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

Souza, Alda Paiva de; Buschpigel, Márcia; Mathias, L; Malheiros, Carlos Alberto; Alves, Vera Lúcia dos Santos

doi:10.1590/s0034-70942009000200005

Cited by 14 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study by Souza et al [23] compared the use of RM with progressive PEEP of 10, 15 and 20 cmH 2 O versus CPAP 30 cmH 2 O and found that the RM with progressive PEEP obtained lower mean airway pressures, p = 0.0003, (MD -7.40, 95% CI − 11.45 to − 3.35; participants = 33; studies = 1; I 2 = 0%).…”

Section: Alveolar Recruitment Maneuver Plus Peep 10 15 and 20 Versusmentioning

confidence: 99%

“…Three studies [21,23,24] compared alveolar recruitment maneuvers (RM) versus PEEP to evaluate intra operative gas exchange, with the mean PaO 2 /FiO 2 ratio found to be greater in the groups that underwent RM, p = 0.03, (MD 79.93, 95% CI 8.83 to 151.04; participants = 121; studies = 5; I 2 = 80%,). Figure 3 shows the comparison of three different studies, separate in four subgroups, where the best results were in favor of RM Fig.…”

Section: Effects Of Interventions Alveolar Recruitment Maneuvers Versmentioning

confidence: 99%

“…Three studies [23][24][25] evaluated mean airway pressures by comparing RM with progressive PEEP of 10, 15 and 20 cmH 2 O versus Peep of 4 or 5 cmH 2 O only and found that the use of PEEP without RM led to lower airway pressure, p < 0.001 (MD 9.29, 95% CI 5.05 to 13.53; participants = 98; studies = 4; I 2 = 89%). Figure 4 shows the comparison of three different studies, separate in two subgroups, where the best results were in favor of PEEP when airway pressure was measured.…”

Section: Effects Of Interventions Alveolar Recruitment Maneuvers Versmentioning

confidence: 99%

See 2 more Smart Citations

Intraoperative ventilation strategies for obese patients undergoing bariatric surgery: systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background: Obesity is a global epidemic, and it is widely known that increased Body mass index (BMI) is associated with alterations in respiratory mechanics. Bariatric surgery is established as an effective treatment for this condition. Objective: To assess the safety and effectiveness of different ventilation strategies in obese patients undergoing bariatric surgery. Methods: A systematic review of randomized clinical trials aimed at evaluating ventilation strategies for obese patients was carried out. Primary outcomes: in-hospital mortality, adequacy of gas exchange, and respiration mechanics alterations. Results: Fourteen clinical trials with 574 participants were included. When recruitment maneuvers (RM) vs Positive endexpiratory pressure (PEEP) were compared, RM resulted in better oxygenation p = 0.03 (MD 79.93), higher plateau pressure p < 0.00001 (MD 7.30), higher mean airway pressure p < 0.00001 (MD 6.61), and higher compliance p < 0.00001 (MD 21.00); when comparing RM + Zero end-expiratory pressure (ZEEP) vs RM + PEEP 5 or 10 cmH2O, RM associated with PEEP led to better oxygenation p = 0.001 (MD 167.00); when comparing Continuous Positive Airway Pressure (CPAP) 40 cmH2O + PEEP 10 cmH2O vs CPAP 40 cmH2O + PEEP 15 cmH2O, CPAP 40 + PEEP 15 achieved better gas exchange p = 0.003 (MD 36.00) and compliance p = 0.0003 (MD 3.00). Conclusion: There is some evidence that the alveolar recruitment maneuvers associated with PEEP lead to better oxygenation and higher compliance. There is no evidence of differences between pressure control ventilation (PCV) and Volume control ventilation (VCV).

show abstract

Section: Alveolar Recruitment Maneuver Plus Peep 10 15 and 20 Versusmentioning

confidence: 99%

Section: Effects Of Interventions Alveolar Recruitment Maneuvers Versmentioning

confidence: 99%

Section: Effects Of Interventions Alveolar Recruitment Maneuvers Versmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative ventilation strategies for obese patients undergoing bariatric surgery: systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Still, the literature suggests that it should be initiated immediately after or up to the 30th minute following induction and then continued throughout the operation. 2,33 In our study, the mean duration of the surgery was 55 6 4.59 minutes for each rabbit. PEEP was initiated at induction and was continued throughout the surgery.…”

Section: Discussionmentioning

confidence: 76%

Effect of Intraoperative PEEP Application on Colonic Anastomoses Healing: An Experimental Animal Study

Türkoğlu

Bostancı

Bilgili

et al. 2016

International Surgery

View full text Add to dashboard Cite

This study aimed to assess the effect of intraoperative positive end-expiratory pressure (PEEP) intervention on the healing of colonic anastomoses in rabbits. A total of 32 New Zealand type male rabbits were divided into 2 groups of 16 animals each. Following ventilation with tracheostomy, colonic resection and anastomosis were performed in both groups. Although 10 cm of H 2 O PEEP level was applied in group 1 (PEEP), group 2 [zero end-expiratory pressure (ZEEP)] was ventilated without PEEP throughout the surgery. Half of both the PEEP and ZEEP group animals were killed on the third postoperative day, whereas the remaining half were killed on the seventh. Anastomotic bursting pressures, the tissue concentrations in hydroxyproline, and histologic assessments were

show abstract

“…This relationship was explored in the study by Souza et al, (25) which demonstrated that the technique of ARM with sudden increases in PEEP to 30cmH 2 O resulted in the best response in the PaO 2 /FiO 2 relationship compared to the gradual increase of PEEP. However, Futier et al compared a ventilatory strategy associated with the use of ARM in healthy and obese subjects undergoing abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

Alveolar recruitment maneuver and perioperative ventilatory support in obese patients undergoing abdominal surgery

Júnior¹,

Rezende²,

Forgiarini³

2013

Revista Brasileira De Terapia Intensiva

View full text Add to dashboard Cite

The development of abdominal surgery represents an alternative therapy for the morbidly obese; however, patients undergoing this surgical procedure often experience postoperative pulmonary complications. The use of alveolar recruitment maneuvers and/or perioperative ventilatory strategies is a possible alternative to reduce these complications, focusing on the reduction of postoperative pulmonary complications. In this review, the benefits of perioperative ventilatory strategies and the implementation of alveolar recruitment maneuvers in obese patients undergoing abdominal surgery are described.

show abstract

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

Abstract: Alveolar recruitment maneuver with sudden increase of PEEP to 30 cmH2O showed a better response of the PaO2/FiO2 ratio.

Cited by 14 publications

References 23 publications

Intraoperative ventilation strategies for obese patients undergoing bariatric surgery: systematic review and meta-analysis

Intraoperative ventilation strategies for obese patients undergoing bariatric surgery: systematic review and meta-analysis

Effect of Intraoperative PEEP Application on Colonic Anastomoses Healing: An Experimental Animal Study

Alveolar recruitment maneuver and perioperative ventilatory support in obese patients undergoing abdominal surgery

Contact Info

Product

Resources

About