Changes in lung aeration and respiratory function after open abdominal surgery: A quantitative magnetic resonance imaging study.
magnetic resonance imaging
perioperative medicine
postoperative atelectasis
respiratory function
Journal
Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
13
04
2022
received:
07
02
2022
accepted:
13
06
2022
pubmed:
7
7
2022
medline:
18
8
2022
entrez:
6
7
2022
Statut:
ppublish
Résumé
Atelectasis is one of the most common respiratory complications in patients undergoing open abdominal surgery. Peripheral oxygen saturation (SpO Post-hoc analysis of a randomized trial conducted at a University Hospital in Dresden, Germany. Patients undergoing pre- and postoperative lung MRI were included. MRI signal intensity was analyzed quantitatively to define poorly and nonaerated lung compartments. Postoperative atelectasis was defined as nonaerated lung volume above 2% of the total lung volume in the respective MRI investigation. This study included 45 patients, 27 with and 18 patients without postoperative atelectasis. Patients with atelectasis had higher body mass index (p = .024), had more preoperative poorly aerated lung volume (p = .049), a lower preoperative SpO SpO
Sections du résumé
BACKGROUND
Atelectasis is one of the most common respiratory complications in patients undergoing open abdominal surgery. Peripheral oxygen saturation (SpO
METHODS
Post-hoc analysis of a randomized trial conducted at a University Hospital in Dresden, Germany. Patients undergoing pre- and postoperative lung MRI were included. MRI signal intensity was analyzed quantitatively to define poorly and nonaerated lung compartments. Postoperative atelectasis was defined as nonaerated lung volume above 2% of the total lung volume in the respective MRI investigation.
RESULTS
This study included 45 patients, 27 with and 18 patients without postoperative atelectasis. Patients with atelectasis had higher body mass index (p = .024), had more preoperative poorly aerated lung volume (p = .049), a lower preoperative SpO
CONCLUSION
SpO
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
944-953Informations de copyright
© 2022 Acta Anaesthesiologica Scandinavica Foundation.
Références
Canet J, Sabaté S, Mazo V, et al. Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: a prospective, observational study. Eur J Anaesthesiol. 2015;32:458-470.
Ball L, Battaglini D, Pelosi P. Postoperative respiratory disorders. Curr Opin Crit Care. 2016;22:379-385.
Serpa Neto A, Hemmes SNT, Barbas CSV, et al. Incidence of mortality and morbidity related to postoperative lung injury in patients who have undergone abdominal or thoracic surgery: a systematic review and meta-analysis. Lancet Respir Med. 2014;2:1007-1015.
Duggan M, Kavanagh BP. Atelectasis in the perioperative patient. Curr Opin Anaesthesiol. 2007;20:37-42.
do Nascimento Junior P, Módolo NSP, Andrade S, Guimarães MMF, Braz LG, El Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2014;(3):CD006058. doi:10.1002/14651858.CD006058.pub3
Hemmes SNT, de Abreu MG, Pelosi P, et al. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial. Lancet. 2014;384:495-503.
Reinius H, Jonsson L, Gustafsson S, et al. Prevention of atelectasis in morbidly obese patients during general anesthesia and paralysis: a computerized tomography study. Anesthesiology. 2009;111:979-987.
Ireland CJ, Chapman TM, Mathew SF, Herbison GP, Zacharias M. Continuous positive airway pressure (CPAP) during the postoperative period for prevention of postoperative morbidity and mortality following major abdominal surgery. Cochrane Database Syst Rev. 2014;8:CD008930.
Westerdahl E, Lindmark B, Eriksson T, Friberg Ö, Hedenstierna G, Tenling A. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005;128:3482-3488.
Ball L, Almondo C, Pelosi P. Perioperative lung protection: general mechanisms and protective approaches. Anesth Analg. 2020;131:1789-1798.
Kia L, Cuttica MJ, Yang A, et al. The utility of pulmonary function testing in predicting outcomes following liver transplantation: pulmonary function tests and LT. Liver Transpl. 2016;22:805-811.
Ferrando C, Romero C, Tusman G, et al. The accuracy of postoperative, non-invasive Air-Test to diagnose atelectasis in healthy patients after surgery: a prospective, diagnostic pilot study. BMJ Open. 2017;7:1-10.
Ball L, Braune A, Spieth P, et al. Magnetic resonance imaging for quantitative assessment of lung aeration: a pilot translational study. Front Physiol. 2018;9:1120.
Noll E, Ohana M, Hengen M, et al. Validation of MRI for volumetric quantification of atelectasis in the perioperative period: an experimental study in swine. Front Physiol. 2019;10:695.
Ball L, Vercesi V, Costantino F, Chandrapatham K, Pelosi P. Lung imaging: how to get better look inside the lung. Ann Transl Med. 2017;5:294.
Spieth PM, Güldner A, Uhlig C, et al. Variable versus conventional lung protective mechanical ventilation during open abdominal surgery (PROVAR): a randomised controlled trial. Br J Anaesth. 2018;120:581-591.
Spieth PM, Carvalho AR, Pelosi P, et al. Variable tidal volumes improve lung protective ventilation strategies in experimental lung injury. Am J Respir Crit Care Med. 2009;179:684-693.
Tokics L, Hedenstierna G, Strandberg A, Brismar B, Lundquist H. Lung collapse and gas exchange during general anesthesia: effects of spontaneous breathing, muscle paralysis, and positive end-expiratory pressure. Anesthesiology. 1987;66:157-167.
Brown LD, Cai TT, DasGupta A. Interval estimation for a binomial proportion. Stat Sci. 2001;16:101-117. doi:10.1214/ss/1009213286
Cressoni M, Gallazzi E, Chiurazzi C, et al. Limits of normality of quantitative thoracic CT analysis. Crit Care. 2013;17:R93.
Gama de Abreu M, Cuevas M, Spieth PM, et al. Regional lung aeration and ventilation during pressure support and biphasic positive airway pressure ventilation in experimental lung injury. Crit Care. 2010;14:R34.
Reber A, Nylund U, Hedenstierna G. Position and shape of the diaphragm: implications for atelectasis formation: diaphragm and anaesthesia. Anaesthesia. 1998;53:1054-1061.
Rao VK, Khanna AK. Postoperative respiratory impairment is a real risk for our patients: the intensivist's perspective. Anesthesiol Res Pract. 2018;2018:1-7.
Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth. 2002;89:622-632.
Taylor JL, Amann M, Duchateau J, Meeusen R, Rice CL. Neural contributions to muscle fatigue: from the brain to the muscle and back again. Med Sci Sports Exerc. 2016;48:2294-2306.
Jammer I, Wickboldt N, Sander M, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol. 2015;32:88-105.