Reference : Recruitment of lung volume during surgery neither affects the postoperative spirometr...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
http://hdl.handle.net/2268/173174
Recruitment of lung volume during surgery neither affects the postoperative spirometry nor the risk of hypoxaemia after laparoscopic gastric bypass in morbidly obese patients: a randomized controlled study.
English
DEFRESNE, Aline mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
HANS, Grégory mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
GOFFIN, Pierre mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
BINDELLE, Simon mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
AMABILI, Philippe mailto [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
De Roover, Arnaud mailto [Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques >]
Poirrier, Robert mailto [Université de Liège - ULiège > Département des sciences cliniques > Médecine du sommeil >]
Brichant, Jean-François mailto [Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation >]
JORIS, Jean mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
2014
British Journal of Anaesthesia
113
3
501-7
Yes (verified by ORBi)
International
0007-0912
1471-6771
United Kingdom
[en] anaesthesia ; functional residual capacity ; obesity ; pulmonary ventilation
[en] BACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation. Whether these benefits persist after operation remains unknown. We tested the hypothesis that intraoperative RMs associated with PEEP improve postoperative spirometry including FRC and reduce the incidence of postoperative hypoxaemia in morbidly obese (MO) patients undergoing laparoscopic gastric bypass. METHODS: After IRB approval and informed consent, 50 MO patients undergoing laparoscopic gastric bypass under volume-controlled ventilation (tidal volume 6 ml kg(-1) of IBW) were randomly ventilated with either 10 cm H(2)O PEEP or with 10 cm H(2)O PEEP and one RM carried out after induction of pneumoperitoneum, and another after exsufflation. Anaesthesia and analgesia were standardized. Spirometry was assessed before operation and 24 h after surgery. Postoperative oxygenation and the apnoea-hypopnoea index (AHI) were recorded during the first postoperative night. RESULTS: Age, BMI, and STOP BANG score were similar in both groups. FRC decrease after surgery was minimal [0.15 (0.14) litre in control and 0.38 (0.19) litre in the RM group] and similar between the groups (P=0.35). FVC, FEV1, mean [Formula: see text], percentage of time spent with [Formula: see text] below 90%, and AHI did not differ significantly between the groups. CONCLUSIONS: This study demonstrates that when added to a protective mechanical ventilation combining low tidal volume and high PEEP, two RMs do not improve postoperative lung function including FRC, arterial oxygenation, and the incidence of obstructive apnoea in MO patients after laparoscopic upper abdominal surgery. CLINICAL TRIAL REGISTRATION: EudraCT 2011-000999-33.
http://hdl.handle.net/2268/173174
10.1093/bja/aeu101
(c) The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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