Intraabdominal Pressure Targeted Positive End-expiratory Pressure during Laparoscopic Surgery An Open-label, Nonrandomized, Crossover, Clinical Trial

Conclusions Transpulmonary driving pressure rises with an increase in intraabdominal pressure, an effect that can be counterbalanced by targeted PEEP. Future studies have to elucidate which combination of PEEP and intraabdominal pressure is best in term of clinical outcomes.Editor ’s PerspectiveWhat We Already Know about This TopicTranspulmonary driving pressure (ratio of tidal volume to respiratory system compliance) increases with increased intraabdominal pressure during laparoscopic surgery. High transpulmonary driving pressure during laparoscopic surgery is associated with increased risk of postoperative pulmonary complications.Intraoperative positive end-expiratory pressure prevents atelectasis, but may also cause overdistension.What This Article Tells Us That Is NewThis single-center study found that titrating intraoperative positive end-expiratory pressure in relation to observed intraabdominal pressure may counterbalance pneumoperitoneum-related rises in transpulmonary driving pressure during laparoscopic cholecystectomies.
Source: Anesthesiology - Category: Anesthesiology Source Type: research