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atelectasis of anesthesia

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https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#1
Cecilia M Acosta, Gerardo Tusman, Mauro Costantini, Camila Echevarría, Sergio Pollioto, Diego Abrego, Fernando Suarez-Sipmann, Stephan H Böhm
BACKGROUND: Doppler images of pulmonary vessels in pulmonary diseases associated with subpleural consolidations have been described. Color Doppler easily identifies such vessels within consolidations while spectral Doppler analysis allows the differentiation between pulmonary and bronchial arteries. Thus, Doppler helps in diagnosing the nature of consolidations. To our knowledge, Doppler analysis of pulmonary vessels within anesthesia-induced atelectasis has never been described before...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27877032/pulmonary-complications-after-abdominal-surgery-in-patients-with-mild-to-moderate-chronic-obstructive-pulmonary-disease
#2
Tae Hoon Kim, Jae Seung Lee, Sei Won Lee, Yeon-Mok Oh
Postoperative pulmonary complications (PPCs) are one of the most important causes of postoperative morbidity and mortality after abdominal surgery. Although chronic obstructive pulmonary disease (COPD) has been considered a risk factor for PPCs, it remains unclear whether mild-to-moderate COPD is a risk factor. This retrospective cohort study included 387 subjects who underwent abdominal surgery with general anesthesia in a tertiary referral hospital. PPCs included pneumonia, pulmonary edema, pulmonary thromboembolism, atelectasis, and acute exacerbation of COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#3
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
November 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27829093/postoperative-pulmonary-complications-early-mortality-and-hospital-stay-following-noncardiothoracic-surgery-a-multicenter-study-by-the-perioperative-research-network-investigators
#4
Ana Fernandez-Bustamante, Gyorgy Frendl, Juraj Sprung, Daryl J Kor, Bala Subramaniam, Ricardo Martinez Ruiz, Jae-Woo Lee, William G Henderson, Angela Moss, Nitin Mehdiratta, Megan M Colwell, Karsten Bartels, Kerstin Kolodzie, Jadelis Giquel, Marcos Francisco Vidal Melo
Importance: Postoperative pulmonary complications (PPCs), a leading cause of poor surgical outcomes, are heterogeneous in their pathophysiology, severity, and reporting accuracy. Objective: To prospectively study clinical and radiological PPCs and respiratory insufficiency therapies in a high-risk surgical population. Design, Setting, and Participants: We performed a multicenter prospective observational study in 7 US academic institutions...
November 9, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27669555/lung-ultrasonography-for-the-assessment-of-perioperative-atelectasis-a-pilot-feasibility-study
#5
Audrey Monastesse, Francois Girard, Nathalie Massicotte, Carl Chartrand-Lefebvre, Martin Girard
BACKGROUND: Few diagnostic tools are available to anesthesiologists when confronted with intraoperative hypoxemia. Lung ultrasonography is a safe and accurate bedside imaging modality. The aim of this study was to evaluate the feasibility of lung ultrasonography during the perioperative period and assess its ability to detect intraoperative respiratory complications and oxygenation changes resulting from perioperative atelectasis. METHODS: In this prospective observational pilot study, 30 consecutive patients scheduled for laparoscopic surgery were recruited...
September 23, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27666549/-interventional-bronchoscopy-for-the-treatment-of-pulmonary-sarcoma
#6
Hongwu Wang, Nan Zhang, Dongmei Li, Hang Zou, Jieli Zhang, Yunzhi Zhou, Xiuyun Bai
BACKGROUND: Pulmonary sarcoma is a rare malignant tumor in soft tissues. Resection is the preferred option to treat this tumor. The aim of this study is to explore the effect of interventional bronchoscopies in the treatment of pulmonary sarcoma if the patient is inoperable. METHODS: Sixteen cases with pulmonary sarcoma were retrospectively reviewed in our hospital from November 2008 to July 2014. The mean age was (53.1±5.4) years old. Rigid bronchoscopy was applied for the first procedure with general anesthesia, and electronic bronchoscopy was used for the second procedure or slight patients...
September 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/27645688/hypoxic-pulmonary-vasoconstriction-from-molecular-mechanisms-to-medicine
#7
Kimberly J Dunham-Snary, Danchen Wu, Edward A Sykes, Amar Thakrar, Leah Rg Parlow, Jeffrey D Mewburn, Joel L Parlow, Stephen L Archer
Hypoxic pulmonary vasoconstriction (HPV) is a homeostatic mechanism that is intrinsic to the pulmonary vasculature. Intrapulmonary arteries constrict in response to alveolar hypoxia, diverting blood to better-oxygenated lung segments, thereby optimizing ventilation-perfusion matching and systemic oxygen delivery. In response to alveolar hypoxia, a mitochondrial sensor dynamically changes reactive oxygen species and redox couples in PASMC. This inhibits potassium channels, depolarizes PASMC, activates voltage-gated calcium channels, and increases cytosolic calcium, causing vasoconstriction...
