Effects of intra-operative positive end-expiratory pressure setting guided by oesophageal pressure measurement on oxygenation and respiratory mechanics during laparoscopic gynaecological surgery: A randomised controlled trial

BACKGROUND The creation of pneumoperitoneum during laparoscopic surgery can lead to adverse effects on the respiratory system. Positive end-expiratory pressure (PEEP) plays an important role in mechanical ventilation during laparoscopic surgery. OBJECTIVE To evaluate whether PEEP setting guided by oesophageal pressure (Poeso) measurement would affect oxygenation and respiratory mechanics during laparoscopic gynaecological surgery. DESIGN A randomised controlled study. SETTING A single-centre trial from March 2018 to June 2018. PATIENTS Forty-four adult patients undergoing laparoscopic gynaecological surgery with anticipated duration of surgery more than 2 h. INTERVENTION PEEP set according to Poeso measurement (intervention group) versus PEEP constantly set at 5 cmH2O (control group). MAIN OUTCOME MEASURES Gas exchange and respiratory mechanics after induction and intubation (T0) and at 15 and 60 min after initiation of pneumoperitoneum (T1 and T2, respectively). RESULTS PEEP during pneumoperitoneum was significantly higher in the intervention group than in the control group (T1, 12.5 ± 1.9 vs. 5.0 ± 0.0 cmH2O and T2, 12.4 ± 1.9 vs. 5.0 ± 0.0 cmH2O, both P 
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Ventilation Source Type: research