Effect of intra‐operative pressure support vs pressure controlled ventilation on oxygenation and lung function in moderately obese adults*

Obesity impairs peri‐operative lung function. To evaluate the impact of pressure support ventilation vs pressure controlled ventilation in moderately obese adults upon early postoperative lung function, we randomly assigned 68 moderately obese patients (body mass index 25–35 kg.m^?2) undergoing minor surgery to receive intra‐operative ventilation either with pressure support or pressure controlled ventilation. We performed intra‐operative blood gas analysis and measured pulse oximetry saturation, spirometry values at pre‐operative assessment (baseline) and at 10 min, 30 min, 2 h and 24 h after extubation. The intra‐operative oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) in the pressure support ventilation group was significantly improved over time (p < 0.0001). Postoperatively, the pressure support ventilation group also had better lung function and oxygenation values than did the pressure controlled ventilation group (p < 0.005). We conclude that pressure support ventilation better maintains lung function than pressure controlled ventilation in moderately overweight patients scheduled for minor surgery.     

Prostaglandin Synthesis Inhibitors Block Alcohol-Induced Fetal Hypoplasia

Alcohol-induced growth retardation is a fetal effect consistently associated with maternal ethanol consumption. In humans, those infants whose mothers consume even a limited amount of ethanol during pregnancy have a significant incidence of growth inhibition. The molecular mechanism responsible for this growth deficiency is unknown, and prevention depends on maternal abstinence during pregnancy. The data reported here suggest that ethanol-mediated increases in tissue prostaglandin (PG) E levels (PGE1 plus PGE2) are correlated with the growth retardation. Further, simultaneous administration of PG synthesis inhibitors with the alcohol blocks the rise in tissue PG levels and protects against the alcohol-induced hypoplasia.