The Effects of the Alveolar Recruitment Maneuver and Positive End-Expiratory Pressure on Arterial Oxygenation During Laparoscopic Bariatric Surgery

2006 ◽  
Vol 102 (1) ◽  
pp. 298-305 ◽  
Author(s):  
Francis X. Whalen ◽  
Ognjen Gajic ◽  
Geoffrey B. Thompson ◽  
Michael L. Kendrick ◽  
Florencia L. Que ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Recruitment Maneuver ◽  
Alveolar Recruitment ◽  
Laparoscopic Bariatric Surgery ◽  
Arterial Oxygenation ◽  
Positive End Expiratory Pressure ◽  
Alveolar Recruitment Maneuver

scholarly journals Impact of Alveolar Recruitment Maneuver in the Postoperative Period of Videolaparoscopic Bariatric Surgery

2011 ◽  
Vol 61 (2) ◽  
pp. 163-176 ◽  
Author(s):  
Paula Patelli Juliani Remístico ◽  
Sebastião Araújo ◽  
Luciana Castilho de Figueiredo ◽  
Esperidião Elias Aquim ◽  
Larissa Mottim Gomes ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Postoperative Period ◽  
Recruitment Maneuver ◽  
Alveolar Recruitment ◽  
Alveolar Recruitment Maneuver

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.

scholarly journals The Influences of three Intraoperative Ventilatory Strategies on Arterial Oxygenation in Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery

2021 ◽  
pp. 1-16
Author(s):  
Shaimaa E. Shaban ◽  
Reda S. Salama ◽  
Mohamed M. Abu Elyazed ◽  
Abdelraheem M. Dowidar
Keyword(s):  
Bariatric Surgery ◽  
Cardiac Output ◽  
Respiratory Mechanics ◽  
Recruitment Maneuver ◽  
Conventional Ventilation ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
Arterial Oxygenation ◽  
Morbid Obese ◽  
The Mean

Background: Maintaining satisfactory ventilation for obese patients undergoing bariatric surgery frequently poses a challenge for anesthetists. The optimal ventilation strategy during pneumoperitoneum remains obscure in obese patients. In this study, we investigated the effect of conventional ventilation, inverse ratio ventilation (IRV) and alveolar recruitment maneuver (RM) on arterial oxygenation, lung mechanics and hemodynamics in morbid obese patients undergoing laparoscopic bariatric surgery. Methods: 105 adult obese patients scheduled for elective laparoscopic bariatric surgery were randomly allocated into three groups: Conventional ratio ventilation (I:E ratio was 1:2, PEEP 5 cmH2O and no RM), Inverse Ratio Group (IRVG) (I:E ratio was 2:1 and PEEP 5 cmH2O and No RM ) and Recruitment Maneuver Group (RMG) ( RM was done and I:E ratio was 1:2). Arterial blood gases and respiratory mechanics were recorded after induction of anesthesia (T1), 5 minutes (T2), 30 minutes (T3), 60 minutes (T4) after the beginning of pneumoperitoneum and at the end of the surgery (T5).  Cardiac output was recorded at (T1), (T2), (T3) and (T5). Results: At T3, T4 and T5, arterial oxygen tension was higher in RMG than IRVG than CG (P ˂ 0.05). At T3, T4 and T5, the mean airway pressure and dynamic compliance (Cdyn) were significantly higher in IRVG and RMG compared with CG (P ˂ 0.05) while at those times, the mean air way pressure and Cdyn in IRVG and RMG were comparable. Cardiac output result were comparable between all groups throughout the study period (P ˃ 0.05). Conclusions: RM and IRV had provided better arterial oxygenation and respiratory mechanics compared to conventional ventilation in morbid obese patients undergoing laparoscopic bariatric surgery. However, RM had better gas exchange than IRV.

scholarly journals Analysis of the Effects of the Alveolar Recruitment Maneuver on Blood Oxygenation during Bariatric Surgery

2009 ◽  
Vol 59 (2) ◽  
pp. 177-186 ◽  
Author(s):  
Alda Paiva de Souza ◽  
Márcia Buschpigel ◽  
Ligia Andrade Silva Telles Mathias ◽  
Carlos Alberto Malheiros ◽  
Vera Lucia dos Santos Alves
Keyword(s):  
Bariatric Surgery ◽  
Recruitment Maneuver ◽  
Alveolar Recruitment ◽  
Blood Oxygenation ◽  
Alveolar Recruitment Maneuver
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