Journal of Cardiothoracic and Vascular Anesthesia
Volume 20, Issue 2 , Pages 136-142 , April 2006

Effect of Lung Ventilation With 50% Oxygen in Air or Nitrous Oxide Versus 100% Oxygen on Oxygenation Index After Cardiopulmonary Bypass

Presented at the 52nd Annual Conference of Indian Society of Anaesthesiologists, Bhopal, India, December 26-30, 2004.

  • Prabhat Kumar Sinha, MD

      Affiliations

    • Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
    • Corresponding Author InformationAddress reprint requests to Prabhat Kumar Sinha, MD, H. No. IX/561, Chettikunnu, Podujanam Road, Kumarpuram, Medical College P.O., Trivandrum, PIN-695011, Kerala, India.
  • ,
  • Praveen Kumar Neema, MD

      Affiliations

    • Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
  • ,
  • Koniparambil Pappu Unnikrishnan, MD

      Affiliations

    • Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
  • ,
  • Praveen Kerala Varma, MCh

      Affiliations

    • Department of Cardiothoracic Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
  • ,
  • Karunakaran Jaykumar, MCh

      Affiliations

    • Department of Cardiothoracic Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
  • ,
  • Ramesh Chandra Rathod, MD

      Affiliations

    • Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India

References 

  1. Johnson D , Hurst T , Thomson D , et al.   Respiratory function after cardiac surgery . J Cardiothorac Vasc Anesth . 1996;10:571–577
  2. Shenkman Z , Shir Y , Weiss YG , et al.   The effects of cardiac surgery on early and late pulmonary function . Acta Anaesthesiol Scand . 1997;41:1193–1199
  3. Magnusson L , Zemgulis V , Wicky S , et al.   Atelectasis is a major cause of hypoxemia and shunt after cardiopulmonary bypass (An experimental study) . Anesthesiology . 1997;87:1153–1163
  4. Vargas FS , Cukier A , Terra-Filho M , et al.   Influence of atelectasis on pulmonary function after coronary artery bypass grafting . Chest . 1993;104:434–437
  5. Hachenberg T , Tenling A , Nystrom SO , et al.   Ventilation-perfusion inequality in patients undergoing cardiac surgery . Anesthesiology . 1994;80:509–519
  6. Wan S , LeClerc JL , Vincent JL . Inflammatory response to cardiopulmonary bypass (Mechanisms involved and possible therapeutic strategies) . Chest . 1997;112:676–692
  7. Hall RI , Smith MS , Rocker G . The systemic inflammatory response to cardiopulmonary bypass (Pathophysiological, therapeutic, and pharmacological considerations) . Anesth Analg . 1997;85:766–782
  8. Montes RF , Maldonado JD , Paez S , et al.   Off-pump versus on-pump coronary artery bypass surgery and postoperative pulmonary dysfunction . J Cardiothorac Vasc Anesth . 2004;18:698–703
  9. Lindberg P , Gunnarson L , Tokics L , et al.   Atelectasis and lung function in the postoperative period . Acta Anaesthesiol Scand . 1992;36:546–553
  10. Magnusson L , Spahn DR . New concepts of atelectasis during general anaesthesia . Br J Anaesth . 2003;91:61–72
  11. Agarwal A , Singh PK , Dhiraj S , et al.   Oxygen in air (FIO2 0.4) improves gas exchange in young healthy patients during general anesthesia . Can J Anesth . 2002;49:1040–1043
  12. Register SD , Down JB , Stock MC , et al.   Is 50% oxygen harmful? . Crit Care Med . 1987;15:598–601
  13. Dantzker DR , Wagner PD , West JB . Proceedings (Instability of poorly ventilated lung units during oxygen breathing) . J Physiol . 1974;242:72
  14. Rothen HU , Sporre B , Engberg G , et al.   Airway closure, atelectasis and gas exchange during general anaesthesia . Br J Anaesth . 1998;81:681–686
  15. Benoit Z , Wicky S , Fischer J-F , et al.   The effect of increased FIO2 before tracheal extubation on postoperative atelectasis . Anesth Analg . 2002;95:1777–1781
  16. Rothen HU , Sporre B , Engberg G , et al.   Atelectasis and pulmonary shunting during induction of general anaesthesia—Can they be avoided? . Acta Anaesthesiol Scand . 1996;40:524–529
  17. Claxton BA , Morgan P , Mckeague H , et al.   Alveolar recruitment strategy improves arterial oxygenation after cardiopulmonary bypass . Anaesthesia . 2003;58:111–116
