Effects of Recruitment Maneuver and Positive End-Expiratory Pressure on Respiratory Mechanics and Transpulmonary Pressure During Laparoscopic Surgery

2013 ◽  
Vol 57 (6) ◽  
pp. 282-283
Author(s):  
Gilda Cinnella ◽  
Salvatore Grasso ◽  
Savino Spadaro ◽  
Michela Rauseo ◽  
Lucia Mirabella ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Respiratory Mechanics ◽  
Recruitment Maneuver ◽  
Transpulmonary Pressure ◽  
Positive End Expiratory Pressure

scholarly journals Effects of Recruitment Maneuver and Positive End-expiratory Pressure on Respiratory Mechanics and Transpulmonary Pressure during Laparoscopic Surgery

2013 ◽  
Vol 118 (1) ◽  
pp. 114-122 ◽  
Author(s):  
Gilda Cinnella ◽  
Salvatore Grasso ◽  
Savino Spadaro ◽  
Michela Rauseo ◽  
Lucia Mirabella ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Respiratory Mechanics ◽  
Recruitment Maneuver ◽  
Transpulmonary Pressure ◽  
Positive End Expiratory Pressure

scholarly journals Effect of pressure-controlled ventilation-volume guaranteed mode combined with individualized positive end-expiratory pressure on respiratory mechanics, oxygenation and lung injury in patients undergoing laparoscopic surgery in Trendelenburg position

2021 ◽  
Author(s):  
Jianli Li ◽  
Saixian Ma ◽  
Xiujie Chang ◽  
Songxu Ju ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Lung Injury ◽  
Respiratory Mechanics ◽  
Lung Mechanics ◽  
Trial Registry ◽  
Positive End Expiratory Pressure ◽  
Clinical Trial Registry ◽  
Trendelenburg Position ◽  
Pressure Controlled Ventilation ◽  
Pressure Controlled

AbstractThe study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH2O PEEP), PF group (PCV-VG plus 5cmH2O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). Pmean, Ppeak, Cdyn, PaO2/FiO2, VD/VT, A-aDO2 and Qs/Qt were recorded at T1 (15 min after the induction of anesthesia), T2 (60 min after pneumoperitoneum), and T3 (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T1 and T3. Our results showed that the Pmean was increased in VI and PI group, and the Ppeak was lower in PI group at T2. At T2 and T3, the Cdyn of PI group was higher than that in other groups, and PaO2/FiO2 was increased in PI group compared with VF and VI group. At T2 and T3, A-aDO2 of PI and PF group was reduced than that in other groups. The Qs/Qt was decreased in PI group compared with VF and VI group at T2 and T3. At T2, VD/VT in PI group was decreased than other groups. At T3, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury.Clinical Trial registry: chictr.org. identifier: ChiCTR-2100044928

scholarly journals Comparison of Positive End-Expiratory Pressure versus Tidal Volume-Induced Ventilator-Driven Alveolar Recruitment Maneuver in Robotic Prostatectomy: A Randomized Controlled Study

2021 ◽  
Vol 10 (17) ◽  
pp. 3921
Author(s):  
Kangha Jung ◽  
Sojin Kim ◽  
Byung Jun Kim ◽  
MiHye Park
Keyword(s):  
Laparoscopic Surgery ◽  
Tidal Volume ◽  
Supine Position ◽  
Recruitment Maneuver ◽  
Lung Compliance ◽  
Robotic Prostatectomy ◽  
Alveolar Recruitment ◽  
Driving Pressure ◽  
Positive End Expiratory Pressure ◽  
Alveolar Recruitment Maneuver

