[Effectiveness of a recruitment manoeuvre and positive end-expiratory pressure on respiratory mechanics during laparoscopic bariatric surgery]. / Efficacité d'une manoeuvre de recrutement alvéolaire associée à une pression expiratoire positive sur la mécanique respiratoire en coeliochirurgie bariatrique.
Ann Fr Anesth Reanim
; 28(2): 130-4, 2009 Feb.
Article
em Fr
| MEDLINE
| ID: mdl-19232883
ABSTRACT
OBJECTIVE:
To evaluate recruitment manoeuvre (RM) efficiency associated with a 10 cmH(2)O positive end expiratory pressure (PEEP) on respiratory mechanic estimated by lung compliance (Ctp) and PEEP to ZEEP expiratory volume delta (Delta VTE) during laparoscopic bariatric surgery in patients with morbid obesity. STUDYDESIGN:
Prospective randomized study.METHODS:
Twenty-six obese patients (BMI>40 kg/m(2)) undergoing laparoscopic bariatric surgery. The recruitment group received an RM followed by a 10 cmH(2)O PEP versus only 10 cmH(2)O PEP in the control group. Ctp was measured during the intervention and functional residual capacity (FRC) was estimated measuring Delta VTE during a PEP to ZEP manoeuvre. Mann and Whitney tests as well as a t-test were used (significance p<0.05).RESULTS:
In the RM group, a significant improvement of 52+/-14 ml/cmH(2)O was noted versus a 36+/-10 ml/cmH(2)O in the PEP group (p=0,004). This improvement was transitory and no statistically significant Delta VTE difference was noted between the groups at the end of the intervention (360 [90-770]ml [MRA] and 310 [190-450]ml [PEP]).CONCLUSION:
In patients with morbid obesity undergoing laparoscopic bariatric surgery, an RM conducted prior the pneumoperitoneum temporarily improves lung mechanics but without any change of the end expiratory lung volume at the end of the surgery in comparison with PEP alone. The RM was well tolerated.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alvéolos Pulmonares
/
Gastroplastia
/
Mecânica Respiratória
/
Complacência Pulmonar
/
Respiração com Pressão Positiva
/
Laparoscopia
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Fr
Revista:
Ann Fr Anesth Reanim
Ano de publicação:
2009
Tipo de documento:
Article