Effects of two different stepwise lung recruitment maneuvers on patient hemodynamics during anesthesia for laparoscopic surgery.

Autor: Othman, Mahmoud M., farid, Sherif F., Mohamed, Ghada F., Messeha, Medhat M.
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Zdroj: Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research); 2021, Vol. 12 Issue 6, p234-244, 11p
Abstrakt: Introduction Pneumoperitonium for laparoscopic surgery usually result in decrease total respiratory compliance due to cranial shift of the diaphragm. Alveolar recuirtment was applied hopefully to minimize lung atlectasis and open collapsed alveoli to maintain arterial oxygenation. The anantomicalproximity of lungs and heart within the chest means that any increase in intrathoracic pressure could have major effect on cardiovascular functions. Aim this study was designed to investigate the effect of two individualized recruitment maneuversduring anesthesia forlaparoscopic surgery to encourage best arterial oxygenation with the least hemodynamic compromise. Participants &MethodsEighty two patients of both sex, ASA I and II who were scheduled for laparoscopic surgery in urology nephrology center - Mansoura University were included in this prospective randomized study, Patients were randomly assigned to one of two equal groups, according to computer-generated randomization sequence: group (RM TV):Recuritment maneuver with stepwise increase in tidal volume by means of 4ml/kg predicted body weight, and group (RM PEEP): Recruitment maneuver with with stepwise increase in positive end expiratory pressure from 5 cmH2o, 10 cmH2o, 15 cmH2o and 20 cmH2o. Results study showed comparable changes in haemodynamic parameters, horowitz ratio and dead space ratio between PEEP and Tidal volume group, while PEEP group showed statistically significant increase in peak airway pressure, plateau pressure, driving pressure, static and dynamic compliance. Conclusion comparable changes in haemodynamic parameters between both groups, significant improvement in oxygenation and dead space ratio occur in each group separetely. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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