Pediatric anesthesia & critical care
Pressure support ventilation improves ventilation during inhalational induction of anesthesia in children: A pilot study
Authors' conclusion
The ventilator settings used during inhalational induction of anesthesia in children have an impact on lung ventilation. PSV during inhalational induction of anesthesia in children may restore the end-expiratory lung volume independently from the increase in TV.
Study context
- Population
- Children (ASA 1 or 2) undergoing planned or unplanned surgery with inhalational induction of anaesthesia, after onset of Guedel's stage 3; University Children's Hospital of Lyon, France20 analyzed
- Participants
- 22 children
- Exposure
- Positive end-expiratory pressure (PEEP) 4 cmH2O alone vs pressure support ventilation (PSV) 4 to 7 cmH2O above PEEP 4 cmH2O vs SB-Mask during inhalational induction
- Outcome
- Lung volume and ventilation distribution (Electrical Impedance Tomography (EIT))
Methodological detailssingle-centre, systematic sequence of ventilator settings (60 s each), electrical impedance tomography
- Single-centre
- Systematic sequence of ventilator settings (60 s each)
- Electrical impedance tomography
Main finding
As reported in the abstract
- Increase in end-expiratory lung impedance (EELI) with PSV (arbitrary units), median [IQR]
- +0.60 [0.48-0.91]
- Increase in EELI with PEEP 4 cmH2O alone (arbitrary units), median [IQR]; vs PSV p = 0.005
- +0.39 [0.20-0.06]
- Increase in EELI with increased level of PSV (arbitrary units), median [IQR]; did not change
- +0.66 [0.40-1.22]
- Dorsal fraction of ventilation, SB-mask, median [IQR]
- 56 % [45-63]
- Dorsal fraction of ventilation, PSV 4cmH2O, median [IQR]; vs SB-mask p = 0.002
- 53 % [43-56]
- Dorsal fraction of ventilation, PSV 7cmH2O, median [IQR]; vs SB-mask p = 0.001
- 47 % [40-55]
Observational data: associations, not effects.
Original publication
Pressure support ventilation improves ventilation during inhalational induction of anesthesia in children: A pilot study. J Clin Anesth. Published 17 December 2024. doi:10.
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