Comparison of low and high positive end-expiratory pressure during low tidal volume ventilation in robotic gynaecological surgical patients using electrical impedance tomography: A randomised controlled trial
BACKGROUND
The appropriate level of positive end-expiratory pressure (PEEP) during intra-operative mechanical ventilation remains unclear.
OBJECTIVE
The aim of this study was to investigate the effects of different levels of PEEP with low tidal volume (low-VT) ventilation in a steep Trendelenburg position (30°) and pneumoperitoneum on oxygenation, respiratory mechanics and ventilation distribution using electrical impedance tomography.
DESIGN
A randomised controlled trial.
SETTING
Single university secondary care centre, conducted from January 2017 to December 2017.
PATIENTS
Forty female patients, aged 20 to 60 years, and of American Society of Anesthesiologists’ (ASA) physical status 1 or 2, undergoing elective robotic gynaecological surgery were included.
INTERVENTION
Forty patients were allocated randomly to a PEEP4 (PEEP 4 cmH2O) group or a PEEP8 (PEEP 8 cmH2O) group.
MAIN OUTCOME MEASURES
The primary outcomes were respiratory mechanics. The secondary outcomes included changes in ventilation distribution across the ventral and dorsal regions of interest and postoperative pulmonary complications (PPCs) using a modified clinical pulmonary infection score.
RESULTS
There was no difference in PaO2 at any time point. The peak inspiratory pressure (PIP) and mean airway pressure (MPAW) of the PEEP4 group were lower than those of the PEEP8 group (P
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Ventilation Source Type: research