Research on the correlation between ventilation pressure and tidal volume in assisted mechanical ventilation with facemask during anesthesia induction_West China Medical Journal

Authors：

LIAO Zhimin ,  LUO Linli , HUANG Wei , NI Juan

Department of Anesthesiology, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education; Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LUO Linli, Email: linli-luo@163.com

Keywords：

Induction; Anesthesia; Tidal volume; Ventilation pressure; Assisted mechanical ventilation with facemask

DOI：

10.7507/1002-0179.201509154

Video：

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Objective To investigate the curve correlation between ventilation pressure and tidal volume in assisted mechanical ventilation with facemask during anesthesia induction. Methods Between January and August 2015, 120 patients, American Society of Anesthesiology Ⅰ-Ⅱ, undergoing selective gynecological surgery were randomly divided into four groups: groups P₅, P₁₀, P₁₅ and P₂₀, with 30 patients in each group. Mask ventilation pressure for the four groups were respectively 5, 10, 15 and 20 cm H₂O (1 cm H₂O=0.098 kPa). Patients were ventilated by preset ventilation pressure and frequency based on different groups after loss of consciousness. Mean ventilation volume (mean value of three tidal volumes) and end-tidal carbon dioxide pressure (PetCO₂) were recorded for analysis. Results There was no significant difference among the four groups in patient’s general condition (P>0.05). The tidal volume of assisted mechanical ventilation increased with ventilation pressure degrees, and the differences among the four groups were significant (P<0.05). After curve regression analysis, tidal volume and ventilation pressure showed a positive linear correlation when ventilation pressure was set at 5-20 cm H₂O, and the correlation equation was: tidal volume = 33.612×ventilation pressure-53.155. PetCO₂ in P₅ group was lower than those in the other three groups (P<0.05), while there were no significant differences among groups P₁₀, P₁₅ and P₂₀ (P>0.05). Conclusion When ventilation pressure is set at 5-20 cm H₂O in assisted mechanical ventilation with facemask during anesthesia induction, tidal volume and ventilation pressure show a positive linear correlation.

Citation： LIAO Zhimin, LUO Linli, HUANG Wei, NI Juan. Research on the correlation between ventilation pressure and tidal volume in assisted mechanical ventilation with facemask during anesthesia induction. West China Medical Journal, 2017, 32(4): 559-562. doi: 10.7507/1002-0179.201509154 Copy

1.	Vakkuri AP, Lindgren L, Korttila KT, et al. Transient hyperdynamic response associated with controlled hypocapneic hyperventilation during sevoflurane-nitrous oxide mask induction in adults. Anesth Analg, 1999, 88(6): 1384-1388.
2.	于布为, 吴新民, 左明章, 等. 困难气道管理指南. 临床麻醉学杂志, 2013, 29(1): 93-98.
3.	Ehrenfeld JM, Cassedy EA, Forbes VE, et al. Modified rapid sequence induction and intubation: a survey of United States current practice. Anesth Analg, 2012, 115(1): 95-101.
4.	Brown JP, Werrett G. Bag-mask ventilation in rapid sequence induction. Anaesthesia, 2009, 64(7): 784-785.
5.	De Jong A, Futier E, Millot A, et al. How to preoxygenate in operative room: healthy subjects and situations " at risk”. Ann Fr Anesth Reanim, 2014, 33(7/8): 457-461.
6.	Ho-Tai LM, Devitt JH, Noel AG, et al. Gas leak and gastric insufflation during controlled ventilation: face mask versus laryngeal mask airway. Can J Anaesth, 1998, 45(3): 206-211.
7.	Bouvet L, Albert ML, Augris C, et al. Real-time detection of gastric insufflation related to facemask pressure-controlled ventilation using ultrasonography of the antrum and epigastric auscultation in nonparalyzed patients: a prospective, randomized, double-blind study. Anesthesiology, 2014, 120(2): 326-334.
8.	Lagarde S, Semjen F, Nouette-Gaulain K, et al. Facemask pressure-controlled ventilation in children: what is the pressure limit?. Anesth Analg, 2010, 110(6): 1676-1679.
9.	廖志敏, 罗林丽, 熊雅琴, 等. 限制性气管正压通气法在腹腔镜手术麻醉诱导中的应用. 四川大学学报: 医学版, 2016, 47(3): 445-447.
10.	Seet MM, Soliman KM, Sbeih ZF. Comparison of three modes of positive pressure mask ventilation during induction of anaesthesia: a prospective, randomized, crossover study. Eur J Anaesthesiol, 2009, 26(11): 913-916.
11.	de Gregorio C, Saporito F, Andò G, et al. Hyperventilation-induced ST segment elevation mimicking acute myocardial infarction in a comatose patient with tracheostomy. Int J Cardiol, 2011, 149(2): 47-49.
12.	Chen CC, Chen SA, Tai CT, et al. Hyperventilation facilitates induction of supraventricular tachycardia: a novel method and the possible mechanism. J Cardiovasc Electrophysiol, 2001, 12(11): 1242-1246.
13.	Siddiqui SR, Zafar A, Khan FS, et al. Effect of hyperventilation on electroencephalographic activity. J Pak Med Assoc, 2011, 61(9): 850-852.
14.	金晓青, 孙宏斌, 莫文胜. 脑电图检查中过度换气诱发试验对癫痫诊断的影响. 中国实验诊断学, 2012, 16(9): 1667-1668.
15.	de Arriba-Arnau A, Dalmau A, Salvat-Pujol N, et al. Hypocapnia and hyperoxia induction using a hyperventilation protocol in electroconvulsive therapy. Rev Psiquiatr Salud Ment, 2017, 10(1): 21-27.

