Comparative Study between Intra - Operative Ventilatory Techniques to Prevent Postoperative Pulmonary Complications in Obese Patients Undergoing Laparoscopic Surgery

Allah, Doaa M Awad; Kady, Galal A El; Kaschef, Nevine A; Khalaf, K M; Mohamed, Marwa Mamdouh

doi:10.12816/0045042

Cited by 1 publication

(5 citation statements)

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“…There was significant difference between the studied groups as regards oxygen saturation as the fourth group had the highest oxygen saturation at T3, T4, T5, T6, and T7. Our results are in agreement with the results of El-Kady et al (10) . The current study revealed that there was high significant difference between the studied groups as regard length of stay in PACU, as the 4 th group had the shortest stay in PACU.…”

Section: Discussionsupporting

confidence: 94%

“…Only two cases in group four developed lamellar and plate atelectasis as was proved by the postoperative CT scan. Our results agree with the study of El Kady et al (10) who demonstrated that pressure control ventilation group showed the highest number of both lobar and segmental atelectasis followed by volume control ventilation group, which showed also a high number of segmental atelectasis. Miles (23) reported similar results and concluded that the application of "PEEP" (10 cm H2O) in morbidly obese patients was very effective in preventing atelectasis during the induction of general anesthesia.…”

Section: Discussionsupporting

confidence: 93%

“…These results are consistent with the results of Souza et al (19) who compared alveolar recruitment maneuver "RM" versus positive end expiratory pressure "PEEP" to evaluate intraoperative gas exchange, with the mean PaO 2 /FiO 2 ratio found to be greater in the groups that underwent RM. Also, our results consistent with Elkady et al (10) stated that regarding the value of PaO 2 /FiO 2 , there was significant difference between them as regards intra-operative and postoperative values as the 4 th group has the highest PaO 2 /FiO 2 ratio.…”

Section: Discussionsupporting

confidence: 91%

“…The pathophysiological changes induced by obesity make these patients prone to peri-operative complications especially pulmonary complications, which are the main cause of overall peri-operative morbidity and mortality following general anesthesia. Reduction of these complications would improve the quality of medical care and decrease hospital stay and costs (9,10) . Different strategies have been investigated to re-expand collapsed lung during general anesthesia to optimize oxygenation and to improve respiratory mechanics (11) .…”

Section: Discussionmentioning

confidence: 99%

“…It was calculated according to arterial partial pressure of oxygen/fraction inspired oxygen (PaO 2 /FiO 2 ratio) in previous study (10) . It was calculated by Open-Epi program to be 92 patients (23 patients in each group) with CI 95% and power of the test 80%.…”

Section: Sample Size Calculationmentioning

confidence: 99%

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Different Intraoperative Ventilatory Strategies for Prevention of Pulmonary Atelectasis in Obese Patients Undergoing Non-Bariatric Surgeries; Randomized Controlled Trial

El-Fattah

Faried

Galel

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Upper abdominal surgeries have been reported to be associated with an increased incidence of postoperative atelectasis. Preventing atelectasis is important for all patients but is more important when caring for obese patients. Objectives: To determine which of the following ventilatory strategies is better in prevention of pulmonary atelectasis in obese patients undergoing non-bariatric surgery: Volume control ventilation "VC", Pressure control Ventilation "PC", Volume control ventilation + Positive End Expiratory Pressure "PEEP", Volume control ventilation + Positive End Expiratory Pressure "PEEP" + lung recruitment maneuver. Patients and methods: A randomized-controlled trial study was carried out in the operating room (OR) in Zagazig University Hospital including 92 patients. Patients were randomly allocated into four groups. G1: Volume control ventilation "VC", G2: Pressure control Ventilation "PC", G3: Volume control ventilation + Positive End Expiratory Pressure "PEEP", G4: as in G3 + lung recruitment maneuver. Results: There was significant difference between the studied groups as regards PaO 2 /FiO 2 ratio as the 4 th group was highly significant. There was also significant difference between the studied groups as regards atelectasis score with the least atelectasis score in group 4. There was a significant difference in group 4 than the other groups as regards length of stay in PACU, and need for 100% Fio2 in PACU. Finally, there was a significant difference between the studied groups as regards postoperative pulmonary complications with the 4 th group has the least postoperative complication. Conclusion:Our results suggest that volume control ventilation + Positive End Expiratory Pressure "PEEP" + lung recruitment maneuver had beneficial effects on oxygenation continued into the early recovery period and decrease pulmonary complications in the early post-operative period in obese patients undergoing non-bariatric upper abdominal surgeries.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%