Beta
165505

Different Intraoperative Ventilatory Strategies for Prevention of Pulmonary Atelectasis in Obese Patients Undergoing Non-Bariatric Surgeries; Randomized Controlled Trial

Article

Last updated: 24 Dec 2024

Subjects

-

Tags

-

Abstract

Background: Upper abdominal surgeries have been reported to be associated with an increased incidence of postoperative atelectasis. Preventing atelectasis is important for all patients but is more important when caring for obese patients. Objectives: To determine which of the following ventilatory strategies is better in prevention of pulmonary atelectasis in obese patients undergoing non-bariatric surgery: Volume control ventilation "VC", Pressure control Ventilation "PC", Volume control ventilation + Positive End Expiratory Pressure "PEEP", Volume control ventilation + Positive End Expiratory Pressure "PEEP" + lung recruitment maneuver. Patients and methods: A randomized-controlled trial study was carried out in the operating room (OR) in Zagazig University Hospital including 92 patients. Patients were randomly allocated into four groups. G1: Volume control ventilation "VC", G2: Pressure control Ventilation "PC", G3: Volume control ventilation + Positive End Expiratory Pressure "PEEP", G4: as in G3 + lung recruitment maneuver. Results: There was significant difference between the studied groups as regards PaO2/FiO2 ratio as the 4th group was highly significant. There was also significant difference between the studied groups as regards atelectasis score with the least atelectasis score in group 4. There was a significant difference in group 4 than the other groups as regards length of stay in PACU, and need for 100% Fio2 in PACU.Finally,there was a significant difference between the studied groups as regards postoperative pulmonary complications with the 4th group has the least postoperative complication. Conclusion: Our results suggest that volume control ventilation + Positive End Expiratory Pressure "PEEP" + lung recruitment maneuver had beneficial effects on oxygenation continued into the early recovery period and decrease pulmonary complications in the early post-operative period in obese patients undergoing non-bariatric upper abdominal surgeries.    

DOI

10.21608/ejhm.2021.165505

Keywords

atelectasis, obese, Ventilatory Strategies, Bariatric

Authors

First Name

Mohamed Ezzat

Last Name

Abd El-Fattah

MiddleName

-

Affiliation

Departments of Anesthesia and Surgical Intensive Care Faculty of Medicine, Zagazig University, Egypt.

Email

mohammedezzat2002@gmail.com

City

-

Orcid

-

First Name

Doaa Mohamed

Last Name

Faried

MiddleName

-

Affiliation

Departments of Anesthesia and Surgical Intensive Care Faculty of Medicine, Zagazig University, Egypt.

Email

-

City

-

Orcid

-

First Name

Essam Fathi

Last Name

Abd-El Galel

MiddleName

-

Affiliation

Departments of Anesthesia and Surgical Intensive Care Faculty of Medicine, Zagazig University, Egypt.

Email

-

City

-

Orcid

-

First Name

Ayat Ahmed

Last Name

Amer

MiddleName

-

Affiliation

Departments of Anesthesia and Surgical Intensive Care Faculty of Medicine, Zagazig University, Egypt.

Email

-

City

-

Orcid

-

First Name

Ahmed Abd El-Aziz

Last Name

El-Sammak

MiddleName

-

Affiliation

Departments of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt.

Email

-

City

-

Orcid

-

Volume

83

Article Issue

1

Related Issue

23025

Issue Date

2021-04-01

Receive Date

2021-04-21

Publish Date

2021-04-01

Page Start

1,302

Page End

1,311

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_165505.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=165505

Order

77

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Different Intraoperative Ventilatory Strategies for Prevention of Pulmonary Atelectasis in Obese Patients Undergoing Non-Bariatric Surgeries; Randomized Controlled Trial

Details

Type

Article

Created At

22 Jan 2023