Minerva anestesiologica
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Minerva anestesiologica · Jun 2013
Improved ventilation-perfusion matching by abdominal insufflation (pneumoperitoneum) with CO2 but not with air.
Pneumoperitoneum (PP) by CO2-insufflation causes atelectasis however with maintained or even improved oxygenation. We studied the effect of abdominal insufflation by carbon dioxide (CO2) and air on gas exchange during PP. ⋯ CO2-PP enhanced the shift of blood flow towards better ventilated areas of the lung compared to Air-PP and SNP blunted the effects seen with CO2-PP. SNP may thus have blunted and CO2 potentiated vasoconstriction, by hypoxic pulmonary vasoconstriction or another mechanism.
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Minerva anestesiologica · Jun 2013
The immune response to one-lung-ventilation is not affected by repeated alveolar recruitment manoeuvres in pigs.
Background: Acute lung injury after thoracic surgery relates to alveolar inflammation induced by one-lung ventilation (OLV) and surgical manipulation. However, alveolar recruitment manoeuvres (ARM), conventional ventilation, and airway manipulation may increase alveolar trauma. This study evaluates pulmonary immune effects of these co-factors in a porcine model. ⋯ Expression of interleukin-8-mRNA increased after OLV, but mRNA expression was not modulated by anesthetics. Conclusion: ARM, standard TLV and repetitive BAL do not additionally contribute to lung injury resulting from OLV for thoracic surgery in healthy porcine lungs. OLV induces expression of interleukin-8-mRNA in alveolar cells, which is not modulated by different anesthetic drugs.