دوره 30، شماره 138 - ( 10-1400 )                   جلد 30 شماره 138 صفحات 16-12 | برگشت به فهرست نسخه ها


XML English Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Sehat Kashani S, Rokhtabnak F, Ghodraty M R, Zamani M M, Mesbah Kiaee M, Ghorbanlo M, et al . The Effect of Open Lung Ventilation on Respiratory Mechanics, Postoperative Organ Function, and Inflammatory Mediators in Coronary Artery Bypass Surgery. J Adv Med Biomed Res 2022; 30 (138) :12-16
URL: http://journal.zums.ac.ir/article-1-6210-fa.html
The Effect of Open Lung Ventilation on Respiratory Mechanics, Postoperative Organ Function, and Inflammatory Mediators in Coronary Artery Bypass Surgery. Journal of Advances in Medical and Biomedical Research. 1400; 30 (138) :12-16

URL: http://journal.zums.ac.ir/article-1-6210-fa.html


چکیده:   (110993 مشاهده)

Background and Objective: The present study aimed to assess the supportive role of open lung ventilation on respiratory mechanics, the rate of oxygenation, inflammatory biomarkers, and probable liver or renal injuries following coronary artery bypass grafting surgery.
Materials and Methods: This randomized double-blinded clinical trial study was conducted on 64 candidates for coronary artery bypass surgery using a cardiopulmonary pump. The patients were randomly categorized into the Positive end-expiratory pressure (PEEP) group (n = 32) or Zero End Expiratory Pressure (ZEEP) group (n = 32).
Results: Interleukin-6 levels were similar between the PEEP and ZEEP groups before surgery (p = 0.18) and were significantly higher in the ZEEP group after pump insertion (p = 0.005). On the contrary, the levels of Interleukin-6 were significantly higher in the PEEP group after extubation (p = 0.001). The Between-group analysis also showed a significant difference between the levels of interleukin-6 in the ZEEP and PEEP groups, representing a greater increase in the PEEP group (p < 0.001). There was no difference in certain hemodynamic parameters, including heart rate, mean blood pressure, mean CO2 pressure (PCO2), mean concentration of HCO3, and base excess. The mean arterial O2 saturation was higher overall in the PEEP group compared to the ZEEP group. The mean PaO2/FiO2 was significantly higher in the PEEP than in the ZEEP group (p < 0.001).
Conclusion: Supportive ventilation technique leads to better oxygenation and better lung expansion, as well as lowering inflammatory biomarkers, after coronary artery bypass surgery.

متن کامل [PDF 238 kb]   (106748 دریافت)    
نوع مطالعه: مقاله پژوهشی | موضوع مقاله: Clinical medicine
دریافت: 1399/6/18 | پذیرش: 1399/12/11 | انتشار: 1400/7/25