Background: We evaluated the pulmonary effects of two ventilator-driven alveolar recruitment maneuver (ARM) methods during laparoscopic surgery. Methods: Sixty-four patients undergoing robotic prostatectomy were randomized into two groups: incrementally increasing positive end-expiratory pressure in a stepwise manner (PEEP group) versus tidal volume (VT group). We performed each ARM after induction of anesthesia in the supine position (T1), after pneumoperitoneum in the Trendelenburg position (T2), and after peritoneum desufflation in the supine position (T3). The primary outcome was change in end-expiratory lung impedance (EELI) before and 5 min after ARM at T3, measured by electrical impedance tomography. Results: The PEEP group showed significantly higher increasing EELI 5 min after ARM than the VT group at T1 and T3 (median [IQR] 460 [180,800] vs. 200 [80,315], p = 0.002 and 280 [170,420] vs. 95 [55,175], p = 0.004, respectively; PEEP group vs. VT group). The PEEP group showed significantly higher lung compliance and lower driving pressure at T1 and T3. However, there was no significant difference in EELI change, lung compliance, or driving pressure after ARM at T2. Conclusions: The ventilator-driven ARM by the increasing PEEP method led to greater improvements in lung compliance at the end of laparoscopic surgery than the increasing VT method.

Beneficial effects of high positive end-expiratory pressure in lung respiratory mechanics during laparoscopic surgery

2009 ◽  
Vol 53 (2) ◽  
pp. 210-217 ◽  
Author(s):  
L. F. MARACAJÁ-NETO ◽  
N. VERÇOSA ◽  
A. C. RONCALLY ◽  
A. GIANNELLA ◽  
F. A. BOZZA ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Respiratory Mechanics ◽  
Positive End Expiratory Pressure ◽  
Beneficial Effects

scholarly journals Comparison of the effects of different positive end-expiratory pressure levels on respiratory mechanics and oxygenation in laparoscopic surgery

Medicine ◽  
2018 ◽  
Vol 97 (48) ◽  
pp. e13396
Author(s):  
Min Wang ◽  
Nan Geng ◽  
Ya Gao ◽  
Yan Zhang ◽  
Yingbin Wang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Respiratory Mechanics ◽  
Positive End Expiratory Pressure

Intraoperative Recruitment Maneuver Reverses Detrimental Pneumoperitoneum-induced Respiratory Effects in Healthy Weight and Obese Patients Undergoing Laparoscopy

2010 ◽  
Vol 113 (6) ◽  
pp. 1310-1319 ◽  
Author(s):  
Emmanuel Futier ◽  
Jean-Michel Constantin ◽  
Paolo Pelosi ◽  
Gerald Chanques ◽  
Fabrice Kwiatkoskwi ◽  
...  
Keyword(s):  
Dead Space ◽  
Respiratory Mechanics ◽  
Recruitment Maneuver ◽  
Obese Patients ◽  
Healthy Weight ◽  
Positive End Expiratory Pressure ◽  
Trendelenburg Position ◽  
Before And After ◽  
Induced Changes ◽  
Reverse Trendelenburg Position

Background Pulmonary function is impaired during pneumoperitoneum mainly as a result of atelectasis formation. We studied the effects of 10 cm H2O of positive end-expiratory pressure (PEEP) and PEEP followed by a recruitment maneuver (PEEP+RM) on end-expiratory lung volume (EELV), oxygenation and respiratory mechanics in patients undergoing laparoscopic surgery. Methods Sixty consecutive adult patients (30 obese, 30 healthy weight) in reverse Trendelenburg position were prospectively studied. EELV, static elastance of the respiratory system, dead space, and gas exchange were measured before and after pneumoperitoneum insufflation with zero end-expiratory pressure, with PEEP alone, and with PEEP+RM. Results are presented as mean ± SD. Results Pneumoperitoneum reduced EELV (healthy weight, 1195 ± 405 vs. 1724 ± 774 ml; obese, 751 ± 258 vs. 886 ± 284 ml) and worsened static elastance and dead space in both groups (in all P < 0.01 vs. zero-end expiratory pressure before pneumoperitoneum) whereas oxygenation was unaffected. PEEP increased EELV (healthy weight, 570 ml, P < 0.01; obese, 364 ml, P < 0.01) with no effect on oxygenation. Compared with PEEP alone, EELV and static elastance were further improved after RM in both groups (P < 0.05), as was oxygenation (P < 0.01). In all patients, RM-induced change in EELV was 16% (P = 0.04). These improvements were maintained 30 min after RM. RM-induced changes in EELV correlated with change in oxygenation (r = 0.42, P < 0.01). Conclusion RM combined with 10 cm H2O of PEEP improved EELV, respiratory mechanics, and oxygenation during pneumoperitoneum whereas PEEP alone did not.

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