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Canadian Journal of Anesthesia, Vol 19, 381-393, Copyright © 1972 by Canadian Anesthesiologists' Society

The Significance of Transpulmonary Pressure Changes in Children Anaesthetized for Cardiac Surgery-Analysis of Respiratory Mechanics

RICHARD M. LEVIN M.D.1, FRANK L. SELENY M.D., CRCP(C)1, C. W. JOSHI M.D.1, and MICHAEL V. STRECZYN 1

1 Department of Anesthesia, Northwestern University Medical School and Children's Memorial Hospital, Chicago, Illinois 60614

To find a pratical objective parameter indicating the need for ventilatory assistance in paediatric patients after cardiac surgery, measurements were made of transpulmonary prexssure, pulmonary compliance and inspiratory pulmonary resistance in 121 anaesthetized infants and children while they were being ventilated by a volume controlled respirator. Transpulmonary pressure, defined as that transpulmonary pressure required to produce a PaCO2 from 30 to 35 torr, varied inversely with pulmonary compliance and directly with inspiratory pulmonary resistance, reflecting changes in the forces resisting expansion of the lungs. Transpulmonary pressure greater than 20 cm water intraoperatively was present only in patients requiring ventilatory assistance after surgery. Transpulmonary pressure therefore was found to be an objective parameter of pulmonary function which can be measured intraoperatively and could be used to help forecast impending respiratory failure in the postoperative period.

Note:

Supported by Ortho S.A. Sprague Memorial Fund and NIH Grant FR 05475. Presented in part at the International Congress of Paediatrics, Vienna, Austria, September, 1971 and at the American Academy of Paediatrics, Vienna, Austria, October, 1971.






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Copyright © 1972 by the Canadian Anesthesiologists' Society.