Airway closure in anesthetized infants and children: influence of inspiratory pressures and volumes

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

Background: Cyclic opening and closing of lung units during tidal breathing may be an important cause of iatrogenic lung injury. We hypothesized that airway closure is uncommon in children with healthy lungs when inspiratory pressures are kept low, but paradoxically may occur when inspiratory pressures are increased. Methods: Elastic equilibrium volume (EEV) and closing capacity (CC) were measured with a tracer gas (SF6) technique in 11 anesthetized, muscle-relaxed, endotracheally intubated and artificially ventilated healthy children, aged 0.6-13years. Airway closing was studied in a randomized order at two inflation pressures, +20 or +30 cmH(2)O, and CC and CC/EEV were calculated from the plots obtained when the lungs were exsufflated to -20 cmH(2)O. (CC/EEV >1 indicates that airway closure might occur during tidal breathing). Furthermore, a measure of uneven ventilation, multiple breath alveolar mixing efficiency (MBAME), was obtained. Results: Airway closure within the tidal volume (CC/EEV>1) was observed in four and eight children (not significant, NS) after 20 and 30cmH(2)O inflation, respectively. However, CC30/EEV was>CC20/EEV in all children (Pless than or equal to0.001). The MBAME was 75+/-7% (normal) and did not correlate with CC/EEV. Conclusion: Airway closure within tidal volumes may occur in artificially ventilated healthy children during ventilation with low inspiratory pressure. However, the risk of airway closure and thus opening within the tidal volume increases when the inspiratory pressures are increased.

Detaljer

Författare
  • Adalbjörn Thorsteinsson
  • Olof Werner
  • Christer Jonmarker
  • A Larsson
Enheter & grupper
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Anestesi och intensivvård

Nyckelord

Originalspråkengelska
Sidor (från-till)529-536
TidskriftActa Anaesthesiologica Scandinavica
Volym46
Utgåva nummer5
StatusPublished - 2002
PublikationskategoriForskning
Peer review utfördJa

Relaterad forskningsoutput

Thorsteinsson, A., 2001, 98 s.

Forskningsoutput: AvhandlingDoktorsavhandling (sammanläggning)

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