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Mechanical Ventilation II: Invasive Ventilation

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Ventilation with low tidal volumes during upper abdominal surgery does not improve postoperative lung function.

T A Treschan1, W Kaisers, M S Schaefer

  • 1Department of Anaesthesiology, Düsseldorf University Hospital, Düsseldorf, Germany. tanja.treschan@med.uni-duesseldorf.de

British Journal of Anaesthesia
|June 5, 2012
PubMed
Summary

Low tidal volume ventilation did not improve postoperative lung function in major upper abdominal surgery patients. This study found no significant difference in lung function recovery between high and low tidal volume groups.

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Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
09:31

Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism

Published on: February 14, 2022

Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Pulmonary Medicine

Background:

  • Major upper abdominal surgery frequently results in prolonged postoperative lung function decline.
  • Low tidal volume ventilation is hypothesized to mitigate intraoperative lung injury.
  • This study investigated the impact of tidal volume on postoperative lung function.

Purpose of the Study:

  • To compare postoperative lung function in patients undergoing major upper abdominal surgery.
  • To evaluate the efficacy of low tidal volume ventilation versus high tidal volume ventilation.
  • To assess secondary outcomes including oxygenation and complications.

Main Methods:

  • A double-blind, prospective, randomized controlled trial involving 101 patients (age ≥ 50 yr, ASA ≥ II).
  • Patients were ventilated with either 6 ml kg(-1) predicted body weight (PBW) or 12 ml kg(-1) PBW tidal volumes.
  • Time-weighted averages of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) were compared up to 120 hours post-operation.

Main Results:

  • No statistically significant difference was observed in the time-weighted averages of FVC (P=0.12) or FEV(1) (P=0.15) between the low and high tidal volume groups.
  • Individual time points for FVC and FEV(1) also showed no significant differences.
  • Secondary outcomes, including oxygenation and complication rates, did not differ significantly between the groups.

Conclusions:

  • Low tidal volume ventilation does not ameliorate prolonged impaired lung function after major abdominal surgery.
  • The findings suggest that current low tidal volume strategies may not offer protective benefits in this patient population.
  • Further research may be needed to explore alternative ventilation strategies for major abdominal surgery.