The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients
- Autores
- Bohm, Stephan H.; Maisch, Stefan; Von Sandersleben, Alexandra; Thamm, Oliver; Martinez Arca, Jorge; Tusman, Gerardo
- Año de publicación
- 2008
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- In this study, we analyzed the effect of the alveolar recruitment strategy (ARS) and positive end-expiratory pressure (PEEP) titration on Phase III slope (S III) of volumetric capnography (VC) in morbidly obese patients. METHODS: Eleven anesthetized morbidly obese patients were studied. Lungs were ventilated with tidal volumes of 10 mL · kg−1, respiratory rates of 12–14 bpm, inspiration:expiration ratio of 1:2, and Fio2 of 0.4. ARS was performed by increasing PEEP in steps of five from 0 end-expiratory pressure to 15 cm H2O. During lung recruitment, plateau pressure was limited to 50 cm H2O, whereas tidal volume was increased to the ventilator’s maximum value of 1400 mL, and PEEP was increased to 20 cm H2O for 2 min. Thereafter, PEEP was reduced in steps of 5 cm H2O, from 15 to 0. VC, arterial blood gases, and lung mechanics data were determined for each PEEP step. RESULTS: S III decreased from 0.014 ± 0.006 to 0.005 ± 0.005 mm Hg/mL when 0 end-expiratory pressure was compared against 15 cm H2O of PEEP after ARS (15ARS, P < 0.05). This decrement in S III was accompanied by increases in Pao2 (27%, P < 0.002) and compliance (32%, P < 0.001), whereas Paco2 decreased by 8% (P < 0.038) when comparing values before and after ARS. A good prediction of the lung recruitment effect by S III was derived from the receiver operating characteristic curve analysis (area under the curve of 0.81, sensitivity of 0.75, and specificity of 0.74; P < 0.001). CONCLUSION: The S III in VC was useful to detect the optimal level of PEEP after lung recruitment in anesthetized morbidly obese patients.
Fil: Bohm, Stephan H.. University Hospital; Alemania
Fil: Maisch, Stefan. University Hospital; Alemania
Fil: Von Sandersleben, Alexandra. University Hospital; Alemania
Fil: Thamm, Oliver. University of Witten/Herdecke; Alemania
Fil: Martinez Arca, Jorge. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; Argentina
Fil: Tusman, Gerardo. Fundación Medica de Mar del Plata. Hospital Privado de Comunidad; Argentina - Materia
-
Volumetric Capnography
Phase Iii Slope
Lung Recruitment
Optimun Peep - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/34951
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oai:ri.conicet.gov.ar:11336/34951 |
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The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patientsBohm, Stephan H.Maisch, StefanVon Sandersleben, AlexandraThamm, OliverMartinez Arca, JorgeTusman, GerardoVolumetric CapnographyPhase Iii SlopeLung RecruitmentOptimun Peephttps://purl.org/becyt/ford/2.6https://purl.org/becyt/ford/2In this study, we analyzed the effect of the alveolar recruitment strategy (ARS) and positive end-expiratory pressure (PEEP) titration on Phase III slope (S III) of volumetric capnography (VC) in morbidly obese patients. METHODS: Eleven anesthetized morbidly obese patients were studied. Lungs were ventilated with tidal volumes of 10 mL · kg−1, respiratory rates of 12–14 bpm, inspiration:expiration ratio of 1:2, and Fio2 of 0.4. ARS was performed by increasing PEEP in steps of five from 0 end-expiratory pressure to 15 cm H2O. During lung recruitment, plateau pressure was limited to 50 cm H2O, whereas tidal volume was increased to the ventilator’s maximum value of 1400 mL, and PEEP was increased to 20 cm H2O for 2 min. Thereafter, PEEP was reduced in steps of 5 cm H2O, from 15 to 0. VC, arterial blood gases, and lung mechanics data were determined for each PEEP step. RESULTS: S III decreased from 0.014 ± 0.006 to 0.005 ± 0.005 mm Hg/mL when 0 end-expiratory pressure was compared against 15 cm H2O of PEEP after ARS (15ARS, P < 0.05). This decrement in S III was accompanied by increases in Pao2 (27%, P < 0.002) and compliance (32%, P < 0.001), whereas