Application of PEEP using the i-gel during volume-controlled ventilation in anesthetized, paralyzed patients |
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Authors: | Yong Beom Kim Young Jin Chang Wol Seon Jung Sang Ho Byen Youn Yi Jo |
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Affiliation: | 1. Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea
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Abstract: | Purpose This prospective, randomized trial was designed to assess whether the i-gel supraglottic airway device is suitable for volume-controlled ventilation while applying positive end-expiratory pressure (PEEP) of 5 cmH2O under general anesthesia. It was believed that this device might improve arterial oxygenation. Methods Forty adult patients (aged 20–60 years) scheduled for elective orthopedic surgery were enrolled in this study. Twenty patients were ventilated without external PEEP [zero positive end-expiratory pressure (ZEEP) group], and the other 20 were ventilated with PEEP 5 cmH2O (PEEP group) after placing an i-gel device. Volume-controlled ventilation at a tidal volume (TV) of 8 ml/kg of ideal body weight, leak volume, and arterial blood gas analysis were investigated. Results The incidences of a significant leak were similar in the ZEEP and PEEP groups (3/20 and 1/20, respectively; P = 0.605), as were leak volumes. No significant PaO2 difference was observed between the two groups at 1 h after satisfactory i-gel insertion (215 ± 38 vs. 222 ± 54; P = 0.502). Conclusions The use of an i-gel during PEEP application at 5 cmH2O did not increase the incidence of a significant air leak, and a PEEP of 5 cmH2O failed to improve arterial oxygenation during controlled ventilation in healthy adult patients. |
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