On-line expiratory flow-volume curves during thoracic surgery: occurrence of auto-PEEP

• Published in: British journal of anaesthesia : BJA Vol. 72; no. 1; p. 25
• Main Authors: Bardoczky, G, d'Hollander, A, Yernault, J C, Van Meuylem, A, Moures, J M, Rocmans, P
• Format: Journal Article
• Language: English
• Published: England 01-01-1994
• Subjects: Adult; Aged; Airway Resistance; Anesthesia, General; Forced Expiratory Volume; Humans; Lung - physiopathology; Lung - surgery; Middle Aged; Positive-Pressure Respiration; Pulmonary Ventilation - physiology
• ISSN: 0007-0912
• DOI: 10.1093/bja/72.1.25

Flow-volume loops were monitored continuously in 39 patients undergoing thoracic surgery requiring one-lung ventilation. In 26 of the 39 patients (67%), auto-positive end-expiratory pressure (auto-PEEP) was seen on the flow-volume curves during both two-lung and one-lung ventilation. Eighty-seven percent of the patients whose trachea was intubated with a smaller size (35- and 37-French gauge) double-lumen tracheal tube exhibited auto-PEEP, compared with patients in whom the tube used was larger (39- or 41-French gauge: 54% and 50%, respectively). Before operation, mean airway resistance was significantly greater in patients who exhibited auto-PEEP during anaesthesia (2.4 cm H2O litre-1 s) than in patients without auto-PEEP (1.7 cm H2O litre-1 s).