Effect of Lung Recruitment Maneuvers on Reduction of Atelectasis Determined by Lung Ultrasound in Patients More Than 60 Years Old Undergoing Laparoscopic Surgery for Colorectal Carcinoma: A Prospective Study at a Single Center

Yang, Yujiao; Yuan, Geng; Zhang, Donghang; Wan, Yong; Wang, Rurong

doi:10.12659/msm.926748

Cited by 12 publications

(39 citation statements)

References 31 publications

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“…The reasons for the 183 exclusions were as follows: 105 were non-RCTs, 7 were non-adult studies, 18 reported open abdominal surgery, 13 did not report PPCs, 33 were animal experiments and 7 did not compare recruitment maneuvers to conventional mechanical ventilation. Finally, 17 RCTs with a total of 3480 patients were examined [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. The details of the included studies are presented in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Due to the completeness of the outcome data and lack of selective reporting, the risks of attrition bias and reporting bias were likewise evaluated as low. Five trials did not provide information on allocation concealment [ 18 , 26 , 28 , 31 , 32 ]. Twelve studies did not report the blinding of the outcome evaluators [ 15 , 18 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five trials did not provide information on allocation concealment [ 18 , 26 , 28 , 31 , 32 ]. Twelve studies did not report the blinding of the outcome evaluators [ 15 , 18 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Seven studies showed a high risk of “other bias” owing to the small sample sizes [ 16 , 18 , 24 , 26 , 28 , 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies did not report the blinding of the outcome evaluators [ 15 , 18 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Seven studies showed a high risk of “other bias” owing to the small sample sizes [ 16 , 18 , 24 , 26 , 28 , 30 , 31 ]. We did not detect publication bias for each index using Begg’s test and Egger’s test with Stata (version 17.0, StataCorp, College Station, TX, USA).…”

Section: Resultsmentioning

confidence: 99%

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Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Pei

Wei

Yang

et al. 2022

JCM

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Background: Lung-protective ventilation strategies are recommended for patients undergoing mechanical ventilation. However, there are currently no guidelines to follow regarding recruitment maneuvers (RMs). We attempted to identify the effects of RMs on patients undergoing laparoscopic abdominal surgery. Methods: We searched for randomized controlled trials (RCTs) in PubMed, the Cochrane Library databases, Embase, Web of Science and the ClinicalTrials.gov registry for trials published up to December 2021. The primary outcome was postoperative pulmonary complications (PPCs). The secondary outcomes consisted of the static lung compliance, driving pressure (DP), intraoperative oxygenation index (OI), OI in the post-anesthesia care unit (PACU), mean arterial pressure (MAP) and heart rate (HR). Seventeen RCTs with a total of 3480 patients were examined. Results: Patients who received RMs showed a considerable reduction in PPCs (risk ratio (RR) = 0.70; 95% confidence interval (CI): 0.62 to 0.79; p < 0.01), lower DP (weighted mean difference (WMD) = −3.96; 95% CI: −5.97 to −1.95; p < 0.01), elevated static lung compliance (WMD = 10.42; 95% CI: 6.13 to 14.71; p < 0.01) and improved OI (intraoperative: WMD = 53.54; 95% CI: 21.77 to 85.31; p < 0.01; PACU: WMD = 59.40; 95% CI: 39.10 to 79.69; p < 0.01) without substantial changes in MAP (WMD = −0.16; 95% CI −1.35 to 1.03; p > 0.05) and HR (WMD = −1.10; 95% CI: −2.29 to 0.10; p > 0.05). Conclusions: Recruitment maneuvers reduce postoperative pulmonary complications and improve respiratory mechanics and oxygenation in patients undergoing laparoscopic abdominal surgery. More data are needed to elucidate the effect of recruitment maneuver on the circulatory system.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Pei

Wei

Yang

et al. 2022

JCM

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“…The sample size was calculated using the data from the previous studies. Yang et al found that the frequency of atelectasis after a lung recruitment maneuver was 50%, compared with 95% in adults after laparoscopic colorectal surgery who did not receive a recruitment maneuver [21]. The sensitivity of lung ultrasound to detect atelectasis is 88% [19].…”

