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Вестник анестезиологии и реаниматологии

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МАНЕВР РЕКРУТМЕНТА В УСЛОВИЯХ ОБЩЕЙ АНЕСТЕЗИИ ПРИ АБДОМИНАЛЬНЫХ ОПЕРАЦИЯХ

https://doi.org/10.21292/2078-5658-2016-13-6-72-80

Аннотация

В обзоре рассматривается применение рекрутмент-маневра (РМ) в условиях общей анестезии при абдоминальных операциях у пациентов с исходно не поврежденными легкими. Цель: выявление оптимальных способов выполнения РМ, определение необходимых временных характеристик РМ, а также групп пациентов, применение РМ у которых будет особенно полезно. Заключение. Применение РМ в совокупности с другими элементами протективной искусственной вентиляции легких во время общей анестезии у пациентов с высоким риском респираторных осложнений является эффективным и безопасным механизмом, позволяющим предупредить развитие респираторных осложнений. У пациентов с высоким анестезиологическим риском пошаговый способ выполнения РМ позволяет предотвратить появление неблагоприятных гемодинамических инцидентов во время выполнения РМ.

 

Об авторах

И. Б. Заболотских
Кубанский государственный медицинский университет, г. Краснодар
Россия
доктор медицинских наук, профессор, заведующий кафедрой анестезиологии, реаниматологии и трансфузиологии ФПК и ППС


Р. В. Вейлер
Кубанский государственный медицинский университет, г. Краснодар
Россия
аспирант кафедры анестезиологии, реаниматологии и трансфузиологии ФПК и ППС


Н. В. Трембач
Кубанский государственный медицинский университет, г. Краснодар
Россия
кандидат медицинских наук, ассистент кафедры анестезиологии, реаниматологии и трансфузиологии ФПК и ППС


Список литературы

1. Трембач Н. В., Заболотских И. Б. Эффективность и безопасность маневра открытия легких у больных с различной чувствительностью периферического хеморефлекса // Анестезиол. и реаниматол. − 2015. − Т. 60, № 6. − С. 8−11.

2. Almarakbi W. A., Fawzi H. M., Alhashemi J. A. Effects of four intraoperative ventilatory strategies on respiratory compliance and gas exchange during laparoscopic gastric banding in obese subjects // Br. J. Anaesth. – 2009. – Vol. 102, № 6. – P. 862−868.

3. Ball L., Pelosi P. Predictive scores for postoperative pulmonary complications: time to move towards clinical practice // Minerva Anestesiol. 2016. – Vol. 82, № 3. – P. 265−267.

4. Bartlett D. Jr. Origin and regulation of spontaneous deep breaths // Respir. Physiol. – 1971. – Vol. 12, № 2. – P. 230−238.

5. Bendixen H. H., Bullwinkel B., Hedley-Whyte J. et al. Atelectasis and shunting during spontaneous ventilation in anesthetized subjects // Anesthesiology. – 1964. – Vol. 25. – P. 297−301.

6. Biddle C., Epps L., Hassanein R. The efficacy of sighs in subjects with COPD undergoing general anesthesia and controlled ventilation // AANA J. – 1989. – Vol. 57, № 2. – P. 131−136.

7. Blevins S. S., Connolly M. J., Carlson D. E. Baroreceptor mediated compensation for hemodynamic effects of positive end-expiratory pressure // J. Appl. Physiol. – 1999. – Vol. 86. – P. 285–293.

8. Bohm S. H., Thamm O. C., von Sandersleben A. et al. Alveolar recruitment strategy and high positive end expiratory pressure levels do not affect hemodynamics in morbidly obese intravascular volume-loaded patients // Anesth. Analg. – 2009. – Vol. 109, № 1. – P. 160−163.

9. Brismar B., Hedenstierna G., Lundquist H. et al. Pulmonary densities during anesthesia with muscular relaxation – a proposal of atelectasis // Anesthesiology. – 1985. – Vol. 62, № 4. – P. 422−428.

10. Chalhoub V., Yazigi A., Sleilaty G. et al. Effect of vital capacity maneuvers on arterial oxygenation in morbidly obese patients undergoing open bariatric surgery // Eur. J. Anaesthesiol. – 2007. – Vol. 24, № 3. – P. 283−288.

11. Cui Y., Pi X., Wang C. et al. Effects of different ventilation strategies on exhaled nitric oxide in geriatric abdominal surgery // J. Breath. Res. – 2015. –Vol. 26. – P. 9.

12. D’Angelo E., Koulouris N. G., Della Valle P. et al. The fall in exhaled nitric oxide with ventilation at low lung volumes in rabbits: an index of small airway injury // Respir. Physiol. Neurobiol. – 2008. – Vol. 160. – P. 215–223.

