Effect of lung recruitment maneuvers combined with individualized positive end-expiratory pressure on degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery
10.3760/cma.j.cn131073.20231007.00206
- VernacularTitle:肺复张联合个体化PEEP策略对腹腔镜手术老年患者术后肺不张程度的影响
- Author:
Jiwen WANG
1
;
Meng ZHUANG
;
Beiying SHAN
;
Lixue WU
;
Liangliang CAO
;
Nan DONG
;
Jiru ZHANG
Author Information
1. 徐州医科大学麻醉学院，徐州 221004
- Keywords:
Respiration, artificial;
Positive-pressure respiration;
Laparoscopy;
Pulmonary atelectasis
- From:
Chinese Journal of Anesthesiology
2024;44(2):150-154
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of lung recruitment maneuvers combined with individualized positive end-expiratory pressure(PEEP) on the degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery.Methods:One hundred and forty-three elderly patients, aged ≥65 yr, with body mass index of 18.5-30.0 kg/m 2, scheduled for elective laparoscopic surgery, were assigned to either individualized PEEP combined with recruitment maneuvers (group Ⅱ) or fixed PEEP (group Ⅰ) using a random number table method. PEEP was maintained at 6 cmH 2O starting from the beginning of procedure until the end of the procedure in group I. Individualized PEEP titration was performed after induction of anesthesia in group Ⅱ. The primary outcome measure was the 12-zone lung ultrasound score at 15 min after tracheal extubation. Other outcome measures were the occurrence of postoperative pulmonary complications within 7 days after surgery, Quality of Recovery-15 scale score on 3rd day after surgery, rate of unplanned admission to intensive care units, length of hospital stay, incidence of intraoperative hypoxemia, usage rate of intraoperative vasoactive drugs, and incidence of postoperative hypotension. Results:Compared with group Ⅰ, the lung ultrasound score, driving pressure and postoperative pulmonary complications were significantly decreased, the dynamic lung compliance was increased ( P<0.05 or 0.01), and no significant changes were found in the other parameters in group Ⅱ ( P>0.05). Conclusions:Individualized PEEP combined with recruitment maneuvers can reduce the degree of postoperative atelectasis in elderly patients undergoing laparoscopic surgery.