Section: Sample Size Estimationmentioning

confidence: 99%

The effect of ultrasound-guided lung recruitment maneuvers on atelectasis in lung-healthy patients undergoing laparoscopic gynecologic surgery: a randomized controlled trial

et al. 2022

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Background Atelectasis is the primary cause of hypoxemia during general anesthesia. This study aimed to evaluate the impact of the combination of recruitment maneuvers (RM) and positive end-expiratory pressure (PEEP) on the incidence of atelectasis in adult women undergoing gynecologic laparoscopic surgery using pulmonary ultrasound. Methods In this study, 42 patients with healthy lungs undergoing laparoscopic gynecologic surgery were randomly divided into the recruitment maneuver group (RM group; 6 cm H2O PEEP and RM) or the control group (C group; 6 cm H2O PEEP and no RM), 21 patients in each group. Volume-controlled ventilation was used in all selected patients, with a tidal volume of 6–8 mL·kg−1 of ideal body weight. When atelectasis was detected, patients in the RM group received ultrasound-guided RM, while those in the C group received no intervention. The incidence and severity of atelectasis were determined using lung ultrasound scores. Results A total of 41 patients were investigated. The incidence of atelectasis was lower in the RM group (40%) than in the C group (80%) 15 min after arrival in the post-anesthesia care unit (PACU). Meanwhile, lung ultrasound scores (LUSs) were lower in the RM group compared to the C group. In addition, the differences in the LUS between the two groups were mainly due to the differences in lung ultrasound scores in the posterior regions. However, this difference did not persist after 24 h of surgery. Conclusions In conclusion, the combination of RM and PEEP could reduce the incidence of atelectasis in patients with healthy lungs 15 min after arrival at the PACU; however, it disappeared within 24 h after surgery. Trial registration (Prospectively registered): ChiCTR2000033529. Registered on 4/6/2020.

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Effect of ultrasound-guided recruitment maneuver on atelectasis: a systematic review and meta-analysis of randomized controlled trials

Xu,

Han,

Zhuang

et al. 2024

APS

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To summarize the existing evidence on the effects of ultrasound-guided recruitment maneuver (RM) during perioperative period on atelectasis, oxygenation and other clinical outcomes in adult patients undergoing abdominal surgery. In this systematic review and meta-analysis, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and WanFang databases were searched from inception to May 2023 for relevant randomized controlled trials (RCTs) comparing the perioperative use of ultrasound-guided RM with a control group in adult patients undergoing abdominal surgery. The primary outcome was the incidence of early postoperative atelectasis (within 24 h after surgery). A total of 12 RCTs with 895 patients were included. The ultrasound-guided RM significantly reduced the incidence of postoperative atelectasis (RR [risk ratio]: 0.44, 95% CI [confidence interval]: 0.34 to 0.57, P < 0.001), with a median fragility index of 4. Prespecified subgroup analyses demonstrated the consistent findings. Additionally, ultrasound-guided RM could decrease postoperative lung ultrasound score (MD [mean difference]: − 3.02, 95% CI: − 3.98 to − 2.06, P < 0.001), reduce the incidence of postoperative hypoxemia (RR: 0.32, 95% CI: 0.18 to 0.56, P < 0.001), improve postoperative oxygenation index (MD: 45.23 mmHg, 95% CI: 26.54 to 63.92 mmHg, P < 0.001), and shorten post-anesthesia care unit (MD: − 1.89 min, 95% CI: − 3.14 to − 0.63 min, P = 0.003) and hospital length of stay (MD: − 0.17 days, 95% CI: − 0.30 to − 0.03 days, P = 0.02). However, there was no significant difference in the incidence of atelectasis at the end of surgery between two groups (RR: 0.99, 95% CI: 0.86 to 1.14, P = 0.89). The use of ultrasound-guided RM perioperatively reduced the risk of atelectasis and improve oxygenation after abdominal surgery. Strategies to reduce the development of perioperative atelectasis are presented to highlight areas for future research.

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Effect of Lung Recruitment Maneuvers on Reduction of Atelectasis Determined by Lung Ultrasound in Patients More Than 60 Years Old Undergoing Laparoscopic Surgery for Colorectal Carcinoma: A Prospective Study at a Single Center

Cited by 12 publications

References 31 publications

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

The effect of ultrasound-guided lung recruitment maneuvers on atelectasis in lung-healthy patients undergoing laparoscopic gynecologic surgery: a randomized controlled trial

Effect of ultrasound-guided recruitment maneuver on atelectasis: a systematic review and meta-analysis of randomized controlled trials

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