Effects of prone position on alveolar dead space and gas exchange during general anaesthesia in surgery of long duration

European Journal of Anaesthesiology

Volumn 24, Issue 5, 2007, Pages 431-437

  Soro, M ^a   Garcia Perez M L ^a   Belda, F J ^a   Ferrandis, R ^a   Aguilar, G ^a   Tusman, G ^b   Gramuntell, F ^c  

^a HOSPITAL CLÍNICO UNIVERSITARIO   (Spain)

^b HOSPITAL PRIVADO DE COMUNIDAD   (Argentina)

^c HOSPITAL ARNAU DE VILANOVA   (Spain)

Author keywords

Long duration; Prone position; Pulmonary gas exchange; Respiratory dead space; Surgery

Indexed keywords

CISATRACURIUM; FENTANYL; PROPOFOL; REMIFENTANIL; SUXAMETHONIUM;

ADULT; AGED; AIRWAY; ANESTHESIA INDUCTION; ARTICLE; ARTIFICIAL VENTILATION; BODY POSTURE; CAPNOGRAPHY; CLINICAL ARTICLE; CONTINUOUS INFUSION; CONTROLLED STUDY; DYNAMICS; FEMALE; GAS EXCHANGE; GENERAL ANESTHESIA; HEMODYNAMICS; HUMAN; INSPIRATORY CAPACITY; LUNG DEAD SPACE; MALE; MUSCLE RELAXATION; NORMAL HUMAN; OXYGENATION; POSITIVE END EXPIRATORY PRESSURE; PRESSURE; SPINE SURGERY; SUPINE POSITION; TIDAL VOLUME; TREATMENT DURATION;

ANESTHESIA, GENERAL; ANESTHETICS, INTRAVENOUS; ATRACURIUM; CAPNOGRAPHY; FEMALE; HUMANS; MALE; MIDDLE AGED; NEUROMUSCULAR BLOCKING AGENTS; PIPERIDINES; PRONE POSITION; PROPOFOL; PULMONARY ALVEOLI; PULMONARY GAS EXCHANGE; REFERENCE VALUES; RESPIRATION, ARTIFICIAL; RESPIRATORY DEAD SPACE; SPINE; SUPINE POSITION; SURGICAL PROCEDURES, ELECTIVE; TIDAL VOLUME; TIME; TIME FACTORS;

EID: 34247598386     PISSN: 02650215     EISSN: 13652346     Source Type: Journal    
DOI: 10.1017/S0265021506001888     Document Type: Article

References (28)

