title: Comparison of respiratory mechanics in adult patients undergoing minimally invasive repair of the pectus excavatum and removal of a pectus bar.
abstract: OBJECTIVE
  The objective of this study was to compare the respiratory mechanics and gas exchange in adult patients undergoing minimally invasive repair of the pectus excavatum (MIRPE group) and removal of a pectus bar (bar removal group).
  
  
  METHODS
  A prospective observational study.
  
  
  METHODS
  A tertiary university hospital.
  
  
  METHODS
  Thirty-two patients scheduled for elective MIRPE or removal of a pectus bar.
  
  
  METHODS
  None.
  
  
  RESULTS
  Spirometry was used to measure the peak inspiratory airway pressure (PIP), static compliance, and respiratory resistance. The measurements were recorded at 1 minute after beginning mechanical ventilation (T0), 15 minutes after beginning sevoflurane inhalation (T1), and after the insertion (or removal) of a pectus bar through the chest wall (T2). Pulmonary gas exchange was assessed by calculating the alveolar arterial oxygen tension difference (AaDO2) before surgical incision and after insertion (or removal) of the pectus bar. In the MIRPE group, static compliance was decreased significantly (p < 0.001), and PIP was increased significantly (p < 0.001) after insertion of the pectus bar (T2) compared with baseline. In contrast, the bar removal group showed the opposite results. There were significant differences in static compliance and PIP at T2 between the groups (p = 0.002 and 0.026, respectively). AaDO2 was increased significantly in the MIRPE group compared with the bar removal group (p = 0.012).
  
  
  CONCLUSIONS
  Insertion of the pectus bar through the chest wall results in significant changes in respiratory mechanics and gas exchange. Therefore, close attention to pulmonary function is required during and after these surgical procedures.
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Moon
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Hyung Joo
authors.initials: HJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000403:Airway Resistance; D000771:Anesthesia, Intravenous; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008170:Lung Compliance / Q000502:physiology; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016343:Monitoring, Intraoperative; D010101:Oxygen Consumption; D011659:Pulmonary Gas Exchange / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012121:Respiration, Artificial; D015656:Respiratory Mechanics / Q000502:physiology*; D013147:Spirometry; D055815:Young Adult