Publication: Reclutamiento alveolar con dispositivos supraglóticos con acceso gástrico: LMA Supreme y LMA Proseal
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2018-11-26
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Universidad Complutense de Madrid
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Abstract
Es sabido que las atelectasias aparecen durante la anestesia general y afectan casi al 90% de los pacientes quirúrgicos. Las maniobras de reclutamiento alveolar abren los alveolos colapsados, incrementan el intercambio de gases y mejoran la oxigenación arterial. Además, hoy endía, el uso de dispositivos supraglóticos está ampliamente extendido en numerosos procedimientos quirúrgicos realizados bajo anestesia general.Por ello, consideramos necesario estudiar tanto la efectividad como la seguridad de realizar maniobras de reclutamiento alveolar con dispositivos supraglóticos con acceso gástrico (LMA Suprme y LMAProseal). Métodos. Cien pacientes, adultos, ASA I-III, no obesos, a los que se les iba a realizar distintos procedimientos quirúrgicos bajo anestesia general, se distribuyeron de manera aleatoria en dos grupos, LMA Supreme y LMAProseal. El procedimiento anestésico fue estandarizado. Durante la anestesia general se realizaron maniobras de reclutamiento alveolar, incrementando la PEEP de manera progresiva. Se recogieron los valores de complianza, volumen tidal espirado, presión pico y presión meseta,presión arterial, SpO2, CO2 espirado y PEEP, antes, durante y después de las maniobras de reclutamiento...
It is well known that atelectasis appears during general anesthesia and affects almost 90% of surgical patients. Alveolar recruitment maneuvers recruit collapsed alveoli, increase gas exchangeand improve arterial oxygenation. Besides, the use of supraglottic devicesis highly extended nowadays in many surgical procedures performed under general anesthesia. We consider necessary to study the effectiveness and safety of alveolar recruitment maneuvers executed with supraglottic devices with gastric access (LMA Supreme and LMA Proseal). Methods. One hundred patients, adults, ASA I-III, non obese, undergoing different surgical procedures with general anesthesia, were randomly allocated into two different groups, LMA Supreme and LMA Proseal. Anesthesia management was standardized. During general anesthesia, alveolar recruitment maneuvers increasing PEEP were performed. Values of compliance, expired tidal volumen, peak pressure and plateau pressure, arterial pressure, SpO2, EtCO2 and PEEP were written down. Besides, the ease of insertion of supraglottic device and the appearance of adverse effects were also evaluated...
It is well known that atelectasis appears during general anesthesia and affects almost 90% of surgical patients. Alveolar recruitment maneuvers recruit collapsed alveoli, increase gas exchangeand improve arterial oxygenation. Besides, the use of supraglottic devicesis highly extended nowadays in many surgical procedures performed under general anesthesia. We consider necessary to study the effectiveness and safety of alveolar recruitment maneuvers executed with supraglottic devices with gastric access (LMA Supreme and LMA Proseal). Methods. One hundred patients, adults, ASA I-III, non obese, undergoing different surgical procedures with general anesthesia, were randomly allocated into two different groups, LMA Supreme and LMA Proseal. Anesthesia management was standardized. During general anesthesia, alveolar recruitment maneuvers increasing PEEP were performed. Values of compliance, expired tidal volumen, peak pressure and plateau pressure, arterial pressure, SpO2, EtCO2 and PEEP were written down. Besides, the ease of insertion of supraglottic device and the appearance of adverse effects were also evaluated...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Farmacología, leída el 11/09/2017