  18. Gould MK , Ruoss SJ , Rizk NW , et al.   Indices of hypoxemia in patients with acute respiratory distress syndrome (Reliability, validity, and clinical usefulness) . Crit Care Med . 1997;25:6–8
  19. Knaus WA , Sun X , Hakim RB , et al.   Evaluation of definitions for adult respiratory distress syndrome . Am J Resp Crit Care Med . 1994;150:311–317
  20. Marvel SL , Elliot CG , Tocino I , et al.   Positive end-expiratory pressure following coronary artery bypass grafting . Chest . 1986;90:537–541
  21. Rothen HU , Sporre B , Engberg G , et al.   Re-expansion of atelectasis during general anaesthesia may have a prolonged effect . Acta Anaesthesiol Scand . 1995;39:118–125
  22. Rothen HU , Sporre B , Engberg G , et al.   Prevention of atelectasis during general anaesthesia . Lancet . 1995;345:1387–1391
  23. Tusman G , Bohn SH , Vasquez de Anda GF , et al.   ‘Alveolar recruitment strategy’ improves arterial oxygenation during general anaesthesia . Br J Anaesth . 1999;82:8–13
  24. Magnusson L , Zemgulis V , Tenling A , et al.   Use of vital capacity maneuver to prevent atelectasis after cardiopulmonary bypass (An experimental study) . Anesthesiology . 1998;88:134–142
  25. Rothen HU , Sporre B , Engberg G , et al.   Influence of gas composition on recurrence of atelectasis after a re-expansion maneuver during general anesthesia . Anesthesiology . 1995;82:832–842
  26. Hess W , Kannmacher J , Kruse J . Contamination of anaesthetic gases with nitric oxide and its influence on oxygenation (Study in patients undergoing open heart surgery) . Br J Anaesth . 2004;93:629–633
  27. Lee KH , Tan PS , Rico P , et al.   Low levels of nitric oxide contaminant in hospital compressed air (Physiologic significance?) . Crit Care Med . 1997;25:1143–1146
  28. Benzing A , Loop T , Mols G , et al.   Unintended inhalation of nitric oxide by contamination of compressed air . Anesthesiology . 1999;9:945–950
  29. Marczin N . Tiny wonders of tiny impurities of nitrous oxide during anaesthesia . Br J Anaesth . 2004;93:619–623
  30. Kurusz M , Mills NL . Management of unusual problems encountered in initiating and maintaining cardiopulmonary bypass . In:  Gravlee GP ,  Davis RF ,  Kurusz M ,  Utley JR editor. Cardiopulmonary Bypass Principles and Practice . (ed 2). Philadelphia, PA: Lippincott Williams & Wilkins; 2000;p. 578–612
  31. Wells DG , Podolakin W , Mohr M , et al.   Nitrous oxide and cerebrospinal fluid markers of ischaemia following cardiopulmonary bypass . Anaesth Intens Care . 1987;15:431–435
  32. Gilbert TB , Barnas GM , Sequeira AJ . Impact of pleurotomy, continuous positive airway pressure, and fluid balance during cardiopulmonary bypass on lung mechanics and oxygenation . J Cardiothorac Vasc Anesth . 1996;10:844–849
  33. Hornick P , Taylor KM . Immune and inflammatory responses after cardiopulmonary bypass . In:  Gravlee GP ,  Davis RF ,  Kurusz M , et al. editor. Cardiopulmonary Bypass Principles and Practice . (ed 2). Philadelphia, PA: Lippincott Williams & Wilkins; 2000;p. 303–319
  34. Royston D , Fleming JS , Desai JB , et al.   Increased peroxide generation associated with open heart surgery (evidence for free radical generation) . J Thorac Cardiovasc Surg . 1986;91:759–766
  35. Clarke JP , Schuitemaker MN , Sleigh JW . The effect of intraoperative ventilation strategies on perioperative atelectasis . Anaesth Intens Care . 1998;26:262–266
  36. Rolla G , Fogliati P , Bucca C , et al.   Effect of pleurotomy on pulmonary function after coronary artery bypass grafting with internal mammary artery . Respir Med . 1994;88:417–420
  37. Berrizbeitia LD , Tessler S , Jacobowitz IJ , et al.   Effect of sternotomy and coronary artery bypass surgery on postoperative pulmonary mechanics (Comparison of internal mammary and saphenous vein bypass grafts) . Chest . 1989;96:873–876
  38. Gass GD , Olsen GN . Preoperative pulmonary function testing to predict postoperative morbidity and mortality . Chest . 1986;89:127–135
  39. Zibrak JD , Rossetti P , Wood E . Effect of reductions in respiratory therapy on patients’ outcome . N Engl J Med . 1986;315:292–295

PII: S1053-0770(05)00467-2

doi: 10.1053/j.jvca.2005.11.017

Journal of Cardiothoracic and Vascular Anesthesia
Volume 20, Issue 2 , Pages 136-142 , April 2006