Paco2 decreased by 8% (P < 0.038) when comparing values before and after ARS. A good prediction of the lung recruitment effect by S III was derived from the receiver operating characteristic curve analysis (area under the curve of 0.81, sensitivity of 0.75, and specificity of 0.74; P < 0.001). CONCLUSION: The S III in VC was useful to detect the optimal level of PEEP after lung recruitment in anesthetized morbidly obese patients.Fil: Bohm, Stephan H.. University Hospital; AlemaniaFil: Maisch, Stefan. University Hospital; AlemaniaFil: Von Sandersleben, Alexandra. University Hospital; AlemaniaFil: Thamm, Oliver. University of Witten/Herdecke; AlemaniaFil: Martinez Arca, Jorge. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; ArgentinaFil: Tusman, Gerardo. Fundación Medica de Mar del Plata. Hospital Privado de Comunidad; ArgentinaLippincott Williams2008-11-13info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/34951Bohm, Stephan H.; Maisch, Stefan; Von Sandersleben, Alexandra; Thamm, Oliver; Martinez Arca, Jorge; et al.; The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients; Lippincott Williams; Anesthesia And Analgesia; 109; 1; 13-11-2008; 151-1590003-2999CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/anesthesia-analgesia/Abstract/2009/07000/The_Effects_of_Lung_Recruitment_on_the_Phase_III.26.aspxinfo:eu-repo/semantics/altIdentifier/doi/10.1213/ane.0b013e31819bcbb5info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:41:07Zoai:ri.conicet.gov.ar:11336/34951instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:41:07.401CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
title |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
spellingShingle |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients Bohm, Stephan H. Volumetric Capnography Phase Iii Slope Lung Recruitment Optimun Peep |
title_short |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
title_full |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
title_fullStr |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
title_full_unstemmed |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
title_sort |
The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients |
dc.creator.none.fl_str_mv |
Bohm, Stephan H. Maisch, Stefan Von Sandersleben, Alexandra Thamm, Oliver Martinez Arca, Jorge Tusman, Gerardo |
author |
Bohm, Stephan H. |
author_facet |
Bohm, Stephan H. Maisch, Stefan Von Sandersleben, Alexandra Thamm, Oliver Martinez Arca, Jorge Tusman, Gerardo |
author_role |
author |
author2 |
Maisch, Stefan Von Sandersleben, Alexandra Thamm, Oliver Martinez Arca, Jorge Tusman, Gerardo |
author2_role |
author author author author author |
dc.subject.none.fl_str_mv |
Volumetric Capnography Phase Iii Slope Lung Recruitment Optimun Peep |
topic |
Volumetric Capnography Phase Iii Slope Lung Recruitment Optimun Peep |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/2.6 https://purl.org/becyt/ford/2 |
dc.description.none.fl_txt_mv |
In this study, we analyzed the effect of the alveolar recruitment strategy (ARS) and positive end-expiratory pressure (PEEP) titration on Phase III slope (S III) of volumetric capnography (VC) in morbidly obese patients. METHODS: Eleven anesthetized morbidly obese patients were studied. Lungs were ventilated with tidal volumes of 10 mL · kg−1, respiratory rates of 12–14 bpm, inspiration:expiration ratio of 1:2, and Fio2 of 0.4. ARS was performed by increasing PEEP in steps of five from 0 end-expiratory pressure to 15 cm H2O. During lung recruitment, plateau pressure was limited to 50 cm H2O, whereas tidal volume was increased to the ventilator’s maximum value of 1400 mL, and PEEP was increased to 20 cm H2O for 2 min. Thereafter, PEEP was reduced in steps of 5 cm H2O, from 15 to 0. VC, arterial blood gases, and lung mechanics data were determined for each PEEP step. RESULTS: S III decreased from 0.014 ± 0.006 to 0.005 ± 0.005 mm Hg/mL when 0 end-expiratory pressure was compared against 15 cm H2O of PEEP after ARS (15ARS, P < 0.05). This decrement in S III was accompanied by increases in Pao2 (27%, P < 0.002) and compliance (32%, P < 0.001), whereas Paco2 decreased by 8% (P < 0.038) when comparing values before and after ARS. A good prediction of the lung recruitment effect by S III was derived from the receiver operating characteristic curve analysis (area under the curve of 0.81, sensitivity of 0.75, and specificity of 0.74; P < 0.001). CONCLUSION: The S III in VC was useful to detect the optimal level of PEEP after lung recruitment in anesthetized morbidly obese patients. Fil: Bohm, Stephan H.. University Hospital; Alemania Fil: Maisch, Stefan. University Hospital; Alemania Fil: Von Sandersleben, Alexandra. University Hospital; Alemania Fil: Thamm, Oliver. University of Witten/Herdecke; Alemania Fil: Martinez Arca, Jorge. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; Argentina Fil: Tusman, Gerardo. Fundación Medica de Mar del Plata. Hospital Privado de Comunidad; Argentina |
description |
In this study, we analyzed the effect of the alveolar recruitment strategy (ARS) and positive end-expiratory pressure (PEEP) titration on Phase III slope (S III) of volumetric capnography (VC) in morbidly obese patients. METHODS: Eleven anesthetized morbidly obese patients were studied. Lungs were ventilated with tidal volumes of 10 mL · kg−1, respiratory rates of 12–14 bpm, inspiration:expiration ratio of 1:2, and Fio2 of 0.4. ARS was performed by increasing PEEP in steps of five from 0 end-expiratory pressure to 15 cm H2O. During lung recruitment, plateau pressure was limited to 50 cm H2O, whereas tidal volume was increased to the ventilator’s maximum value of 1400 mL, and PEEP was increased to 20 cm H2O for 2 min. Thereafter, PEEP was reduced in steps of 5 cm H2O, from 15 to 0. VC, arterial blood gases, and lung mechanics data were determined for each PEEP step. RESULTS: S III decreased from 0.014 ± 0.006 to 0.005 ± 0.005 mm Hg/mL when 0 end-expiratory pressure was compared against 15 cm H2O of PEEP after ARS (15ARS, P < 0.05). This decrement in S III was accompanied by increases in Pao2 (27%, P < 0.002) and compliance (32%, P < 0.001), whereas Paco2 decreased by 8% (P < 0.038) when comparing values before and after ARS. A good prediction of the lung recruitment effect by S III was derived from the receiver operating characteristic curve analysis (area under the curve of 0.81, sensitivity of 0.75, and specificity of 0.74; P < 0.001). CONCLUSION: The S III in VC was useful to detect the optimal level of PEEP after lung recruitment in anesthetized morbidly obese patients. |
publishDate |
2008 |
dc.date.none.fl_str_mv |
2008-11-13 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/34951 Bohm, Stephan H.; Maisch, Stefan; Von Sandersleben, Alexandra; Thamm, Oliver; Martinez Arca, Jorge; et al.; The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients; Lippincott Williams; Anesthesia And Analgesia; 109; 1; 13-11-2008; 151-159 0003-2999 CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/34951 |
identifier_str_mv |
Bohm, Stephan H.; Maisch, Stefan; Von Sandersleben, Alexandra; Thamm, Oliver; Martinez Arca, Jorge; et al.; The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients; Lippincott Williams; Anesthesia And Analgesia; 109; 1; 13-11-2008; 151-159 0003-2999 CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/anesthesia-analgesia/Abstract/2009/07000/The_Effects_of_Lung_Recruitment_on_the_Phase_III.26.aspx info:eu-repo/semantics/altIdentifier/doi/10.1213/ane.0b013e31819bcbb5 |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Lippincott Williams |
publisher.none.fl_str_mv |
Lippincott Williams |
dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
reponame_str |
CONICET Digital (CONICET) |
collection |
CONICET Digital (CONICET) |
instname_str |
Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.name.fl_str_mv |
CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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1844614441112436736 |
score |
13.070432 |