title: Application of PEEP using the i-gel during volume-controlled ventilation in anesthetized, paralyzed patients.
abstract: OBJECTIVE
  This prospective, randomized trial was designed to assess whether the i-gel supraglottic airway device is suitable for volume-controlled ventilation while applying positive end-expiratory pressure (PEEP) of 5 cmH(2)O under general anesthesia. It was believed that this device might improve arterial oxygenation.
  
  
  METHODS
  Forty adult patients (aged 20-60 years) scheduled for elective orthopedic surgery were enrolled in this study. Twenty patients were ventilated without external PEEP [zero positive end-expiratory pressure (ZEEP) group], and the other 20 were ventilated with PEEP 5 cmH(2)O (PEEP group) after placing an i-gel device. Volume-controlled ventilation at a tidal volume (TV) of 8 ml/kg of ideal body weight, leak volume, and arterial blood gas analysis were investigated.
  
  
  RESULTS
  The incidences of a significant leak were similar in the ZEEP and PEEP groups (3/20 and 1/20, respectively; P = 0.605), as were leak volumes. No significant PaO(2) difference was observed between the two groups at 1 h after satisfactory i-gel insertion (215 ± 38 vs. 222 ± 54; P = 0.502).
  
  
  CONCLUSIONS
  The use of an i-gel during PEEP application at 5 cmH(2)O did not increase the incidence of a significant air leak, and a PEEP of 5 cmH(2)O failed to improve arterial oxygenation during controlled ventilation in healthy adult patients.
authors: Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea.
authors: Yong Beom
authors: YB
authors: Kim
authors: Young Jin
authors: YJ
authors: Chang
authors: Wol Seon
authors: WS
authors: Jung
authors: Sang Ho
authors: SH
authors: Byen
authors: Youn Yi
authors: YY
authors: Jo
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000295:instrumentation* / Q000379:methods; D001784:Blood Gas Analysis; D004864:Equipment and Supplies; D005260:Female; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods; D011312:Pressure; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012121:Respiration, Artificial; D013990:Tidal Volume / Q000502:physiology*; D014691:Ventilation / Q000295:instrumentation*
references: Anaesthesist. 2001 Mar;50(3):187-91
references: 11315492
references: Eur J Anaesthesiol. 2010 Jun;27(6):508-13
references: 20404729
references: Anesth Analg. 2003 Dec;97(6):1835-1839
references: 14633570
references: Anaesthesia. 2010 Dec;65(12):1173-9
references: 20958278
references: Br J Anaesth. 2009 Feb;102(2):264-8
references: 19151051
references: Minerva Anestesiol. 2002 May;68(5):332-6
references: 12029240
references: Am J Respir Crit Care Med. 2001 Jun;163(7):1609-13
references: 11401882
references: Br J Anaesth. 2005 Dec;95(6):831-4
references: 16199419
references: Indian J Anaesth. 2009 Jun;53(3):302-5
references: 20640137
references: Anaesthesia. 2008 Oct;63(10):1124-30
references: 18616521
references: Crit Care Med. 2008 Mar;36(3):669-75
references: 18091555
references: Can Respir J. 2010 May-Jun;17(3):e45-50
references: 20617214
references: Br J Anaesth. 2008 Mar;100(3):351-6
references: 18158311
references: Anesthesiology. 2002 Feb;96(2):289-95
references: 11818758
references: Anesth Analg. 2009 Oct;109(4):1092-5
references: 19641052
references: Anesthesiology. 1973 Jan;38(1):68-74
references: 4564846
references: Anaesthesia. 2005 Oct;60(10):1022-6
references: 16179048
references: J Clin Anesth. 2007 Mar;19(2):125-9
references: 17379125