Echanges gazeux per- et postopératoires: hyperventilation isocapnique versus normoventilation [Per- and post-operative gas exchange: isocapnic hyperventilation versus normoventilation]

Détails

ID Serval
serval:BIB_8487E030887C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Echanges gazeux per- et postopératoires: hyperventilation isocapnique versus normoventilation [Per- and post-operative gas exchange: isocapnic hyperventilation versus normoventilation]
Périodique
Annales Françaises d'Anesthésie et de Réanimation
Auteur(s)
Bayer-Berger M.M., Ravussin P.
ISSN
0750-7658
Statut éditorial
Publié
Date de publication
1987
Peer-reviewed
Oui
Volume
6
Numéro
6
Pages
486-492
Langue
français
Notes
Publication types: Clinical Trial ; English Abstract ; Journal Article ; Randomized Controlled Trial
Résumé
The effects of isocapnic hyperventilation (A) and normoventilation (B) on PaCO2, PaO2 and A-aDO2 were compared in 102 patients undergoing elective surgery, randomized into two comparable groups A and B. Cases for thoracic, high abdominal and intracranial surgery were excluded, as well as patients with clinically evident pulmonary pathology. A volumetric ventilator was used in association with three different breathing systems (A: Bain system and circle system without CO2 absorption; B: circle system with CO2 absorption). The groups were comparable, except for percentage of overweight: 75% in group A and 56% in group B. Overweight was defined as weight above the mean ideal weight of 100%, and obesity as a weight above 120% the mean ideal weight. Blood gases were sampled 1) preoperatively, 2) 15 min and 3) 60 min after the beginning of mechanical ventilation, 4) postoperatively, 90 min after extubation, without supplemental oxygen. The preoperative mean PaO2 values were 79 +/- 11.4 mmHg (A) and 82.5 +/- 13.2 mmHg (B); the PaCO2 were 37.2 +/- 3.7 mmHg (A) and 37.2 +/- 3.8 mmHg (B). During surgery, PaO2 was distinctly higher (p less than 0.01) in group A than in group B (on average 15-20 mmHg higher), indicating the favourable effect of great tidal volumes on gas exchange. Correspondingly, the A-aDO2 was less increased in group A than in group B (p less than 0.01). At 15 min, 33% of the patients were hypocapnic (PaCO2 less than 35 mmHg): one case in group A and three in group B could be classed as severe hypocapnia (PaCO2 = 25-30 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)
Mots-clé
Anoxia/physiopathology, Blood Gas Analysis, Carbon Dioxide/blood, Double-Blind Method, Female, Humans, Hyperventilation/physiopathology, Intraoperative Period, Male, Oxygen/blood, Postoperative Period, Pulmonary Gas Exchange, Respiration, Artificial/methods, Tidal Volume
Pubmed
Création de la notice
21/01/2008 18:30
Dernière modification de la notice
03/03/2018 18:55
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