Effect of pressure-controlled inverse ratio ventilation on dead space during robot-assisted laparoscopic radical prostatectomy

Hirabayashi, Go; Ogihara, Yukihiko; Tsukakoshi, Shoichi; Daimatsu, Kiyoshi; Inoue, Masaaki; Kurahashi, Kiyoyasu; Maruyama, Koichi; Andoh, Tomio

doi:10.1097/eja.0000000000000732

Cited by 8 publications

(16 citation statements)

References 18 publications

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“…However, the International Physical Activity Questionnaire and accelerometry could also be helpful in this case [37,38]. A novel analytical method reported calculating shunt V D by subtracting respiratory V D (i.e., anatomical V D and alveolar V D ) from physiological V D [39]. We did not calculate shunt V D , as this method is sophisticated and the shunt V D level was expected to be small.…”

Section: Study Limitationsmentioning

confidence: 99%

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

Chuang

2020

JCM

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Physiological dead space volume (V D ) and dynamic hyperinflation (DH) are two different types of abnormal pulmonary physiology. Although they both involve lung volume, their combination has never been advocated, and thus their effect and implication are unclear. This study aimed (1) to combine V D and DH, and (2) investigate their relationship and clinical significance during exercise, as well as (3) identify a noninvasive variable to represent the V D fraction of tidal volume (V D /V T ). Forty-six male subjects with chronic obstructive pulmonary disease (COPD) and 34 healthy male subjects matched for age and height were enrolled. Demographic data, lung function, and maximal exercise were investigated. End-expiratory lung volume (EELV) was measured for the control group and estimated for the study group using the formulae reported in our previous study. The V D /V T ratio was measured for the study group, and reference values of V D /V T were used for the control group. In the COPD group, the DH peak /total lung capacity (TLC, DH peak %) was 7% and the EELV peak % was 70%. After adding the V Dpeak % (8%), the V D DH peak % was 15% and the V D EELV peak % was 78%. Both were higher than those of the healthy controls. In the COPD group, the V D DH peak % and V D EELV peak % were more correlated with dyspnea score and exercise capacity than that of the DH peak % and EELV%, and had a similar strength of correlation with minute ventilation. The V Tpeak /TLC (V Tpeak %), an inverse marker of DH, was inversely correlated with V D /V T (R 2 ≈ 0.50). Therefore, we recommend that V D should be added to DH and EELV, as they are physiologically meaningful and V Tpeak % represents not only DH but also dead space ventilation. To obtain V D , the V D /V T must be measured. Because obtaining V D /V T requires invasive arterial blood gases, further studies on noninvasive predicting V D /V T is warranted.

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Section: Study Limitationsmentioning

confidence: 99%

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

Chuang

2020

JCM

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“…Мы нашли пять полнотекстовых статей, описывающих сравнительные исследования влияния факторов риска нарушений легочной функции [17][18][19][20][21] (табл. 1) и девять полнотекстовых статей, описывающих сравнительные исследования эффектов различных вмешательств для улучшения легочной функции при РАРП [22][23][24][25][26][27][28][29][30] (табл. 2).…”

Section: результаты исследованияunclassified

“…2). Включенные статьи состояли из трех одноцентровых [17,18,21], одного многоцентрового [19] проспективных и одного ретроспективного [20] исследований; восьми рандомизированных исследований с параллельными группами [22][23][24][25][27][28][29][30] и одного рандомизированного перекрестного исследования [26]. В качестве факторов риска нарушений легочной функции были угол наклона операционного стола при ПТр [17], возраст [18], ИМТ [19][20][21].…”

Section: результаты исследованияunclassified

“…В качестве факторов риска нарушений легочной функции были угол наклона операционного стола при ПТр [17], возраст [18], ИМТ [19][20][21]. В качестве вмешательства для улучшения легочной функции были три исследования режимов ИВЛ [22][23][24], три исследования различных соотношений времени вдоха ко времени выдоха [25][26][27] и три исследования эффективности маневра рекрутмента [28][29][30]. В качестве временных точек сравнения переменных нами были выбраны: Т исх -после индукции анестезии и интубации трахеи в горизонтальном положении пациента, Т макс/мин -максимальное/ минимальное значение за время операции, Т кон -после десуффляции газа из брюшной полости в горизонтальном положении пациента.…”

Section: результаты исследованияunclassified

“…ст. значимо уменьшал МПфиз по сравнению с режимом ИВЛ с обычным дыхательным циклом у пациентов со здоровыми легкими [25].…”

Section: инверсия отношения времени вдоха ко времени выдохаunclassified

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Features of the mechanics of respiration and gas exchange during robot-assisted radical prostatectomy. Review

Lutfarakhmanov

Melnikova

Syrchin

et al. 2021

Annals of Critical Care

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Introduction. Prostate cancer remains the most common urological malignancy, and robot-assisted radical prostatectomy (RARP) is the most effective treatment option. Special conditions for operation (Trendelenburg position and pneumoperitoneum) increase the airway pressure and reduce functional residual capacity of the lungs. Objectives. Review of risk factors for disorders and various interventions to improve pulmonary function and reduce the adverse physiological effects of RARP under general anesthesia. Materials and methods. This review of literature was conducted using the PubMed search engine in electronic databases Medline, Embase, the Cochrane Library and others up to May 2019. Results. A total of 22 studies were searched, including 9 randomized controlled trials. The factor that could worsen gas exchange during RARP was the body mass index 30 kg/m2. It is possible to improve gas exchange by means of recruitment maneuvers. Positive end-expiratory pressure of 5-10 cm H2O improves oxygenation but requires alertness in patients with chronic heart failure and chronic obstructive pulmonary disease. Conclusions. The main risk factors for perioperative respiratory and oxygenation disorders in RARP are pneumoperitoneum and steep Trendelenburg position. The effectiveness of ventilation regimes for the prevention of gas exchange disorders has not been proven. Using the recruitment maneuver and increasing the positive end-expiratory pressure does not improve the respiratory function of the lungs. Further studies with a longer follow-up period are needed to determine the clinical efficacy and safety of RARP.

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Anesthetic considerations and goals in robotic pediatric surgery: a narrative review

2020

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Effect of pressure-controlled inverse ratio ventilation on dead space during robot-assisted laparoscopic radical prostatectomy

Abstract: University Hospital Medical Information Network in Japan 000014004.

Cited by 8 publications

References 18 publications

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

Features of the mechanics of respiration and gas exchange during robot-assisted radical prostatectomy. Review

Anesthetic considerations and goals in robotic pediatric surgery: a narrative review

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