1. Lumb AB, Nunn JF. Respiratory function and rib cage contribution to ventilation in body positions commonly used during anesthesia. Anesth Analg 1991; 73: 422-426.
2. Pelosi P, Massimo C, Calappi E et al. The prone positioning during general anesthesia minimally affects respiratory mechanics while improving functional residual capacity and increasing oxygen tension. Anesth Analg 1995; 80: 955-960.
3. Pelosi P, Croci M, Calappi E et al. Prone positioning improves function in obese patients during general anesthesia. Anesth Analg 1996; 83: 578-583.
4. Nyren S, Mure M, Jacobsson H, Larsson SA, Lindahl SG. Pulmonary perfusion is more uniform in the prone than in the supine position: scintigraphy in healthy humans. J Appl Physiol 1999; 86: 1135-1141.
5. Mure M, Domino KB, Lindahl SG, Hlastala MP, Altemeier WA, Glenny RW. Regional ventilation-perfusion distribution is more uniform in the prone position. J Appl Physiol 2000; 88: 1076-1083.
6. Casati A, Salvo I, Torri G, Calderini E. Arterial to end-tidal carbon dioxide gradient and physiological dead space monitoring during general anaesthesia: effects of patients' position. Minerva Anestesiol 1997; 63: 177-182.
7. Wahba R, Tessler M, Kardash K. Carbon dioxide tensions during anesthesia in the prone position. Anesth Analg 1998; 86: 668-669.
8. Lynch S, Brand L, Levy A. Changes in lung-thorax compliance during orthopedic surgery. Anesthesiology 1959; 20: 278-282.
9. Safar P, Aguto-Escarraga L. Compliance in apneic anesthetized adults. Anesthesiology 1959; 20: 283-289.
10. Palmon S, Kirsch J, Depper J, Toung T. The effect of the prone position on pulmonary mechanics is frame-dependent. Anesth Analg 1998; 87: 1175-1180.
11. Smith RH. One solution to the problem of the prone position for surgical procedures. Anesth Analg 1974; 53: 211-224.
12. Fowler WS. Lung function studies. V. Respiratory dead space in old age and in pulmonary emphysema. J Clin Invest 1950; 29: 1439-1444.
13. 2 analysis: description and validation of a method. Crit Care Med 1996; 24: 96-102.
14. 2 rebreathing techniques for cardiac output assessment in critically ill patients during assisted ventilation. Intensive Care Med 2004; 30: 82-87.
15. Jover JL, Soro M, Belda FJ, Aguilar G, Caro P, Ferrandis R. Measurement of cardiac output after cardiac surgery: validation of a partial carbon dioxide rebreathing (NICO) system in comparison with continuous thermodilution with a pulmonary artery catheter. Rev Esp Anestesiol Reanim 2005; 52: 256-262 (Spanish).
16. Fletcher R, Jonson B. Deadspace and the singlebreath test for carbon dioxide during anaesthesia and artificial ventilation. Effects of tidal volume and frequency of respiration. Br J Anaesth 1984; 56: 109-119.
17. Taskar V, John J, Larsson A, Wetterberg T, Jonsson B. Dynamics of carbon dioxide elimination following ventilator resetting. Chest 1995; 108: 196-202.
18. LaMantia KR, O'Connor T, Barash PG. Comparing methods of measurement: An alternative approach. Anesthesiology 1990; 72: 781-783.
19. Blanch L, Lucangelo U, Lopez-Aguilar J, Fernandez R, Romero PV. Volumetric capnography in patients with acute lung injury: effects of positive end-expiratory pressure. Eur Respir J 1999; 13: 1048-1054.
20. Kallet RH, Daniel BM, Garcia O, Matthay MA. Accuracy of physiologic dead space measurements in patients with acute respiratory distress syndrome using volumetric capnography: comparison with the metabolic monitor method. Respir Care 2005; 50: 462-467.
21. Praetel C, Banner MJ, Monk T, Gabrielli A. Isoflurane inhalation enhances increased physiologic deadspace volume associated with positive pressure ventilation and compromises arterial oxygenation. Anesth Analg 2004; 99: 1107-1113.
22. Mahajan RP, Hennessy N, Aitkenhead AR, Jellinek D. Effect of three different surgical prone positions on lung volumes in healthy volunteers. Anaesthesia 1994; 49: 583-586.
23. Hedenstierna G, Rothen HU. Atelectasis formation during anesthesia: causes and measures to prevent it. J Clin Monit Comput 2000; 16: 329-335.
24. Walther SM, Domino KB, Glenny RW, Hlastala MP. Positive end-expiratory pressure redistributes perfusion to dependent lung regions in supine but not in prone lambs. Crit Care Med 1999; 27: 37-45.
25. Pelosi P, Croci M, Ravagnan I et al. The effects of body mass on lung volumes, respiratory mechanics and gas exchange during general anesthesia. Anesth Analg 1998; 87: 654-660.
26. Mure M, Lindahl SG. Prone position improves gas exchange - but how? Acta Anaesthesiol Scand 2001; 45: 150-159.
27. Radstrom M, Loswick AC, Bengtsson JP. Respiratory effects of the kneeling prone position for low back surgery. Eur J Anaesthesiol 2004; 21: 279-283.
28. Tang Y, Turner MJ, Baker AB. Effects of alveolar dead-space, shunt and V/Q distribution on respiratory dead-space measurements. Br J Anaesth 2005; 95: 538-548.