TY - JOUR T1 - Impact of anaesthesia on lung function in children JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW SP - 26 LP - 29 DO - 10.1183/09059180.00010712 VL - 17 IS - 107 AU - Britta S. von Ungern-Sternberg Y1 - 2008/04/01 UR - http://err.ersjournals.com/content/17/107/26.abstract N2 - Respiratory adverse events are major causes of morbidity and mortality during paediatric anaesthesia. Several factors, such as asthma, bronchial hyperreactivity, upper respiratory tract infection or passive smoking, are known to increase the risk of respiratory complications. Since all these risk factors have a high prevalence in children, it is crucial for the paediatric anaesthesia practice to anticipate, recognise and treat common respiratory complications. The ability to prevent respiratory complications requires an understanding of the underlying physiology and pathophysiology, but until recently little has been known of the impact of anaesthesia and its different components (e.g. anaesthetic agents, ventilation strategies) on respiratory function in children. My research over the past years has focused on this area and, in particular, on the impact of different anaesthetic agents and regional anaesthesia techniques, as well as body positioning on functional residual capacity and ventilation homogeneity. Impact of positive end-expiratory pressure in anesthetised children exposed to high levels of inspired oxygen The high fractions of inspired oxygen (FI,O2) that are commonly administered, especially at induction and termination of anaesthesia, result in airway closure and, as a consequence, decreased functional residual capacity (FRC). Our study examined the effects of FI,O2 0.3 (in air) versus FI,O2 1.0 and its reversibility by the application of continuous positive end-expiratory pressure (PEEP) of 6 cmH2O (0.6 kPa) compared with PEEP of 3 cmH2O (0.3 kPa) on FRC and ventilation distribution in preschool children under general anaesthesia [1]. An increase of FI,O2 from 0.3 to 1.0 with a PEEP of 3 cmH2O (0.3 kPa) decreased the measured FRC and ventilation homogeneity, while FRC and ventilation homogeneity remained unchanged when 6 cmH2O (0.6 kPa) PEEP was applied. Impact of different breathing systems for manual ventilation Skilled use of bag and mask ventilation is of fundamental importance in paediatric anaesthesia. Although often considered as simple, there are a number of potential hazards resulting from inadequate manipulation … ER -