Postoperative Atelectasis

Paul, William L.

doi:10.1001/archsurg.1981.01380190011003

Cited by 21 publications

(3 citation statements)

References 2 publications

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“…In these studies the increase in FRC was measured within 15 min after the CPAP treatment. Only one study concerned PEP and an increase in estimated FRC was found (26). In our study FRC was not measured immediately after the treatment, and none of the regimens was accompanied by persistent changes in FRC.…”

Section: Patients Treated F O R P P C Antibiotics Bronc Hodilators Sucontrasting

confidence: 52%

Postoperative pulmonary complications and lung function in high‐risk patients: a comparison of three physiotherapy regimens after upper abdominal surgery in general anesthesia

Christensen

Schultz

Jensen

et al. 1991

Acta Anaesthesiol Scand

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The effect of three postoperative regimens of respiratory therapy on pulmonary complications and lung function was compared in high-risk patients. Fifty-one patients were randomized to: 1) conventional chest physiotherapy alone (PHYS), 2) chest physiotherapy and positive expiratory pressure (PEP), or 3) chest physiotherapy with both positive expiratory pressure and inspiratory resistance (RMT). Treatments were given twice daily by a physiotherapist and self-administered. The incidence of postoperative pulmonary complications (PPC) was respectively, 71%, 76% and 65% in the PHYS-, PEP- and RMT-groups. The incidence of PPC requiring treatment with antibiotic, bronchodilator or supplementary oxygen according to the existing clinical practice was 47%, 47% and 29%. The incidence of atelectasis was 65%, 64% and 60% and of pneumonia 29%, 35% and 6%. There was no difference between the groups, except for a tendency to a lower frequency of pneumonia in the RMT-group. Postoperatively forced vital capacity (FVC) decreased to mean 54%, forced expired volume in 1 s to 48% and functional residual capacity to 76% of preoperative values. Arterial oxygen tension (PaO2) declined to mean 8.1 kPa and arterial saturation (SaO2) to 89%. There was no difference between the groups except for FVC, PaO2 and SaO2 (P = 0.008, P = 0.008 and P = 0.002), which showed the least decrease in the RMT-group. None of the regimens could be considered as satisfactory concerning the prevention of PPC, but RMT seemed to be the most efficient. Insufficient self-administration of treatment was probably one of the causes of the overall high incidence of PPC in this study.

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Section: Patients Treated F O R P P C Antibiotics Bronc Hodilators Sucontrasting

confidence: 52%

Postoperative pulmonary complications and lung function in high‐risk patients: a comparison of three physiotherapy regimens after upper abdominal surgery in general anesthesia

Christensen

Schultz

Jensen

et al. 1991

Acta Anaesthesiol Scand

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“…Continuous positive airway pressure (CPAP) is usually administered by facemask. It commonly is used in patients with sleep apnea but has been used for decades to treat patients with postoperative atelectasis ( 13 – 16 ), cardiogenic pulmonary edema ( 17 ), and respiratory distress ( 18 , 19 ). CPAP applied with a facemask does not result in airway pressure change, does not provide ventilatory support, and should not be confused with noninvasive positive pressure ventilation (NIPPV), which does provide mechanical ventilatory support via a facemask.…”

Section: Clinical Managementmentioning

confidence: 99%

Proposal for Coronavirus Disease 2019 Management

Downs

Weled

Räsänen

et al. 2020

Critical Care Explorations

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Setting: The coronavirus disease 2019 pandemic has raised fear throughout the nation. Current news and social media predictions of ventilator, medication, and personnel shortages are rampant. Patients: Patients with coronavirus disease 2019 are presenting with early respiratory distress and hypoxemia, but not hypercapnia. Interventions: Patients who maintain adequate alveolar ventilation, normocapnia, and adequate oxygenation may avoid the need for tracheal intubation. Facemask continuous positive airway pressure has been used to treat patients with respiratory distress for decades, including those with severe acute respiratory syndrome. Of importance, protocols were successful in protecting caregivers from contracting the virus, obviating the need for tracheal intubation just to limit the spread of potentially infectious particles. Conclusions: During a pandemic, with limited resources, we should provide the safest and most effective care, while protecting caregivers. Continuous positive airway pressure titrated to an effective level and applied early with a facemask may spare ventilator usage. Allowing spontaneous ventilation will decrease the need for sedative and paralytic drugs and may decrease the need for highly skilled nurses and respiratory therapists. These goals can be accomplished with devices that are readily available and easier to obtain than mechanical ventilators, which then can be reserved for the sickest patients.

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“…Inserting a nasogastric tube may be relatively difficult when using FMV, which could impact the intraoperative need for gastric emptying. Implementing positive end-expiratory pressure (PEEP) during FMV may also be relatively challenging, and PEEP may be necessary for certain patients, such as those with acute respiratory distress syndrome (ARDS) [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of trans-nasal humidified rapid insufflation ventilatory exchange compared with standard facemask oxygenation for pre- and apneic oxygenation during anesthesia induction: A meta-analysis based on randomized controlled trials

Zheng,

Yao,

Luo

et al. 2024

PLoS ONE

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Purpose To further identify the effectiveness of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) for pre- and apneic oxygenation during the anesthesia induction by comparison to facemask ventilation (FMV) based on current available evidence. Methods Medline, EMBASE, Web of Science, Cochrane Library and CNKI databases were searched from inception to December 22, 2023 for available randomized controlled trials (RCTs). Primary outcomes were PaO2 and PaCO2 after intubation and safe apnoea time. Secondary outcomes included the O2 desaturation, end expiratory carbon dioxide (EtCO2) and complications. The effect measures for continuous and categorical outcomes were separately the mean difference (MD) and relative risk (RR) with 95% confidence interval. Results Twelve RCTs with 403 patients in the THRIVE group and 401 patients in th FMV group were included. Pooled results demonstrated that the PaO2 after intubation was significantly higher (MD = 82.90mmHg, 95% CI: 12.25~153.54mmHg, P = 0.02) and safe apnoea time (MD = 103.81s, 95% CI: 42.07~165.56s, P = 0.001) was longer in the THRIVE group. Besides, the incidence rate of O2 desaturation (RR = 0.28, 95% CI: 0.12–0.66, P = 0.004) and gastric insufflation (RR = 0.26, 95% CI: 0.13–0.49, P<0.001) was significantly lower in the THRIVE group. Conclusion Based on current evidence, THRIVE manifested better effectiveness representing as improved oxygenation, prolonged safe apnoea time and decreased risk of complications compared to standard FMV in surgical patients. Therefore, THRIVE could be served as a novel and valuable oxygenation technology for patients during anesthesia induction.

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Postoperative Atelectasis

Cited by 21 publications

References 2 publications

Postoperative pulmonary complications and lung function in high‐risk patients: a comparison of three physiotherapy regimens after upper abdominal surgery in general anesthesia

Postoperative pulmonary complications and lung function in high‐risk patients: a comparison of three physiotherapy regimens after upper abdominal surgery in general anesthesia

Proposal for Coronavirus Disease 2019 Management

Effectiveness of trans-nasal humidified rapid insufflation ventilatory exchange compared with standard facemask oxygenation for pre- and apneic oxygenation during anesthesia induction: A meta-analysis based on randomized controlled trials

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