Minimal volume ventilation during robotically assisted mitral valve surgery

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Kesävuori , R , Vento , A , Lundbom , N , Schramko , A , Jokinen , J J & Raivio , P 2019 , ' Minimal volume ventilation during robotically assisted mitral valve surgery ' , Perfusion , vol. 34 , no. 8 , pp. 705-713 . https://doi.org/10.1177/0267659119847917

Title: Minimal volume ventilation during robotically assisted mitral valve surgery
Author: Kesävuori, Risto; Vento, Antti; Lundbom, Nina; Schramko, Alexey; Jokinen, Janne J.; Raivio, Peter
Contributor organization: III kirurgian klinikka
HUS Heart and Lung Center
Department of Diagnostics and Therapeutics
HUS Medical Imaging Center
Department of Surgery
University Management
Anestesiologian yksikkö
HUS Perioperative, Intensive Care and Pain Medicine
HYKS erva
Päijät-Häme Welfare Consortium
Date: 2019-11
Language: eng
Number of pages: 9
Belongs to series: Perfusion
ISSN: 0267-6591
DOI: https://doi.org/10.1177/0267659119847917
URI: http://hdl.handle.net/10138/322091
Abstract: Introduction: A minimal volume ventilation method for robotically assisted mitral valve surgery is described in this study. In an attempt to reduce postoperative pulmonary dysfunction, 40 of 174 patients undergoing robotically assisted mitral valve surgery were ventilated with a small tidal volume during cardiopulmonary bypass. Methods: After propensity score matching, 31 patients with minimal volume ventilation were compared with 54 patients with no ventilation. Total ventilation time, PaO2/FiO(2) ratio, arterial lactate concentration, and the rate of unilateral pulmonary edema in the matched minimal ventilation and standard treatment groups were evaluated. Results: Patients in the minimal ventilation group had shorter ventilation times, 12.0 (interquartile range: 9.9-15.0) versus 14.0 (interquartile range: 12.0-16.3) hours (p = 0.036), and lower postoperative arterial lactate levels, 0.99 (interquartile range: 0.81-1.39) versus 1.28 (interquartile range: 0.99-1.86) mmol/L (p = 0.01), in comparison to patients in the standard treatment group. There was no difference in postoperative PaO2/FiO(2) ratio levels or in the rate of unilateral pulmonary edema between the groups. Conclusion: Minimal ventilation appeared beneficial in terms of total ventilation time and blood lactatemia, while there was no improvement in arterial blood gas measurements or in the rate of unilateral pulmonary edema. The lower postoperative arterial lactate levels may suggest improved lung perfusion among patients in the minimal volume ventilation group. The differences in the ventilation times were in fact small, and further studies are required to confirm the possible advantages of the minimal volume ventilation method in robotically assisted cardiac surgery.
Subject: anesthesia
minimally invasive surgery
mitral valve
perioperative care
pulmonary function
robotics
ventilation
POSITIVE AIRWAY PRESSURE
ONE-LUNG VENTILATION
REEXPANSION PULMONARY-EDEMA
FREQUENCY JET VENTILATION
INVASIVE CARDIAC-SURGERY
CARDIOPULMONARY BYPASS
REPAIR
HYPERLACTATEMIA
METAANALYSIS
IMPACT
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion


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