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Pressure-controlled...
Pressure-controlled versus manual facemask ventilation for anaesthetic induction in adults : A randomised controlled non-inferiority trial
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- Edmark, Lennart, 1954- (författare)
- Uppsala universitet,Centrum för klinisk forskning, Västerås,Vastmanland Hosp Koping, Dept Anaesthes & Intens Care, Koping, Sweden.
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- Englund, Emma-Karin (författare)
- Vastmanland Hosp Koping, Dept Anaesthes & Intens Care, Koping, Sweden.
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- Jonsson, Alexandra Schottle (författare)
- Vastmanland Hosp Koping, Dept Anaesthes & Intens Care, Koping, Sweden.
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- Zilic, Almira Teskeredzic (författare)
- Vastmanland Hosp Koping, Dept Anaesthes & Intens Care, Koping, Sweden.
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- Cajander, Per (författare)
- Örebro Univ, Örebro Univ Hosp, Sch Med Sci, Dept Anaesthes & Intens Care, Örebro, Sweden.
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- Östberg, Erland, 1971- (författare)
- Uppsala universitet,Centrum för klinisk forskning, Västerås,Vastmanland Hosp Koping, Dept Anaesthes & Intens Care, Koping, Sweden.;Reg Vastmanland Uppsala Univ, Vastmanland Hosp Västerås, Ctr Clin Res, Västerås, Sweden.
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(creator_code:org_t)
- John Wiley & Sons, 2023
- 2023
- Engelska.
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 67:10, s. 1356-1362
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Pressure-controlled face mask ventilation (PC-FMV) with positive end-expiratory pressure (PEEP) after apnoea following induction of general anaesthesia prolongs safe apnoea time and reduces atelectasis formation. However, depending on the set inspiratory pressure, a delayed confirmation of a patent airway might occur. We hypothesised that by lowering the peak inspiratory pressure (PIP) when using PC-FMV with PEEP, confirmation of a patent airway would not be delayed as studied by the first return of CO2, compared with manual face mask ventilation (Manual FMV).Methods: This was a single-centre, randomised controlled non-inferiority trial. Seventy adult patients scheduled for elective day-case surgery under general anaesthesia with body mass index between 18.5 and 29.9 kg m(-2), American Society of Anesthesiologists (ASA) classes I-III, and without anticipated difficult FMV, were included. Before the start of pre-oxygenation and induction of general anaesthesia, participants were randomly allocated to receive ventilation with either PC-FMV with PEEP, at a PIP of 11 and a PEEP of 6 cmH(2)O or Manual FMV, with the adjustable pressure-limiting valve set at 11 cmH(2)O. The primary outcome variable was the number of ventilatory attempts needed until confirmation of a patent airway, defined as the return of at least 1.3 kPa CO2.Results: The return of >= 1.3 kPa CO2 on the capnography curve was observed after mean +/- SD, 3.6 +/- 4.2 and 2.5 +/- 1.9 ventilatory attempts/breaths with PC-FMV with PEEP and Manual FMV, respectively. The difference in means (1.1 ventilatory attempts/breaths) had a 99% CI of similar to 1.0 to 3.1, within the accepted upper margin of four breaths for non-inferiority.Conclusion: Following induction of general anaesthesia, PC-FMV with PEEP was used without delaying a patent airway as confirmed with capnography, if moderate pressures were used.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Nyckelord
- capnography
- CPAP
- PEEP
- pre-oxygenation
- pressure-controlled vs. manual facemask ventilation
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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