September 16, 2016: Chest
https://www.readbyqxmd.com/read/27642575/severe-respiratory-event-initially-thought-to-be-inadvertent-endobronchial-intubation-possible-complications-from-using-of-a-topical-metered-dose-of-8-lidocaine-pump-spray
#8
Young-Chang P Arai, Jun Kawanishi, Yoshikazu Sakakima, Koichi Ohmoto, Akihiro Ito, Yuki Maruyama, Tatsunori Ikemoto
INTRODUCTION: Pulmonary collapse after intubation is common, and it is caused by a variety of factors. CASE PRESENTATION: A 21-year-old man presented at our operation room to undergo an appendectomy. Except for a history of cigarette smoking, his history was negative. Anesthesia was induced with 100% oxygen and sevoflurane, remifentanil infusion, and propofol. Neuromuscular block was obtained with rocuronium. The tip and cuff of a tracheal tube were lubricated with a topical metered-dose of 8% Lidocaine pump spray...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27639431/performance-of-lung-ultrasound-in-detecting-peri-operative-atelectasis-after-general-anesthesia
#9
Xin Yu, Zhenping Zhai, Yongfeng Zhao, Zhiming Zhu, Jianbin Tong, Jianqin Yan, Wen Ouyang
The aim of this prospective observational study was to evaluate the performance of lung ultrasound (LUS) in detecting post-operative atelectasis in adult patients under general anesthesia. Forty-six patients without pulmonary comorbidities who were scheduled for elective neurosurgery were enrolled in the study. A total of 552 pairs of LUS clips and thoracic computed tomography (CT) images were ultimately analyzed to determine the presence of atelectasis in 12 prescribed lung regions. The accuracy of LUS in detecting peri-operative atelectasis was evaluated with thoracic CT as gold standard...
December 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27624632/respiratory-management-of-perioperative-obese-patients
#10
REVIEW
David Ae Imber, Massimiliano Pirrone, Changsheng Zhang, Daniel F Fisher, Robert M Kacmarek, Lorenzo Berra
With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27555159/hypoxia-during-general-anesthesia-unknown-foreign-body-aspiration
#11
Ozgur Senturk, Demet Unal, Onur Selvi
An 18-month-old male patient, classified as American Society of Anesthesiologists I, with bilateral inguinal hernia was scheduled for operation. Preanesthetic evaluation revealed history of completed medical treatment of acute bronchitis 10 days ago, and his respiratory examination was recorded as normal. He was successfully operated under general anesthesia with a laryngeal mask. After removal of the laryngeal mask, he displayed signs of hypoxia. Respiratory sounds were undetectable in the left thorax. He was intubated due to failure of adequate ventilation...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27319088/-what-should-we-know-about-respiratory-physiology-for-the-optimal-anesthesia-management
#12
REVIEW
Ryoichi Ochiai
Gas exchange in the lungs is dependent on the balance between ventilation and pulmonary perfusion, and such balance could be modified and affected by various factors, including gravity, body position, physical property of the lung, and neurological as well as humoral factors. Oxygenation is the process where the oxygen molecule moves from alveoli to the blood plasma, and this process is highly dependent on the diffusion capacity. Although the oxygen partial pressure in the blood plasma at alveoli rises rapidly because of its very low solubility, hemoglobin is essential to maintain adequate oxygen content in the whole blood...
May 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27160623/-sedated-non-intubated-bilateral-thoracoscopic-sympathectomy-r3-r4
#13
José Manuel Mier-Odriozola
Non-intubated thoracic surgery entails procedures performed through regional anesthesia method in awake or mildly sedated, spontaneously ventilating patients. This method represents advantages for the cardiovascular system, and reduces the orotracheal trauma, postoperative atelectasis, and pneumonia. It also possibly reduces costs. Other theoretical advantages are: easier acceptance of surgery, attenuated stress hormone and immune response, and possibly a better survival in oncological surgery. We show a 34-year-old woman with sever palmar-axillary hyperhidrosis...
