1. Positive end-expiratory pressure increases arterial oxygenation in elderly patients undergoing urological surgery using laryngeal mask airway in lithotomy position
- Author
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Gi-Ho Koh, Eunkyul Kim, Jai-Hyun Hwang, Jihion Yu, Young-Kug Kim, Doo-Hwan Kim, and Jun-Young Park
- Subjects
Male ,Risk ,Pulmonary Atelectasis ,Hemodynamics ,Health Informatics ,Atelectasis ,Anesthesia, General ,Critical Care and Intensive Care Medicine ,Laryngeal Masks ,Patient Positioning ,Hypoxemia ,Positive-Pressure Respiration ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Laryngeal mask airway ,030202 anesthesiology ,Pressure ,Supine Position ,Humans ,Medicine ,Anesthesia ,Hypoxia ,Positive end-expiratory pressure ,Aged ,business.industry ,Incidence ,030208 emergency & critical care medicine ,Oxygenation ,Perioperative ,respiratory system ,medicine.disease ,respiratory tract diseases ,Lithotomy position ,Oxygen ,Anesthesiology and Pain Medicine ,Female ,Blood Gas Analysis ,medicine.symptom ,business ,circulatory and respiratory physiology - Abstract
Elderly patients undergoing urological surgery in the lithotomy position may be vulnerable to perioperative hypoxemia. Positive end-expiratory pressure (PEEP) can improve arterial oxygenation. Although laryngeal mask airway (LMA) is widely utilized in urological surgery, it is not known how PEEP affects arterial oxygenation in these patients. We, therefore, evaluated the effect of PEEP on arterial oxygen partial pressure (PaO2) in elderly patients using LMA during urological surgery in the lithotomy position. Patients randomly received zero end-expiratory pressure (group Z, n = 34) or PEEP of 7 cmH2O (group P, n = 33). Ventilatory, respiratory, and haemodynamic variables were measured at 5 min (T0), 30 min (T1), and 60 min (T2) after LMA Supreme™ (sLMA) insertion. The primary outcome was the difference of PaO2 at T2 between the two groups. Atelectasis score, the incidence of a significant leak, and complications associated with sLMA insertion were also evaluated. PaO2 at T2 was significantly higher in group P than in group Z (20.0 ± 4.9 vs. 14.7 ± 3.7 kPa, P
- Published
- 2019
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