13. Dietl P., Frick M., Mair N., et al. Pulmonary consequences of a deep breath revisited // Biol. Neonate. – 2004. – Vol. 85, № 4. – P. 299–304.

14. Dos Santos C. C., Slutsky A. S. Invited review: mechanisms of ventilator-induced lung injury: a perspective // J. Appl. Physiol. – 2000. – Vol. 89. – P. 1645–1655.

15. Duggan M., Kavanagh B. P. Pulmonary atelectasis: a pathogenic perioperative entity // Anesthesiology. – 2005. – Vol. 102. – P. 838–854.

16. Edmark L., Auner U., Hallén J. et al. A ventilation strategy during general anaesthesia to reduce postoperative atelectasis // Ups. J. Med. Sci. – 2014. – Vol. 119, № 3. – P. 242−250.

17. Ferris B. G. Jr., Pollard D. S. The effect of deep and quiet breathing on pulmonary compliance in man // J. Clin. Invest. – 1960. – Vol. 39. – P. 143−149.

18. Futier E., Constantin J. M., Jaber S. Protective lung ventilation in operating room: a systematic review // Minerva Anestesiol. – 2014. – Vol. 80. – P. 726–735.

19. Futier E., Constantin J. M., Pelosi P. et al. Intraoperative recruitment maneuver reverses detrimental pneumoperitoneum−induced respiratory effects in healthy weight and obese patients undergoing laparoscopy // Anesthesiology. – 2010. – Vol. 113, № 6. – P. 1310−1319.

20. Goncalves L. O., Cicarelli D. D. Alveolar recruitment maneuver in anesthetic practice: how, when, and why it may be useful // Rev. Bras. Anestesiol. – 2005. – Vol. 55, № 6. – P. 631−638.

21. de Graaff J. C., Sarfo M. C., van Wolfswinkel L. et al. Anesthesia-related critical incidents in the perioperative period in children; a proposal for an anesthesia-related reporting system for critical incidents in children // Paediatr. Anaesth. – 2015. – Vol. 25, № 6. – P. 621−629.

22. Hedenstierna G., Edmark L. Mechanisms of atelectasis in the perioperative period // Best. Pract. Res. Clin. Anaesthesiol. – 2010. – Vol. 24, № 2. – P. 157−169.

23. Hemmes S., Gama de Abreu M., Severgnini P. et al. High versus low positive end expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomized controlled trial // Lancet. – 2014. – Vol. 384 (9942). – P. 495−503.

24. Hemmes S. N., Severgnini P., Jaber S. et al. Rationale and study design of PROVHILO – a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery // Trials. – 2011 – Vol. 6, № 12. – P. 111−121.

25. Kavanagh B. P., Hedenstierna G. Respiratory Physiology and Pathophysiology / In: Miller R.D. ed. Miller's Anesthesia. 8th ed. // Philadelphia: Churchill Livingstone. – 2014. – P. 444−473.

26. Leithner C., Podolsky A., Globits S. et al Magnetic resonance imaging of the heart during positive end-expiratory pressure ventilation in normal subjects // Crit. Care Med. – 1994. – Vol. 22, № 3. – P. 426−432.

27. Linde-Zwirble W. L., Bloom J. D., Mecca R. S. et al. Postoperative pulmonary complications in adult elective surgery subjects in the US: severity, outcomes, and resources use // Crit. Care. – 2010. – Vol. 14 (Suppl. 1). – P. 210.

28. Lumb A. B., Walton L. J. Perioperative oxygen toxicity //Anesthesiol. Clin. – 2012. – Vol. 30, № 4. – P. 591−605.

29. Pang C. K., Yap J., Chen P. P. The effect of an alveolar recruitment strategy on oxygenation during laparoscopic cholecystectomy // Anaesth. Intens. Care. – 2003. – Vol. 31, № 2. – P. 176−180.

30. Park S. J., Kim B. G., Oh A. H. et al. Effects of intraoperative protective lung ventilation on postoperative pulmonary complications in patients with laparoscopic surgery: prospective, randomized and controlled trial // Surg. Endosc. – 2016. – Vol. 19. – P. 177−186.

31. Paulus F., Binnekade J. M., Vroom M. B. et al. Benefits and risks of manual hyperinflation in intubated and mechanically ventilated intensive care unit subjects: a systematic review // Crit. Care. – 2012. – Vol. 16, № 4. – P. 145.

32. Reinius H., Jonsson L., Gustafsson S. et al. Prevention of atelectasis in morbidly obese patients during general anesthesia and paralysis: a computerized tomography study // Anesthesiology. – 2009. – Vol. 111, № 5. – P. 979−987.

33. Reiss L. K., Kowallik A., Uhlig S. Recurrent recruitment maneuvers improve lung mechanics and minimize lung injury during mechanical ventilation of healthy mice // PLoS One. – 2011. – Vol. 6, № 9. – P. 245.

