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- Title
Effects of intraoperative protective lung ventilation on postoperative pulmonary complications in patients with laparoscopic surgery: prospective, randomized and controlled trial.
- Authors
Park, S.; Kim, B.; Oh, A.; Han, S.; Han, H.; Ryu, J.; Park, S J; Kim, B G; Oh, A H; Han, S H; Han, H S; Ryu, J H
- Abstract
<bold>Background: </bold>Respiratory functions are usually impaired during pneumoperitoneum for laparoscopic surgery. This randomized, controlled and single-blinded study was performed to evaluate whether intraoperative protective lung ventilation influences postoperative pulmonary complications after laparoscopic hepatobiliary surgery.<bold>Methods: </bold>Sixty-two patients were randomized to receive either conventional ventilation with alveolar recruitment maneuver (tidal volume of 10 ml/kg with inspiratory pressure of 40 cmH2O for 30 s after the end of pneumoperitoneum, group R), or protective lung ventilation (low tidal volume of 6 ml/kg with positive end-expiratory pressure [PEEP] of 5 cmH2O, group P). Induction and maintenance of anesthesia were done with balanced anesthesia. Respiratory complications such as atelectasis, pneumonia or desaturation were observed postoperatively. The length of hospital stay, arterial blood gas analysis, peak inspiratory pressure and hemodynamic variables were also recorded. Results are presented as mean ± SD or number of patients (%).<bold>Results: </bold>Postoperative pulmonary complications (P = 0.023) and desaturation below 90 % (P = 0.016) occurred less frequently in group P than in group R. Eight patients of group R and 3 patients of group P showed atelectasis. Pneumonia was diagnosed in 1 patient of group R. No differences were observed in the length of hospital stay, arterial blood gas analysis (pH, PaO2, PaCO2 and PAO2) and hemodynamic variables except PAO2, AaDO2 and peak inspiratory pressure between the two groups.<bold>Conclusion: </bold>Protective lung ventilation (low tidal volume with PEEP) during pneumoperitoneum was associated with less incidences of pulmonary complications than conventional ventilation with alveolar recruitment maneuver after laparoscopic hepatobiliary surgery.
- Subjects
INTRAOPERATIVE care; PERIOPERATIVE care; PULMONARY ventilation-perfusion scans; PULMONARY function tests; HEMODYNAMICS; ARTIFICIAL respiration; ATELECTASIS; BLOOD gases analysis; COMPARATIVE studies; SURGICAL diagnosis; DIGESTIVE organ surgery; LENGTH of stay in hospitals; LAPAROSCOPY; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PNEUMONIA; RESEARCH; RESPIRATORY measurements; SURGICAL complications; EVALUATION research; RANDOMIZED controlled trials; DISEASE incidence; POSITIVE end-expiratory pressure
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 10, p4598
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-4797-x