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Respiratory resistance during anaesthesia with isoflurane, sevoflurane, and desflurane: a randomized clinical trial  V. Nyktari, A. Papaioannou, N. Volakakis,

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Presentation on theme: "Respiratory resistance during anaesthesia with isoflurane, sevoflurane, and desflurane: a randomized clinical trial  V. Nyktari, A. Papaioannou, N. Volakakis,"— Presentation transcript:

1 Respiratory resistance during anaesthesia with isoflurane, sevoflurane, and desflurane: a randomized clinical trial  V. Nyktari, A. Papaioannou, N. Volakakis, A. Lappa, P. Margaritsanaki, H. Askitopoulou  British Journal of Anaesthesia  Volume 107, Issue 3, Pages (September 2011) DOI: /bja/aer155 Copyright © 2011 The Author(s) Terms and Conditions

2 Fig 1 Study protocol. Recordings include flow, inspiratory pressures (Pinsp), tidal volume (VT), total inspiratory resistance (Rrs), minimal inspiratory resistance (Rmin), and effective resistance (DRrs). TIVA, total i.v. anesthesia. British Journal of Anaesthesia  , DOI: ( /bja/aer155) Copyright © 2011 The Author(s) Terms and Conditions

3 Fig 2 Inspiratory occlusion technique during mechanical ventilation with constant flow inflation. From top to bottom, schematic drawing of airway pressure (Paw) and flow. At the end of a baseline breath, the airways are occluded. After occlusion, the sudden pressure decrease from peak pressure (Ppeak) to pressure at first zero flow (P1) is the pure resistive pressure decrease. The slow decay from P1 to the plateau pressure (Pplat) is the pressure dissipation into the viscoelastic units. British Journal of Anaesthesia  , DOI: ( /bja/aer155) Copyright © 2011 The Author(s) Terms and Conditions

4 Fig 3 Flow chart of patient’s enrolment. pts, patients.
British Journal of Anaesthesia  , DOI: ( /bja/aer155) Copyright © 2011 The Author(s) Terms and Conditions

5 Fig 4 Total respiratory (Rrs), minimal resistance (Rmin), and effective resistance (DRrs) during 30 min administration of the three agents at 1.5 MAC. The effect of the volatile agents is expressed as the ratio of the evaluated parameter to baseline values (R/Rbaseline). (Significant differences compared with baseline: * for Rrs, ‡ for Rmin, and § for DRrs; significant difference compared with 0 min: ⊥ for DRrs). Notice that at 30 min, 0.5 and 0 MAC Rrs was significantly lower compared with the maximum value observed at 0 min (arrows). Also, at 30 min, 0.5 and 0 MAC Rmin decreased significantly compared with the maximum increase at 10 min (arrows). British Journal of Anaesthesia  , DOI: ( /bja/aer155) Copyright © 2011 The Author(s) Terms and Conditions

6 Fig 5 Rrs, Rmin, and DRrs during the 30 min administration of 1.5 MAC of the three volatile agents. Rrs, total respiratory; Rmin, minimal resistance; DRrs, effective resistance. The effect of the volatile agents is expressed as the mean % difference from baseline respiratory resistance (sem). *Comparison of desflurane with isoflurane. No difference between sevoflurane and isoflurane is observed. British Journal of Anaesthesia  , DOI: ( /bja/aer155) Copyright © 2011 The Author(s) Terms and Conditions


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