34. Remístico P. P., Araújo S., de Figueiredo L. C. et al. Impact of alveolar recruitment maneuver in the postoperative period of videolaparoscopic bariatric surgery // Rev. Bras. Anestesiol. – 2011. – Vol. 61, № 2. – P. 88−94, 163−168, 169−176.

35. Schilling T., Kretzschmar M., Hachenberg T. et al. The immune response to one-lung-ventilation is not affected by repeated alveolar recruitment maneuvers in pigs // Minerva Anestesiol. – 2013. – Vol. 79, № 6. – P. 590−603.

36. Severgnini P., Selmo G., Lanza C. et al. Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function // Anesthesiology. – 2013. – Vol. 118, № 6. – P. 1307−1321.

37. Shander A., Fleisher L. A., Barie P. S. et al. Clinical and economic burden of postoperative pulmonary complications: subject safety summit on definition, risk-reducing interventions, and preventive strategies // Crit. Care Med. – 2011. – Vol. 39, № 9. – P. 2163−2172.

38. Smetana G. W., Lawrence V. A., Cornell J. E. Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians // Ann. Intern. Med. – 2006. – Vol. 144. – P. 581–595.

39. Souza A. P., Buschpigel M., Mathias L. A. et al. Análise dos efeitos da manobra de recrutamento alveolar na oxigenação sanguínea durante procedimento bariátrico // Rev. Bras. Anestesiol. – 2009. – Vol. 59, № 2. – P. 177−186.

40. Sprung J., Whalen F. X., Comfere T. et al. Alveolar recruitment and arterial desflurane concentration during bariatric surgery // Anesth. Anal. – 2009. – Vol. 108, № 1. – P. 120−127.

41. Sutherasan Y., Vargas M., Pelosi P. Protective mechanical ventilation in the non-injured lung: review and meta-analysis // Crit. Care. – 2014. – Vol. 18, № 2. – P. 211.

42. Talab H. F., Zabani I. A., Abdelrahman H. S. et al. Intraoperative ventilatory strategies for prevention of pulmonary atelectasis in obese patients undergoing laparoscopic bariatric surgery // Anesth. Analg. – 2009. – Vol. 109, № 5. – P. 1511−1516.

43. Tusman G., Bohm S. H., Warner D. O. et al. Atelectasis and perioperative pulmonary complications in high-risk subjects // Curr. Opin. Anaesthesiol. – 2012. – Vol. 25, № 1. – P. 1−10.

44. von Ungern-Sternberg B. S., Ramgolam A., Hall G. L. et al. Peri-operative adverse respiratory events in children // Anaesthesia. – 2015. – Vol. 70, № 4. – P. 440−444.

45. Valipour A., Schneider F., Kössler W. et al. Heart rate variability and spontaneous baroreflex sequences in supine healthy volunteers subjected to nasal positive airway pressure // J. Appl Physiol. – 2005. – Vol. 99, № 6. – P. 2137−2143.

46. van Kaam A. H., Lachmann R. A., Herting E. et al. Reducing atelectasis attenuates bacterial growth and translocation in experimental pneumonia // Am. J. Respir. Crit. Care Med. – 2004. – Vol. 169, № 9. – P. 1046−1053.

47. Wan S., Siow Y. N., Lee S. M. et al. Audits and critical incident reporting in paediatric anaesthesia: lessons from 75,331 anaesthetics // Singapore Med. J. – 2013. – Vol. 54, № 2. – Р. 69−74.

48. Weingarten T. N., Whalen F. X., Warner D. O. et al. Comparison of two ventilatory strategies in elderly subjects undergoing major abdominal surgery // Br. J. Anaesth. – 2010. – Vol. 104, № 1. – P. 16−22.

49. Whalen F. X., Gajic O., Thompson G. B. et al. The effects of the alveolar recruitment maneuver and positive end expiratory pressure on arterial oxygenation during laparoscopic bariatric surgery // Anesth. Analg. – 2006. – Vol. 102, № 1. – P. 298−305.


Рецензия

Для цитирования:


Заболотских И.Б., Вейлер Р.В., Трембач Н.В. МАНЕВР РЕКРУТМЕНТА В УСЛОВИЯХ ОБЩЕЙ АНЕСТЕЗИИ ПРИ АБДОМИНАЛЬНЫХ ОПЕРАЦИЯХ. Вестник анестезиологии и реаниматологии. 2016;13(6):72-80. https://doi.org/10.21292/2078-5658-2016-13-6-72-80

For citation:


Zabolotskikh I.B., Veyler R.V., Trembach N.V. RECRUITMENT MANEUVER UNDER GENERAL ANESTHESIA IN ABDOMINAL SURGERY. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2016;13(6):72-80. (In Russ.) https://doi.org/10.21292/2078-5658-2016-13-6-72-80



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