Impact of Stepwise Recruitment Maneuvers on Cerebral Hemodynamics: Experimental Study in Neonatal Model.
cerebral hemodynamics
cerebral oximetry
intracranial pressure
neonate
recruitment maneuvers
Journal
Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269
Informations de publication
Date de publication:
25 Jul 2023
25 Jul 2023
Historique:
received:
16
06
2023
revised:
12
07
2023
accepted:
19
07
2023
medline:
25
8
2023
pubmed:
25
8
2023
entrez:
25
8
2023
Statut:
epublish
Résumé
Lung recruitment maneuvers (LRMs) have been demonstrated to be effective in avoiding atelectasis during general anesthesia in the pediatric population. Performing these maneuvers is safe at the systemic hemodynamic and respiratory levels. We aimed to evaluate the impact of a stepwise LRM and individualized positive end-expiratory pressure (PEEP) on cerebral hemodynamics in an experimental neonatal model. Eleven newborn pigs (less than 72 h old, 2.56 ± 0.18 kg in weight) were included in the study. The LRM was performed under pressure-controlled ventilation with a constant driving pressure (15 cmH All LRMs were safely performed as scheduled without any interruptions. Systemic hemodynamic stability was maintained during the lung recruitment maneuver. No changes in ICP occurred. We observed an improvement in rSO Stepwise LRMs are a safe tool to avoid atelectasis. We did not observe an impairment in cerebral hemodynamics but an improvement in cerebral oxygenation.
Sections du résumé
BACKGROUND
BACKGROUND
Lung recruitment maneuvers (LRMs) have been demonstrated to be effective in avoiding atelectasis during general anesthesia in the pediatric population. Performing these maneuvers is safe at the systemic hemodynamic and respiratory levels.
AIMS
OBJECTIVE
We aimed to evaluate the impact of a stepwise LRM and individualized positive end-expiratory pressure (PEEP) on cerebral hemodynamics in an experimental neonatal model.
METHODS
METHODS
Eleven newborn pigs (less than 72 h old, 2.56 ± 0.18 kg in weight) were included in the study. The LRM was performed under pressure-controlled ventilation with a constant driving pressure (15 cmH
RESULTS
RESULTS
All LRMs were safely performed as scheduled without any interruptions. Systemic hemodynamic stability was maintained during the lung recruitment maneuver. No changes in ICP occurred. We observed an improvement in rSO
CONCLUSIONS
CONCLUSIONS
Stepwise LRMs are a safe tool to avoid atelectasis. We did not observe an impairment in cerebral hemodynamics but an improvement in cerebral oxygenation.
Identifiants
pubmed: 37623435
pii: jpm13081184
doi: 10.3390/jpm13081184
pmc: PMC10456108
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Crit Care. 2019 Aug 6;23(1):273
pubmed: 31387627
Am J Emerg Med. 2011 Sep;29(7):699-703
pubmed: 20825872
J Trauma. 2005 Mar;58(3):571-6
pubmed: 15761353
BMC Neurol. 2018 Nov 5;18(1):183
pubmed: 30396336
J Neurosurg Anesthesiol. 1997 Apr;9(2):175-9
pubmed: 9100190
Anesthesiology. 1990 Oct;73(4):717-21
pubmed: 2221440
J Neurosurg Anesthesiol. 2022 Jan 1;34(1):e52-e56
pubmed: 32555065
J Neurosurg Anesthesiol. 2013 Jul;25(3):330-4
pubmed: 23519374
J Crit Care. 2015 Dec;30(6):1263-6
pubmed: 26307004
J Neurosurg Anesthesiol. 2018 Jul;30(3):246-250
pubmed: 28671879
Paediatr Anaesth. 2021 Sep;31(9):1003-1010
pubmed: 34152683
Acta Neurochir Suppl. 2002;81:93-7
pubmed: 12168368
Rev Esp Anestesiol Reanim (Engl Ed). 2018 Apr;65(4):209-217
pubmed: 29395110
Respir Care. 2022 Oct;67(10):1300-1309
pubmed: 35853701
Crit Care Med. 1997 Jun;25(6):1059-62
pubmed: 9201061
Front Physiol. 2021 Oct 18;12:711273
pubmed: 34733173
PLoS One. 2018 May 10;13(5):e0196980
pubmed: 29746600
J Neurosurg. 2015 Sep;123(3):743-7
pubmed: 25955869
BMC Neurosci. 2021 Nov 25;22(1):72
pubmed: 34823465
Eurasian J Med. 2022 Oct;54(3):274-280
pubmed: 35950822
Acta Anaesthesiol Scand. 1999 May;43(5):501-8
pubmed: 10341996
Intensive Care Med. 2005 Mar;31(3):373-9
pubmed: 15668765
Crit Care. 2022 Jan 28;26(1):31
pubmed: 35090525
J Crit Care. 2021 Apr;62:246-255
pubmed: 33454552
Ital J Pediatr. 2020 Jul 23;46(1):100
pubmed: 32703261
BMC Anesthesiol. 2019 Jun 19;19(1):109
pubmed: 31215448
Respir Care. 2016 Feb;61(2):142-8
pubmed: 26556900
Anesthesiology. 2003 Jan;98(1):14-22
pubmed: 12502973
Intensive Care Med. 2002 May;28(5):554-8
pubmed: 12029401
Neurocrit Care. 2017 Apr;26(2):174-181
pubmed: 27848125
Neurosurgery. 1981 Apr;8(4):443-9
pubmed: 7017452
J Cereb Blood Flow Metab. 2016 Aug;36(8):1338-50
pubmed: 27174995
J Neurosurg. 1977 Aug;47(2):195-200
pubmed: 327031
Ann Fr Anesth Reanim. 2014 Apr;33(4):e59-65
pubmed: 24582111