The ventilation parameters during the Nuss procedure for repair of pectus excavatum

The ventilation parameters during the Nuss procedure for repair of pectus excavatum depend on surgical procedures and airway protection technique. The aim of the study: analyzing the ventilation parameters during the Nuss procedure for repair of pectus excavatum according to the airway protectio...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	I.I. Myhal, U.A. Fesenko, A.O. Dvorakevich, A.A. Albokrinov
Formato:	article
Lenguaje:	EN UK
Publicado:	Danylo Halytsky Lviv National Medical University 2020
Materias:	tracheal intubation, ventilation, pectus excavatum, nuss procedure Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/161fc61221344ddc8c230d27dafb718c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:161fc61221344ddc8c230d27dafb718c
record_format	dspace
spelling	oai:doaj.org-article:161fc61221344ddc8c230d27dafb718c2021-11-10T19:49:51ZThe ventilation parameters during the Nuss procedure for repair of pectus excavatum1029-42442415-330310.25040/aml2020.02-03.028https://doaj.org/article/161fc61221344ddc8c230d27dafb718c2020-09-01T00:00:00Zhttps://amljournal.com/index.php/journal/article/view/22https://doaj.org/toc/1029-4244https://doaj.org/toc/2415-3303The ventilation parameters during the Nuss procedure for repair of pectus excavatum depend on surgical procedures and airway protection technique. The aim of the study: analyzing the ventilation parameters during the Nuss procedure for repair of pectus excavatum according to the airway protection technique. Material and Methods. The observational prospective study included 60 adolescents (boys/girls=47/13) who had undergone the Nuss procedure for repair of pectus excavatum under a combination of general anesthesia with different types of regional blocks. The patients were randomized into two groups (n=20 in each) according to the airway protection technique: Group S (n=32) where the patients were intubated with a standard single-lumen tube, and capnothorax with 4-6 mmHg intrapleural pressure was applied; Group D (n=28) where the patients were intubated with a double-lumen tube, and open pneumothorax was applied without additional pressure in the thoracic cavity. All patients were ventilated using PCV with changing of the parameters in relevance with EtCO2. The following parameters were analyzed: peripheral blood saturation (SpO2), inspiratory fractional oxygen concentration (FiO2), end-tidal carbon dioxide partial pressure (EtCO2), tidal volume (Tv), peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), the number of repeated intubation attempts, and the quality of operation field visualization checked by surgeon with a 5-point scale. Results and Discussion. During capno/pneumothorax and bar rotation, in both groups SpO2 decreased up to 95%, which required increasing FiO2 up to 70% in Group D, and up to 63% in Group S (р=0.04). Applying capno/pneumothorax lead to reduced Tv, which was 52 ml less in Group D than in Group S (р=0.0001). The levels of EtCO2, PIP, and PEEP were comparable in both groups at all stages of the surgery. The number of repeated intubation attempts was- 1 case (3,1%) in group S, and 2 cases (7,1%) in group D: c2 = 0,51; p=0.48, the adjusted c22 = 3.84 for p <0.05. The quality of operation field visualization evaluated by the surgeons with the 5-point scale was better in Group D (4.5 points), than in Group S - 3 points (р<0.000001) at all stages. Conclusions. The one-lung ventilation using double-lumen left-side tube provides better operating field visualization than ventilation throw single-lumen tube with capnothorax. Both techniques supply adequate ventilation and oxygenation parameters.I.I. MyhalU.A. FesenkoA.O. DvorakevichA.A. AlbokrinovDanylo Halytsky Lviv National Medical Universityarticletracheal intubation, ventilation, pectus excavatum, nuss procedureMedicine (General)R5-920ENUKActa Medica Leopoliensia, Vol 26, Iss 2-3, Pp 28-37 (2020)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	tracheal intubation, ventilation, pectus excavatum, nuss procedure Medicine (General) R5-920
spellingShingle	tracheal intubation, ventilation, pectus excavatum, nuss procedure Medicine (General) R5-920 I.I. Myhal U.A. Fesenko A.O. Dvorakevich A.A. Albokrinov The ventilation parameters during the Nuss procedure for repair of pectus excavatum
description	The ventilation parameters during the Nuss procedure for repair of pectus excavatum depend on surgical procedures and airway protection technique. The aim of the study: analyzing the ventilation parameters during the Nuss procedure for repair of pectus excavatum according to the airway protection technique. Material and Methods. The observational prospective study included 60 adolescents (boys/girls=47/13) who had undergone the Nuss procedure for repair of pectus excavatum under a combination of general anesthesia with different types of regional blocks. The patients were randomized into two groups (n=20 in each) according to the airway protection technique: Group S (n=32) where the patients were intubated with a standard single-lumen tube, and capnothorax with 4-6 mmHg intrapleural pressure was applied; Group D (n=28) where the patients were intubated with a double-lumen tube, and open pneumothorax was applied without additional pressure in the thoracic cavity. All patients were ventilated using PCV with changing of the parameters in relevance with EtCO2. The following parameters were analyzed: peripheral blood saturation (SpO2), inspiratory fractional oxygen concentration (FiO2), end-tidal carbon dioxide partial pressure (EtCO2), tidal volume (Tv), peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), the number of repeated intubation attempts, and the quality of operation field visualization checked by surgeon with a 5-point scale. Results and Discussion. During capno/pneumothorax and bar rotation, in both groups SpO2 decreased up to 95%, which required increasing FiO2 up to 70% in Group D, and up to 63% in Group S (р=0.04). Applying capno/pneumothorax lead to reduced Tv, which was 52 ml less in Group D than in Group S (р=0.0001). The levels of EtCO2, PIP, and PEEP were comparable in both groups at all stages of the surgery. The number of repeated intubation attempts was- 1 case (3,1%) in group S, and 2 cases (7,1%) in group D: c2 = 0,51; p=0.48, the adjusted c22 = 3.84 for p <0.05. The quality of operation field visualization evaluated by the surgeons with the 5-point scale was better in Group D (4.5 points), than in Group S - 3 points (р<0.000001) at all stages. Conclusions. The one-lung ventilation using double-lumen left-side tube provides better operating field visualization than ventilation throw single-lumen tube with capnothorax. Both techniques supply adequate ventilation and oxygenation parameters.
format	article
author	I.I. Myhal U.A. Fesenko A.O. Dvorakevich A.A. Albokrinov
author_facet	I.I. Myhal U.A. Fesenko A.O. Dvorakevich A.A. Albokrinov
author_sort	I.I. Myhal
title	The ventilation parameters during the Nuss procedure for repair of pectus excavatum
title_short	The ventilation parameters during the Nuss procedure for repair of pectus excavatum
title_full	The ventilation parameters during the Nuss procedure for repair of pectus excavatum
title_fullStr	The ventilation parameters during the Nuss procedure for repair of pectus excavatum
title_full_unstemmed	The ventilation parameters during the Nuss procedure for repair of pectus excavatum
title_sort	ventilation parameters during the nuss procedure for repair of pectus excavatum
publisher	Danylo Halytsky Lviv National Medical University
publishDate	2020
url	https://doaj.org/article/161fc61221344ddc8c230d27dafb718c
work_keys_str_mv	AT iimyhal theventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT uafesenko theventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT aodvorakevich theventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT aaalbokrinov theventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT iimyhal ventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT uafesenko ventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT aodvorakevich ventilationparametersduringthenussprocedureforrepairofpectusexcavatum AT aaalbokrinov ventilationparametersduringthenussprocedureforrepairofpectusexcavatum
_version_	1718439752554774528

The ventilation parameters during the Nuss procedure for repair of pectus excavatum

Ejemplares similares