British Journal of Anaesthesia, Vol 80, Issue 5 682-684, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
L. Magnusson, S. Wicky, H. Tyden and G. Hedenstierna
Respiratory failure following cardiopulmonary bypass (CPB) is a major
complication after cardiac surgery. A vital capacity inflation of the
lungs, performed before the end of CPB, may improve gas exchange, but the
necessity to repeat it is unclear. Therefore, we studied 18 pigs undergoing
hypothermic CPB. A vital capacity manoeuvre (VCM) was performed in two
groups and consisted of inflating the lungs for 15 s to 40 cm H2O at the
end of CPB. In one group, VCM was repeated every hour. The third group
served as controls. Atelectasis was studied by CT scan. Intrapulmonary
shunt increased after bypass in the controls and improved spontaneously 3 h
later without returning to baseline values. From 3 to 6 h after CPB, there
was no more improvement and more than 10% atelectasis remained at 6 h. In
contrast, the two groups treated before termination of CPB with VCM showed
only minor atelectasis and no abnormal changes in gas exchange directly
after bypass or later. We conclude that the protective effect of VCM
remained for 6 h after bypass, and there was no extra benefit on gas
exchange by repeating the VCM.
SHORT COMMUNICATIONS
Repeated vital capacity manoeuvres after cardiopulmonary bypass: effects on lung function in a pig model
Department of Cardiothoracic Anaesthesia, Uppsala University Hospital, Uppsala, Sweden and Department of Anaesthesiology, University Hospital, Lausanne, Switzerland; Department of Radiology, Uppsala University Hospital, Uppsala, Sweden; Department of Clinical Physiology, Uppsala University Hospital, Uppsala, Sweden
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