Positive End-expiratory Pressure and Distribution of Ventilation in Pneumoperitoneum Combined with Steep Trendelenburg Position

Conclusions Application of a PEEP of 15 cm H2O resulted in more homogeneous ventilation and favorable physiologic effects during robot-assisted laparoscopic prostatectomy but did not improve postoperative lung function.Editor ’s PerspectiveWhat We Already Know about This TopicPneumoperitoneum and steep Trendelenburg during laparoscopic prostatectomy shift the diaphragm cephalad and cause atelectasis in the dorsal lungsThe ability of positive end-expiratory pressure to mitigate these effects remains controversialWhat This Article Tells Us That Is NewIn patients undergoing robot-assisted laparoscopic prostatectomy, 15 but not 5 cm H2O of positive end-expiratory pressure increased ventilation in the dorsal parts of the lung, resulting in more normal lung mechanics and gas exchangeHigh positive end-expiratory pressure did not improve postoperative lung function
Source: Anesthesiology - Category: Anesthesiology Source Type: research