Changes of Lung Compliance in Pediatric Patients after Surgical Correction of Left to Right Shunt.
10.4097/kjae.1998.35.2.315
- Author:
Eun Sook YOO
1
;
Young Lan KWAK
;
Sang Beom NAM
;
Jaehyung KIM
;
Seung Ho CHOI
;
Sang Gun HAN
;
Seo Ouk BANG
Author Information
1. Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Anesthesia: cardiac;
pediatric;
Lung: compliance.
- MeSH:
Anesthesia;
Carbon Dioxide;
Compliance;
Hemodynamics;
Humans;
Lung Compliance*;
Lung*;
Oxygen;
Postoperative Period;
Ventilators, Mechanical
- From:Korean Journal of Anesthesiology
1998;35(2):315-320
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Low values of lung compliance have been reported in patients with increased pulmonary blood flow due to intracardiac left to right(L-R) shunt. The compliance had returned to within normal limits 4 to 6 weeks after surgical correction of the shunt. We investigated whether lung compliance was improved immediately after surgical correction of the shunt. METHODS: Fifty four pediatric patients who were undergoing repair of intracardiac L-R shunt were evaluated. Lung compliance, arterial oxygen tension(PaO2) and arterial to end-tidal carbon dioxide tension difference(Pa-ETCO2) were measured after induction of anesthesia and at the completion of surgery. Left atrial pressure(LAP) was monitored. Lung compliance and end-tidal carbon dioxide tension were measured by monitoring system built in Cato anesthetic ventilator system. RESULTS: Lung compliance was significantly lower after surgery(6.57+/-6.46 ml/mbar) than after induction of anesthesia(7.71+/-7.18 ml/mbar). After surgery, PaO2 was significantly decreased and Pa-ETCO2 significantly increased than after induction of anesthesia. The decrease in lung compliance after surgery significantly correlated with a decrease in PaO2(r=0.43) and an increase in Pa-ETCO2 (r=0.47) but not correlated with LAP. CONCLUSIONS: Although surgical correction of intracardiac L-R shunt reduces pulmonary blood flow, the lung compliance decreases in immediate postoperative period. Therefore a deterioration of postoperative lung compliance may need judicious management for pulmonary and hemodynamic instability.
