Journal of Shanghai Jiao Tong University (Medical Science) >

2021 , Vol. 41 >Issue 6: 781 - 785

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.06.013

Clinical research

Effect of positive end-expiratory pressure on the incidence of atelectasis in children with congenital heart disease undergoing lateral thoracotomy under cardiopulmonary bypass

  • Pan HE ,
  • Ying SUN ,
  • Yan-yan YANG ,
  • Jie BAI ,
  • Ji-jian ZHENG ,
  • Ma-zhong ZHANG
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  • Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China

Online published: 2021-06-29

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Abstract

Objective

·To evaluate the incidence of atelectasis in children undergoing lateral thoracotomy cardiac surgery with cardiopulmonary bypass (CPB) by lung ultrasound, and investigate the effect of positive end-expiratory pressure (PEEP) on the incidence of atelectasis in these children.

Methods

·Sixty children undergoing selective lateral thoracotomy cardiac surgery with CPB in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine from October 2019 to August 2020 were included. They were randomly divided into PEEP group (P group, n=30) and control group (C group, n=30). The P group was treated with 5 cmH2O PEEP immediately after tracheal intubation until the end of operation. The C group was treated with 5 cmH2O PEEP immediately after tracheal intubation until the beginning of operation. Lung ultrasound exam was performed three times in each patient, 1 min after starting mechanical ventilation of the lungs (T1), 1 min before the beginning of surgery (T2) and the time immediately upon completion of the surgery (T3). The lung ultrasound scores of the two groups were recorded, and the incidences of atelectasis were compared.

Results

·There was no significant difference in the incidences of atelectasis at T1 and T2 between the two groups. The incidence of atelectasis in P group was significantly lower than that in the C group at T3 (P=0.000). The incidence of atelectasis in the C group at T3 was significantly lower than those at T1 and T2 (all P<0.05).

Conclusion

·PEEP can significantly reduce the incidence of atelectasis in children undergoing lateral thoracotomy cardiac surgery with CPB.

Key words： atelectasis; positive end-expiratory pressure (PEEP); lung ultrasound; congenital heart disease; lateral thoracotomy

Cite this article

Pan HE , Ying SUN , Yan-yan YANG , Jie BAI , Ji-jian ZHENG , Ma-zhong ZHANG . Effect of positive end-expiratory pressure on the incidence of atelectasis in children with congenital heart disease undergoing lateral thoracotomy under cardiopulmonary bypass[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2021 , 41(6) : 781 -785 . DOI: 10.3969/j.issn.1674-8115.2021.06.013

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