فهرست منابع
1. Canver CC, Chanda J. Intraoperative and postoperative risk factors for respiratory failure after coronary bypass. Ann ThoracSurg. 2003; 75(3):853-7. [DOI:10.1016/S0003-4975(02)04493-4]
2. Faritous ZS, Aghdaie N, Yazdanian F, Azarfarin R, Dabbagh A. Perioperative risk factors for prolonged mechanical ventilation and tracheostomy in women undergoing coronary artery bypass graft with cardiopulmonary bypass. Saudi J Anaesth. 2011; 5:167-9. [DOI:10.4103/1658-354X.82786] [PMID] [PMCID]
3. Cournand A, Motley HL, Werko L, Richards D. Physiological studies of the effects of intermittent positive pressure breathing on cardiac output in man. Am J Physiol. 1948; 152(1):162-174. [DOI:10.1152/ajplegacy.1947.152.1.162] [PMID]
4. Koyner JL, Murray PT. Mechanical ventilation and the kidney. Blood Purif. 2010; 29(1):52-68. [DOI:10.1159/000259585] [PMID] [PMCID]
5. Annat MDG, Viale MDJP, Xuan BB, Aissa MDOH, Benzoni PDD, Vincent PDM, et al. Effect of PEEP Ventilation on Renal Function, Plasma Renin, Aldosterone, Neurophysins and Urinary ADH, and Prostaglandins. Anesthesiology. 1983; 58(2):136-41. [DOI:10.1097/00000542-198302000-00006] [PMID]
6. Ferrante A, Nandoskar M, Walz A, Goh DH, Kowanko IC. Effects of tumour necrosis factor alpha and interleukin-1 alpha and beta on human neutrophil migration, respiratory burst and degranulation. Int Arch Allergy Immunol. 1988; 86(1):82-91. [DOI:10.1159/000234610] [PMID]
7. Slinger P, Kilpatrick B. Perioperative Lung Protection Strategies in Cardiothoracic Anesthesia. Anesthesiol Clin. 2012; 30(4):607-28. [DOI:10.1016/j.anclin.2012.07.001] [PMID]
8. Habashi NM. Other approaches to open-lung ventilation: airway pressure release ventilation. Crit Care Med. 2005; 33(3):S228-40. [DOI:10.1097/01.CCM.0000155920.11893.37] [PMID]
9. Biondi JW, Schulman DS, Soufer R, Matthay RA, Hines RL, Kay HR, etal. The effect of incremental positive end-expiratory pressure on right ventricular hemodynamics and ejection fraction. AnesthAnalg. 1988; 67(2):144-151. [DOI:10.1213/00000539-198802000-00007]
10. Maggiore SM, Jonson B, Richard JC, Jaber S, Lemaire F, Brochard L. Alveolar derecruitment at decremental positive end-expiratory pressure levels in acute lung injury: comparison with the lower inflection point, oxygenation, and compliance. Am J RespirCrit Care Med. 2001; 164(5):795-801. [DOI:10.1164/ajrccm.164.5.2006071] [PMID]
11. Patel JM. Intra-operative adherence to lung-protective ventilation: a prospective observational study. Perioper Med (Lond). 2016; 5: 8. [DOI:10.1186/s13741-016-0033-4] [PMID] [PMCID]
12. von Bethmann AN, Brasch F, Nusing R, Vogt K, Volk HD, Muller KM, et al. Hyperventilation induces release of cytokines from perfused mouse lung. Am J Respir Crit Care Med. 1998; 157(1):263-72. [DOI:10.1164/ajrccm.157.1.9608052] [PMID]
13. Zupancich E, Paparella D, Turani F, Munch C, Rossi A, Massaccesi S, et al. Mechanical ventilation affects inflammatory mediators in patients undergoing cardiopulmonary bypass for cardiac surgery: a randomized clinical trial. J Thorac Cardiovasc Surg. 2005;130(2):378-83. [DOI:10.1016/j.jtcvs.2004.11.061] [PMID]
14. Lin WQ, Lu XY, Cao LH, Wen LL, Bai XH, Zhong ZJ. [Effects of the lung protective ventilatory strategy on proinflammatory cytokine release during one-lung ventilation]. Ai Zheng. 2008;27(8):870-3.
15. Imai Y, Kawano T, Iwamoto S, Nakagawa S, Takata M, Miyasaka K. Intratracheal anti-tumor necrosis factor-alpha antibody attenuates ventilator-induced lung injury in rabbits. J Appl Physiol. 1999;87(2):510-5. [DOI:10.1152/jappl.1999.87.2.510] [PMID]
16. Dyhr T, Laursen N, Larsson A. Effects of lung recruitment maneuver and positive end-expiratory pressure on lung volume, respiratory mechanics and alveolar gas mixing in patients ventilated after cardiac surgery. Acta Anaesthesiol Scand. 2002;46(6):717-25. [DOI:10.1034/j.1399-6576.2002.460615.x] [PMID]
17. Chaney MA, Nikolov MP, Blakeman BP, Bakhos M. Protective ventilation attenuates postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2000;14(5):514-8 [DOI:10.1053/jcan.2000.9487] [PMID]

بازنشر اطلاعات
Creative Commons License این مقاله تحت شرایط Creative Commons Attribution-NonCommercial 4.0 International License قابل بازنشر است.

کلیه حقوق این وب سایت متعلق به Journal of Advances in Medical and Biomedical Research می باشد.

طراحی و برنامه نویسی : یکتاوب افزار شرق

© 2024 CC BY-NC 4.0 | Journal of Advances in Medical and Biomedical Research

Designed & Developed by : Yektaweb