1. Vakkuri AP, Lindgren L, Korttila KT, et al. Transient hyperdynamic response associated with controlled hypocapneic hyperventilation during sevoflurane-nitrous oxide mask induction in adults. Anesth Analg, 1999, 88(6): 1384-1388.
2. 于布为, 吴新民, 左明章, 等. 困难气道管理指南. 临床麻醉学杂志, 2013, 29(1): 93-98.
3. Ehrenfeld JM, Cassedy EA, Forbes VE, et al. Modified rapid sequence induction and intubation: a survey of United States current practice. Anesth Analg, 2012, 115(1): 95-101.
4. Brown JP, Werrett G. Bag-mask ventilation in rapid sequence induction. Anaesthesia, 2009, 64(7): 784-785.
5. De Jong A, Futier E, Millot A, et al. How to preoxygenate in operative room: healthy subjects and situations " at risk”. Ann Fr Anesth Reanim, 2014, 33(7/8): 457-461.
6. Ho-Tai LM, Devitt JH, Noel AG, et al. Gas leak and gastric insufflation during controlled ventilation: face mask versus laryngeal mask airway. Can J Anaesth, 1998, 45(3): 206-211.
7. Bouvet L, Albert ML, Augris C, et al. Real-time detection of gastric insufflation related to facemask pressure-controlled ventilation using ultrasonography of the antrum and epigastric auscultation in nonparalyzed patients: a prospective, randomized, double-blind study. Anesthesiology, 2014, 120(2): 326-334.
8. Lagarde S, Semjen F, Nouette-Gaulain K, et al. Facemask pressure-controlled ventilation in children: what is the pressure limit?. Anesth Analg, 2010, 110(6): 1676-1679.
9. 廖志敏, 罗林丽, 熊雅琴, 等. 限制性气管正压通气法在腹腔镜手术麻醉诱导中的应用. 四川大学学报: 医学版, 2016, 47(3): 445-447.
10. Seet MM, Soliman KM, Sbeih ZF. Comparison of three modes of positive pressure mask ventilation during induction of anaesthesia: a prospective, randomized, crossover study. Eur J Anaesthesiol, 2009, 26(11): 913-916.
11. de Gregorio C, Saporito F, Andò G, et al. Hyperventilation-induced ST segment elevation mimicking acute myocardial infarction in a comatose patient with tracheostomy. Int J Cardiol, 2011, 149(2): 47-49.
12. Chen CC, Chen SA, Tai CT, et al. Hyperventilation facilitates induction of supraventricular tachycardia: a novel method and the possible mechanism. J Cardiovasc Electrophysiol, 2001, 12(11): 1242-1246.
13. Siddiqui SR, Zafar A, Khan FS, et al. Effect of hyperventilation on electroencephalographic activity. J Pak Med Assoc, 2011, 61(9): 850-852.
14. 金晓青, 孙宏斌, 莫文胜. 脑电图检查中过度换气诱发试验对癫痫诊断的影响. 中国实验诊断学, 2012, 16(9): 1667-1668.
15. de Arriba-Arnau A, Dalmau A, Salvat-Pujol N, et al. Hypocapnia and hyperoxia induction using a hyperventilation protocol in electroconvulsive therapy. Rev Psiquiatr Salud Ment, 2017, 10(1): 21-27.

West China Medical Journal

Research on the correlation between ventilation pressure and tidal volume in assisted mechanical ventilation with facemask during anesthesia induction

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