Cardiothoracic & vascular anesthesia
Effects of Intraoperative Ventilation Strategies on Ventilation Inhomogeneity and Inflammatory Response in Pediatric Cardiac Surgery—A Randomized Pilot Study
Authors' conclusion
In this pilot study, ventilation strategies did not differ in their effect on ventilation distribution, respiratory mechanics, or inflammatory markers when recruitment maneuvers were uniformly applied after CPB.
Study context
- Population
- Children undergoing cardiac surgery with cardiopulmonary bypass (CPB) and aortic cross-clamping
- Comparison
- Lung-protective ventilation (LPV) vs apnea vs continuous positive airway pressure (CPAP) during aortic cross-clamping under CPB
- Primary endpoint
- Postoperative respiratory mechanics and ventilation inhomogeneity
Methodological detailsprospective, pilot, Recruitment maneuvers applied at end of CPB in all groups, Linear mixed-effects models
- Prospective
- Pilot
- Recruitment maneuvers applied at end of CPB in all groups
- Linear mixed-effects models
Primary result
As reported in the abstract
Driving pressure increased preoperatively to postoperatively (mean (SD), mbar)
11.8 (2.6) to 12.9 (2.6)
Dynamic compliance decreased preoperatively to postoperatively (Pa L-1)
9.9 (7.3) to 8.5 (7.4)
Ventilated pixels: spontaneous breathing to mechanical ventilation, then postoperatively
408.2 (77.2) to 495.1 (44.9); 433.9 (72.6)
Center of Ventilation shifted ventrally during mechanical ventilation, normalized afterward
0.491 (0.039) to 0.442 (0.027); 0.485 (0.037)
Further findings
Pulmonary and systemic inflammatory markers
- No statistically significant changes between groups
Feasibility of LPV
- LPV during aortic cross-clamping was feasible
Original publication
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