dr john rutherford dr mahboob khan dumfries & galloway royal infirmary
DESCRIPTION
Does ultrasound measured distance from front of abdomen to spine correlate with depth of breathing?. Dr John Rutherford Dr Mahboob Khan Dumfries & Galloway Royal Infirmary. Introduction. To compare ventilation with facemask and LMA ventilation - PowerPoint PPT PresentationTRANSCRIPT
Does ultrasound measured distance from front of
abdomen to spine correlate with depth of breathing?
Dr John RutherfordDr Mahboob Khan
Dumfries & Galloway Royal Infirmary
Introduction
• To compare ventilation with facemask and LMA ventilation
• Need a method of assessing ventilation that is not dependent on measuring exhaled gas…
• Rechner et al. described measuring abdominal movement Paed Anesth 2007; 17: 609-610
• We didn’t have their equipment…
Methods
• Local research ethics approval
• Information sent to children and parents when booking for surgery
• Consent
• Age <16 years
• GA involving LMA
• Exclusions; reflux, language difficulties or lack of consent
• Age
• Weight
• Height
• IV or inhalational induction then LMA• Ventilated at 5, 10 and 15 cmH2O• M mode ultrasound with curvilinear probe
(Sonosite MicroMaxx) and pneumotachograph for tidal volumes with Datex Ohmeda Aestiva
Analysis
• Changes in upper abdominal distance analysed with paired T-tests using Microsoft Excel Office 2003
Results
• 31 children and parents approached
• 7 refused consent
• 1 not read the information
• 1 unable to communicate in English
• 1 active respiratory tract infection
• 21 consented but unable to see spine in one child
• Age range 1 – 11 years
• Male to female 9 to 12
• AP distances similar for pressure regardless of age of child
• T-test 5-10 cmH2O p< 0.005
– 10-15 cmH2O p< 0.0001
– 5-15 cmH2O p< 0.0001
• Difference in tidal volume +/- probe = 2.6%
Change in AP ventilation with 5, 10 and 15 cmH2O
0
1
2
3
4
5
6
7
8
9
10
Pressure ventilation
Ch
ang
e A
P d
ista
nce
mm
5 10 15
Limitations
• Same location of probe
• Same angle of probe
• However the equipment is widely available in the UK
Questions?
?
Acknowledgements
• Dr Petr Hrobar, consultant radiologist
• Dr Gwen Baxter, R&D department
• Dr Alastair Baxter, consultant paediatric anaesthetist
• We are not aware of any conflict of interest