimental Investigations, c. 5, sy. 3, 2014, ss. 397-02, doi:10.5799/ahinjs.01.2014.03.0427.
Vancouver Çiçek F, Ün C, Kılcı O, Gamlı M, Örnek D, Türkaslan D, Dikmen B. The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations. J Clin Exp Invest. 2014;5(3):397-402.