March 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27069922/early-pulmonary-complications-following-total-knee-arthroplasty-under-general-anesthesia-a-prospective-cohort-study-using-ct-scan
#14
Kai Song, Zhen Rong, Xianfeng Yang, Yao Yao, Yeshuai Shen, Dongquan Shi, Zhihong Xu, Dongyang Chen, Minghao Zheng, Qing Jiang
PURPOSE: Postoperative pulmonary complications (PPCs) are common after major surgeries. However, the number of studies regarding PPCs following total knee arthroplasty (TKA) is limited. The aim of this study was to determine the incidence of early PPCs following TKA by computed tomography (CT) scan and to identify associated risk factors. METHODS: Patients, who were diagnosed with osteoarthritis or rheumatoid arthritis and underwent primary TKA at our institution, were included in this prospective cohort study...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27025125/-efficacy-and-safety-of-lung-recruitment-maneuver-in-patients-with-different-peripheral-chemoreflex-sensitivity
#15
N V Trembach, I B Zabolotskikh
BACKGROUND: The concept of open lungs, which includes a maintaining of positive end-expiratory pressure (PEEP) and lung recruitment maneuver (LRM), proven in the prevention of atelectasis occurring during anesthesia with mechanical ventilation (MV). However, it adversely affects the central hemodynamics, and can increase the incidence of perioperative complications, especially in elderly patients. The sensitivity of the peripheral chemoreflex (SPCR) is a marker of disturbed neuroreflex regulation of the cardiorespiratory system...
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27015614/reasonable-decision-of-anesthesia-methods-in-patients-who-underwent-endoscopic-submucosal-dissection-for-superficial-esophageal-carcinoma-a-retrospective-analysis-in-a-single-japanese-institution
#16
Naoko Yagi Kuwata, Takuji Gotoda, Sho Suzuki, Shuntaro Mukai, Takao Itoi, Fuminori Moriyasu
BACKGROUND/AIMS: Despite being a valuable therapeutic option, it has not yet been reported whether endoscopic submucosal dissection (ESD) for superficial esophageal carcinoma should be performed under general or non-general anesthesia (sedation). MATERIALS AND METHODS: The clinicopathological factors (age, sex, histology, tumor size, tumor location, tumor macroscopic morphology, and adverse events) of 110 superficial esophageal carcinoma lesions (98 patients) treated by ESD at a single Japanese institution from January 2007 to December 2013 were retrospectively reviewed using medical records...
March 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/27005827/-chronic-hepatothorax-due-to-right-diaphragmatic-rupture-an-anesthetic-challenge-in-a-rare-case
#17
Maria Teresa Rincón Vieira Lugarinho-Monteiro, Luciane Pereira, Carlos Seco
BACKGROUND: Diaphragmatic rupture is an uncommon condition, with 90% of ruptures occurring on the left side. However, its incidence on the right side is increasing along with the increase in traffic accidents. Liver herniation may become progressive causing severe atelectasis of the right lung, resulting in impaired respiratory status and hemodynamic changes. CASE REPORT: We report the case of a 40 years old female, ASA III, scheduled for hepatothorax repair that evolved from right diaphragmatic hernia, resulting from a car accident when she was 8 years old...
March 19, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26662053/mild-loss-of-lung-aeration-augments-stretch-in-healthy-lung-regions
#18
Maurizio Cereda, Yi Xin, Hooman Hamedani, Justin Clapp, Stephen Kadlecek, Natalie Meeder, Johnathan Zeng, Harrilla Profka, Brian P Kavanagh, Rahim R Rizi
Inspiratory stretch by mechanical ventilation worsens lung injury. However, it is not clear whether and how the ventilator damages lungs in the absence of preexisting injury. We hypothesized that subtle loss of lung aeration during general anesthesia regionally augments ventilation and distension of ventilated air spaces. In eight supine anesthetized and intubated rats, hyperpolarized gas MRI was performed after a recruitment maneuver following 1 h of volume-controlled ventilation with zero positive end-expiratory pressure (ZEEP), FiO2 0...
February 15, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/26643094/effects-of-anesthesia-on-the-respiratory-system
#19
REVIEW
Göran Hedenstierna, Lennart Edmark
Most anesthetics cause a loss of muscle tone that is accompanied by a fall in the resting lung volume. The lowered lung volume promotes cyclic (tidal) or continuous airway closure. High inspired oxygen fractions cause rapid absorption of gas behind closed airways, resulting in atelectasis. This chapter deals with these mechanisms in more detail, and it addresses possible measures to keep the lung open with the use of recruitment maneuvers, continuous and/or end-expiratory positive pressure, as well as the interaction with different oxygen concentrations...
September 2015: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/26605093/cardiac-and-pulmonary-ultrasound-for-diagnosing-trali
#20
J I Alonso-Fernández, J R Prieto-Recio, C García-Bernardo, I García-Saiz, J Rico-Feijoo, C Aldecoa
Unexpected acute respiratory failure after anesthesia is a diagnostic challenge: residual neuromuscular blockade, bronchial hyperresponsiveness, laryngospasm, atelectasis, aspiration pneumonitis, and other more uncommon causes should be taken into account at diagnosis. Lung ultrasound and echocardiography are diagnostic tools that would provide the differential diagnosis. We report a suspected case of a transfusion related acute lung injury (TRALI) following administration of platelets. The usefulness of lung and cardiac ultrasound is discussed to facilitate the challenging diagnosis of the acute early postoperative respiratory failure...
2015: Case Reports in Critical Care
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