Effects of inspired oxygen concentration during emergence from general anaesthesia on postoperative lung impedance chang
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ORIGINAL RESEARCH
Effects of inspired oxygen concentration during emergence from general anaesthesia on postoperative lung impedance changes evaluated by electrical impedance tomography: a randomised controlled trial Jiyeon Park1,2 · Eun‑Kyung Lee1 · Jong‑Hwan Lee1 · Eun Jung Oh1,3 · Jeong Jin Min1 Received: 20 May 2019 / Accepted: 22 September 2019 © Springer Nature B.V. 2019
Abstract We evaluated the effects of three different inspired oxygen concentrations (40%, 80%, and 100%) at anaesthesia emergence on postoperative lung volumes as measured by global impedance of electrical impedance tomography (EIT). This is a randomised, controlled, and assessor-blinded study in single-centre from May 2017 to August 2017. Seventy-one patients undergoing elective laparoscopic colorectal surgery with healthy lung condition were randomly allocated into the three groups based on the concentration of inspired oxygen applied during anaesthesia emergence: 40%-, 80%- or 100%-oxygen. End-expiratory lung impedance (EELI) with normal tidal ventilation and total lung impedance (TLI) with full respiratory effort were measured preoperatively and before discharge in the post-anaesthesia care unit by EIT, and perioperative changes (the ratio of difference between preoperative and postoperative value to preoperative value) were compared among the three groups. Postoperative lung impedances were significantly reduced compared with preoperative values in all patients (P < 0.001); however, perioperative lung impedance reduction (%) did not differ among the three oxygen groups. The mean reduction ratio in each 40%-, 80%-, and 100%-oxygen group were 37% ± 13%, 41% ± 14%, and 46% ± 14% for EELI (P = 0.125) and 40% ± 20%, 44% ± 17% and 49% ± 20% for TLI (P = 0.276), respectively. Inspired oxygen concentrations applied during anaesthesia emergence did not show a significant difference in postoperative lung volume as measured by EIT in patients undergoing laparoscopic colorectal surgery with healthy lungs. Trial registration cris.nih.go.kr (KCT0002642). Keywords Oxygen concentration · Emergence · Postoperative lung volume change · Postoperative lung impedance change · Electrical impedance tomography
1 Introduction Drs. Jiyeon Park and Eun-Kyung Lee contributed equally to this work. * Jeong Jin Min [email protected] 1
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyukwan University School of Medicine, 81 Irwon‑ro, Gangnam‑gu, Seoul 06351, Korea
2
Department of Anesthesiology and Pain Medicine, School of Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon, Republic of Korea
3
Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, Kangwon University School of Medicine, Chuncheon, Republic of Korea
Perioperative use of high inspired oxygen concentration may contribute to airway closure, alveolar collapse and the development of absorption atelectasis [1–4]. A clinical decision support system can be used to adjust inspired oxygen concentration
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