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187200

The Effects of Alveolar Recruitment Maneuver Versus Low Tidal Volume Ventilation on Oxygenation and Lung Mechanics in Patients Undergoing Laparoscopic Surgeries: A Prospective Ra

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Last updated: 28 Dec 2024

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Abstract

Different ventilatory strategies have been studied to improve gas exchange and compliance of the lungs in patients undergoing laparoscopic surgeries. This study aimed to test the impact of alveolar recruitment maneuver versus low tidal volume ventilation combine with PEEP on arterial oxygenation and lung mechanics in patients undergoing laparoscopic surgeries. Sixty patients were randomly allocated into three equal groups according to the type of ventilation strategy used during surgery. In the control group, patients received conventional volume-controlled ventilation with 10ml/Kg VT and zero PEEP (ZEEP). In group II ( LTV ), patients received low tidal volume ventilation in the form of 6-8 ml/Kg VT and PEEP 5cmH2O. In group III (REC), patients received 6-8 ml/Kg and recruitment maneuvers were done every 10 minutes after intubation till extubation by manual inflation to 40cmH2O peak inspiratory pressure for 15 seconds then the patient was placed back to the same ventilation settings with PEEP of 5cmH2O. The primary outcome is the dynamic compliance. The secondary outcome measures include PaO2, PH, PCO2, SPO2, HR and MAP. Demographic characteristics and duration of surgery were comparable among groups. PaO2 was highly significantly increased (p <0.001) in the recruitment group (Rec) compared to the conventional group (C) and low tidal volume ventilation group (LTV). There was significant increase in dynamic compliance in the recruitment group (REC) compared with the conventional (C) and low tidal volume (LTV) groups. SpO2, PaCO2 showed a highly statistical significance differences between the three ventilated groups. There were no statistically significant differences between the three ventilated groups in terms of PH. There were no statistically significant differences between the three ventilated groups in terms of Mean arterial blood pressure and HR. repeated recruitment maneuvers combined with 5 cm H2O of PEEP increased respiratory system compliance and PaO2 in patients undergoing laparoscopic surgeries without hemodynamics adverse effects.

DOI

10.21608/bjas.2019.187200

Keywords

Recruitment maneuver, Low tidal volume ventilation, Oxygenation, Compliance

Authors

First Name

M.B.

Last Name

Hassanein

MiddleName

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Affiliation

Anaesthia Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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Orcid

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First Name

A.M.

Last Name

Abdel-Hamid

MiddleName

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Affiliation

Anaesthia Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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Orcid

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First Name

A.A.

Last Name

Mosaad

MiddleName

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Affiliation

Anaesthia Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

Email

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Orcid

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First Name

N.S.

Last Name

Ibrahim

MiddleName

-

Affiliation

Anaesthia Dept., Faculty of Medicine, Benha Univ., Benha, Egypt

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City

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Orcid

-

Volume

4

Article Issue

2

Related Issue

23363

Issue Date

2019-03-01

Receive Date

2019-08-03

Publish Date

2019-03-01

Page Start

135

Page End

142

Print ISSN

2356-9751

Online ISSN

2356-976X

Link

https://bjas.journals.ekb.eg/article_187200.html

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https://bjas.journals.ekb.eg/service?article_code=187200

Order

20

Type

Original Research Papers

Type Code

1,647

Publication Type

Journal

Publication Title

Benha Journal of Applied Sciences

Publication Link

https://bjas.journals.ekb.eg/

MainTitle

The Effects of Alveolar Recruitment Maneuver Versus Low Tidal Volume Ventilation on Oxygenation and Lung Mechanics in Patients Undergoing Laparoscopic Surgeries: A Prospective Randomized Controlled Study.

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Article

Created At

23 Jan 2023