Background: Abdominoplasty is a commonly requested procedure for aesthetic improvement of the affected soft tissue layers of skin, fat, and muscle through the slightest incision feasible. The degree of plicature gener...Background: Abdominoplasty is a commonly requested procedure for aesthetic improvement of the affected soft tissue layers of skin, fat, and muscle through the slightest incision feasible. The degree of plicature generates an increase in intraabdominal pressure that causes an increase in intrathoracic pressure. Pressure, volume, flow, and respiratory rate are components of a unique physical variable, the mechanical power (MP), and is an integrated variable linked to most factors related to postoperative pulmonary complications. Purpose: To assess the effect of rectus plication (RP) during abdominoplasty on lung pressures and the contribution to increasing the MP. Method: A open-label study was conducted at TJ Plast Advanced Center for Plastic Surgery in Tijuana, México, from September 2021 to May 2022. The study included forty-six female patients subjected to abdominoplasty or liposuction with abdominoplasty. After the induction of general anesthesia and neuromuscular blockade, they were allocated into two groups: Group 1 pressure control ventilation-volume guaranteed (PCV-VG) and Group 2 volume control ventilation (VCV). Respiratory pressures and MP were assessed before and after RP. Results: During VCV, patients had a greater increase in peak pressure (PIP) (P 0.000). Plateau pressure (P<sub>plat</sub>) increased 1.78 ± 0.35 cmH<sub>2</sub>O in group 2 after RP (P = 0.001). MP had a greater increase in group 2 after RP (P 0.01). Conclusion: This prospective study showed that RP is related to an increase in PIP and P<sub>plat</sub> and an increase in the MP better controlled with PCV-VG ventilation.展开更多
术中机械通气不当会导致气道压力升高,增加肺损伤的发生率,促使术后肺部并发症的发生,以胸科手术患者最为明显。降低肺部并发症的方法较多,压力控制容量保证通气模式(Pressure Control Ventilation-Volume Guaranteed,PCV-VG)以最低压...术中机械通气不当会导致气道压力升高,增加肺损伤的发生率,促使术后肺部并发症的发生,以胸科手术患者最为明显。降低肺部并发症的方法较多,压力控制容量保证通气模式(Pressure Control Ventilation-Volume Guaranteed,PCV-VG)以最低压力输送目标潮气量,适合于肺部并发症的高危人群,小潮气量通气策略有助于降低气道压力,但临床试验关于PCV-VG和小潮气量通气策略能否改善预后存在一定差异。本文将对压力控制容量保证联合小潮气量通气在外科手术中的应用作探讨。展开更多
文摘Background: Abdominoplasty is a commonly requested procedure for aesthetic improvement of the affected soft tissue layers of skin, fat, and muscle through the slightest incision feasible. The degree of plicature generates an increase in intraabdominal pressure that causes an increase in intrathoracic pressure. Pressure, volume, flow, and respiratory rate are components of a unique physical variable, the mechanical power (MP), and is an integrated variable linked to most factors related to postoperative pulmonary complications. Purpose: To assess the effect of rectus plication (RP) during abdominoplasty on lung pressures and the contribution to increasing the MP. Method: A open-label study was conducted at TJ Plast Advanced Center for Plastic Surgery in Tijuana, México, from September 2021 to May 2022. The study included forty-six female patients subjected to abdominoplasty or liposuction with abdominoplasty. After the induction of general anesthesia and neuromuscular blockade, they were allocated into two groups: Group 1 pressure control ventilation-volume guaranteed (PCV-VG) and Group 2 volume control ventilation (VCV). Respiratory pressures and MP were assessed before and after RP. Results: During VCV, patients had a greater increase in peak pressure (PIP) (P 0.000). Plateau pressure (P<sub>plat</sub>) increased 1.78 ± 0.35 cmH<sub>2</sub>O in group 2 after RP (P = 0.001). MP had a greater increase in group 2 after RP (P 0.01). Conclusion: This prospective study showed that RP is related to an increase in PIP and P<sub>plat</sub> and an increase in the MP better controlled with PCV-VG ventilation.
文摘术中机械通气不当会导致气道压力升高,增加肺损伤的发生率,促使术后肺部并发症的发生,以胸科手术患者最为明显。降低肺部并发症的方法较多,压力控制容量保证通气模式(Pressure Control Ventilation-Volume Guaranteed,PCV-VG)以最低压力输送目标潮气量,适合于肺部并发症的高危人群,小潮气量通气策略有助于降低气道压力,但临床试验关于PCV-VG和小潮气量通气策略能否改善预后存在一定差异。本文将对压力控制容量保证联合小潮气量通气在外科手术中的应用作探讨。
