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ORIGINAL ARTICLE
Minerva Anestesiologica 2020 December;86(12):1287-95
DOI: 10.23736/S0375-9393.20.14687-X
Copyright © 2020 EDIZIONI MINERVA MEDICA
language: English
Lung ultrasound to monitor the development of pulmonary atelectasis in gynecologic oncologic surgery
Luciano FRASSANITO 1 ✉, Chiara SONNINO 1, Sara PITONI 2, Bruno A. ZANFINI 1, Stefano CATARCI 1, Gian L. GONNELLA 1, Paolo GERMINI 1, Giuseppe VIZZIELLI 3, Giovanni SCAMBIA 3, Gaetano DRAISCI 1
1 Unit of Anesthesia in Obstetrics, Gynecology and Pain Therapy II, Department of Emergency, Anesthesiology and Intensive Care Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 2 Department of Emergency, Anesthesiology and Intensive Care Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 3 Unit of Gynecologic Oncology, Department of Women’s, Children’s and Public Health Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
BACKGROUND: Atelectasis formation is considered the major cause of hypoxemia during general anesthesia (GA). Gynecologic oncologic surgery (GOS) often requires pneumoperitoneum and steep bed angulation that further reduce lung compliance by shifting bowels and diaphragm. The aim of our study was to assess the impact of intraoperative variables on lung aeration using lung ultrasound (LUS) score and their correlation with postoperative oxygenation in women undergoing GOS.
METHODS: In this prospective observational study 80 patients scheduled for GOS were enrolled. After three minutes pre-oxygenation, propofol-sufentanil-sevoflurane GA and standard mechanical ventilation (MV) were administered (tidal volume of 8 mL/kg of predicted body weight, FiO
RESULTS: LUS score increased significantly between T1 (1.79±2.39) and T2 (11.08±4.40, ΔLUS=9.29±4.10, P<0.05), mostly in basal and posterior areas. Changes in LUS score correlated significantly with time of MV (r=0.246, P<0.05), cumulative time in TR position (r=0.321, P<0.05) and worsening in oxygenation (ΔPaO
CONCLUSIONS: Aeration loss after GOS detected using LUS correlates with TR time, MV time, colloid infusion and worsening in oxygenation.
KEY WORDS: Ultrasonography; Pulmonary atelectasis; Surgical oncology