Anestéziológia a intenzívna medicína 2/2016

The influence of controlled ventilation parameters during anesthesia on mechanical energy absorbed by lungs (EAL)

Goal of the study:To compare the magnitude of the mechanical energy absorbed by lungs during the controlled ventilation between the lung protective ventilation group and historical group. Material and methods:Both groups were made up by 30 patients undergoing coronary artery bypass grafting with extracorporeal circulation. Parametres of ventilation and arterial blood gases were followed in the post-bypass period of operation. In the end the EAL was calculated for both groups. Results:In the lung protective ventilation group the average EAL was 6,99 J/min, whereas in the historical group the EAL was 12,6 J/ min (p<0.001), which is a cut-off value for development of a lung injury. Gas exchange was similar in both groups with no statistically significant differences in PaO2/FiO2 nor EtCO2. We found statistically significant lower peak airway pressure and tidal volume and higher frequency of ventilation in the lung protective ventilation group (p<0.01). Conclusion:We have shown that applying lung protective ventilation strategy led to lower EAL and thus lower risk of lung injury development. This in turn led to minimal incidence of ventilator induced lung injury or other lung complications in our department.

Keywords: controlled ventilation, lung protective ventilation, energy absorbed by lungs, mechanical energy, lung injury