Effect of general anesthesia and controlled mechanical ventilation on pulmonary ventilation distribution assessed by electrical impedance tomography in healthy children

General anesthesia is associated with the development of atelectasis, which may affect lung ventilation. Electrical impedance tomography (EIT) is a noninvasive imaging tool that allows monitoring in real time the topographical changes in aeration and ventilation. To evaluate the pattern of distribut...

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Bibliographic Details
Published in:PloS one 2023-03, Vol.18 (3), p.e0283039-e0283039
Main Authors: Nascimento, Milena S, Rebello, Celso M, Costa, Eduardo L V, Corrêa, Leticia C, Alcala, Glasiele C, Rossi, Felipe S, Morais, Caio C A, Laurenti, Eliana, Camara, Mauro C, Iasi, Marcelo, Apezzato, Maria L P, do Prado, Cristiane, Amato, Marcelo B P
Format: Article
Language:English
Subjects:
Adult
Aeration
Anesthesia
Anesthesia, General - adverse effects
Artificial respiration
Atelectasis
Biology and Life Sciences
Care and treatment
Child
Children
Complications
Complications and side effects
Data analysis
Diaphragm (Anatomy)
Electric Impedance
Electrical impedance
Electrodes
Ethics
General anesthesia
Health aspects
Hospitals
Humans
Imaging systems
Impedance
Information management
Lung - diagnostic imaging
Lung diseases
Mechanical ventilation
Medicine and Health Sciences
Monitoring
Patient outcomes
Patients
Pediatric anesthesia
Pediatrics
Postoperative
Pulmonary Ventilation
Regions
Research and Analysis Methods
Respiration
Respiration, Artificial - methods
Software
Surgery
Telemedicine
Tomography
Tomography - methods
Ventilation
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Description
Summary:General anesthesia is associated with the development of atelectasis, which may affect lung ventilation. Electrical impedance tomography (EIT) is a noninvasive imaging tool that allows monitoring in real time the topographical changes in aeration and ventilation. To evaluate the pattern of distribution of pulmonary ventilation through EIT before and after anesthesia induction in pediatric patients without lung disease undergoing nonthoracic surgery. This was a prospective observational study including healthy children younger than 5 years who underwent nonthoracic surgery. Monitoring was performed continuously before and throughout the surgical period. Data analysis was divided into 5 periods: induction (spontaneous breathing, SB), ventilation-5min, ventilation-30min, ventilation-late and recovery-SB. In addition to demographic data, mechanical ventilation parameters were also collected. Ventilation impedance (Delta Z) and pulmonary ventilation distribution were analyzed cycle by cycle at the 5 periods. Twenty patients were included, and redistribution of ventilation from the posterior to the anterior region was observed with the beginning of mechanical ventilation: on average, the percentage ventilation distribution in the dorsal region decreased from 54%(IC95%:49-60%) to 49%(IC95%:44-54%). With the restoration of spontaneous breathing, ventilation in the posterior region was restored. There were significant pulmonary changes observed during anesthesia and controlled mechanical ventilation in children younger than 5 years, mirroring the findings previously described adults. Monitoring these changes may contribute to guiding the individualized settings of the mechanical ventilator with the goal to prevent postoperative complications.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0283039