Radiologically Undetectable Pulmonary Collapse in the Supine Position

Prys‐Roberts, C.; Nunn, J.F.; Dobson, Rachael; Robinson, R. H.; Greenbaum, R.; Harris, R. Scott

doi:10.1016/s0140-6736(67)92014-4

Cited by 37 publications

(12 citation statements)

References 10 publications

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“…(ii) Tracheobronchitis; classified as an increase in volume, or a change in the color or purulent aspect of the tracheobronchial secretion with a normal chest radiograph (5,6). (iii) Atelectasis; classified by evidence from a chest radiography of a pulmonary atelectasis with associated acute respiratory symptoms (6,7). (iv) Acute exacerbation of chronic obstructive pulmonary disease (COPD); an event in the natural course of the disease characterized by a worsening of the patient’s baseline dyspnea, a cough and/or sputum, which is outside of the normal variability that is sufficient to warrant a change in treatment management.…”

Section: Methodsmentioning

confidence: 99%

Risk factors of postoperative pulmonary complications following elective craniotomy for patients with tumors of the brainstem or adjacent to the brainstem

Chu

Dang

2014

Oncology Letters

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The aim of the present study was to analyze the risk factors of postoperative pulmonary complications (PPCs) of elective craniotomy for patients presenting with brainstem tumors or tumors adjacent to the brainstem. A total of 162 consecutive patients with a brainstem tumor or adjacent brainstem tumor undergoing elective craniotomy were included and monitored. Potential risk factors were identified by data collection and monitoring of the PPCs, as well as the performance of single factor analysis (using the χ2 test). In addition, the independent risk factors of PPCs were screened by logistic analysis. A total of 39 cases of PPC were included in the current study, with an incidence rate of 23.9%. The analysis indicated that smoking history, previous pulmonary diseases, an American Society of Anesthesiologists classification >II and partial tumor resection were risk factors of PPC following an elective craniotomy. Smoking history and partial tumor resection were identified to be independent risk factors of PPCs.

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Section: Methodsmentioning

confidence: 99%

Risk factors of postoperative pulmonary complications following elective craniotomy for patients with tumors of the brainstem or adjacent to the brainstem

Chu

Dang

2014

Oncology Letters

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“…This may result in decreased oxygenation of blood. [1][2][3] A major cause of this derangement appears to be atelectasis, 4 which cannot be seen on conventional chest x-ray, 5 but was demonstrated by computed tomography (CT) of the chest. [6][7][8] Atelectasis in turn causes pulmonary shunt.…”

mentioning

confidence: 99%

Dynamics of re-expansion of atelectasis during general anaesthesia

Rothen

Neumann

Berglund

et al. 1999

British Journal of Anaesthesia

197

110

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A major cause of impaired gas exchange during general anaesthesia is atelectasis, causing pulmonary shunt. A 'vital capacity' (VC) manoeuvre (i.e. inflation of the lungs up to 40 cm H 2 O, maintained for 15 s) may re-expand atelectasis and improve oxygenation. However, such a manoeuvre may cause adverse cardiovascular effects. Reducing the time of maximal inflation may improve the margin of safety. The aim of this study was to analyse the change over time in the amount of atelectasis during a VC manoeuvre in 12 anaesthetized adults with healthy lungs. I.v. anaesthesia with controlled mechanical ventilation (VT 9 (SD 1) ml kg -1 ) was used. For the VC manoeuvre, the lungs were inflated up to an airway pressure (Paw) of 40 cm H 2 O. This pressure was maintained for 26 s. Atelectasis was assessed by analysis of computed x-ray tomography. The amount of atelectasis, measured at the base of the lungs, was 4.0 (SD 2.7) cm 2 after induction of anaesthesia. The decrease in the amount of atelectasis over time during the VC manoeuvre was described by a negative exponential function with a time constant of 2.6 s. At an inspired oxygen concentration of 40%, Pa O 2 increased from 17.2 (4.0) kPa before to 22.2 (6.0) kPa (Pϭ0.013) after the VC manoeuvre. Thus in anaesthetized adults undergoing mechanical ventilation with healthy lungs, inflation of the lungs to a Paw of 40 cm H 2 O, maintained for 7-8 s only, may re-expand all previously collapsed lung tissue, as detected by lung computed tomography, and improve oxygenation. We conclude that the previously proposed time for a VC manoeuvre may be halved in such subjects. 1999; 82: 551-6 Br J Anaesth

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“…Decreases in the FRC have been associated with arterial hypoxemia. A normal chest X ray under these circumstances has led to the 'suggestion that right-to-left shunting is taking place through areas of microatelectasis (2). The same association of hypoxemia and reduction in the FRC has been described in patients who develop stiff lungs following trauma or sepsis (3 (5,6).…”

Section: Abstract a New Triple Tracer Indicator Dilutionmentioning

confidence: 91%

Indicator Dilution Measurements of Lung Volumes and Alveolar Air Exchange During Breathing

Hechtman¹,

Reid²,

Dorn³

et al. 1973

J. Clin. Invest.

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A B S T R A C T A new triple tracer indicatorIn control studies, VAxC was similar to VACo2, obtained with the steady-state CO2 method (r = 0.87), while in critically ill patients the xenon measurement was significantly lower, averaging 54% of VAco2. In theory, underestimates in VAxC and decrease in the ratio VAX,/VAco2 relate to nonuniformity in regional ventilation and perfusion. The effect is greatest for the slightly soluble gas, xenon. The significant inverse correlation between .VAxe/ViAco2 and the physiologic shunt is consistent with this postulate.FRCxe was similar to the predicted FRC in animals but was 76% of the helium measured FRC in patients. FRCxe was significantly lower than the xenon measured air volumes during breath-holding when nonuniformity of ventilation was not operative. Lung tissue volumes in animals were 83%7o of gravimetric lung weights, while in patients the volumes were much lower than predicted. Nonhomogeneous lung function, including failure to perfuse the entire capillary bed, with resultant

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Radiologically Undetectable Pulmonary Collapse in the Supine Position

Cited by 37 publications

References 10 publications

Risk factors of postoperative pulmonary complications following elective craniotomy for patients with tumors of the brainstem or adjacent to the brainstem

Risk factors of postoperative pulmonary complications following elective craniotomy for patients with tumors of the brainstem or adjacent to the brainstem

Dynamics of re-expansion of atelectasis during general anaesthesia

Indicator Dilution Measurements of Lung Volumes and Alveolar Air Exchange During Breathing

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