Low Tidal Volume Positive End-Expiratory Pressure versus High Tidal Volume Zero-Positive End-Expiratory Pressure and Postoperative Pulmonary Functions in Robot-Assisted Laparoscopic Radical Prostatectomy

Haliloglu M., BİLGİLİ B., Ozdemir M., UMUROĞLU T., Bakan N.

MEDICAL PRINCIPLES AND PRACTICE, cilt.26, sa.6, ss.573-578, 2017 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 6
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1159/000484693
  • Dergi Adı: MEDICAL PRINCIPLES AND PRACTICE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.573-578
  • Anahtar Kelimeler: Pneumoperitoneum, Steep Trendelenburg, Low tidal volume, Positive end-expiratory pressure, Pulmonary function, Robot-assisted surgery, STEEP TRENDELENBURG POSITION, LUNG-PROTECTIVE VENTILATION, CONTROLLED-TRIAL, SURGERY, PNEUMOPERITONEUM, COMPLICATIONS, OUTCOMES, UROLOGY
  • Marmara Üniversitesi Adresli: Evet

Özet

Objective: The aim was to compare the effects of low tidal volume (V-T) and moderate positive end-expiratory pressure (PEEP) with high V-T and zero end-expiratory pressure (ZEEP) on postoperative pulmonary functions and oxygenation in patients undergoing robot-assisted laparoscopic radical prostatectomy. Subjects and Methods: Forty-four patients were randomized into low V-T-PEEP and high V-T-ZEEP groups. The patients were ventilated with a V-T of 6 mL/kg and 8 cm H2O PEEP in the low V-T-PEEP group and a V-T of 10 mL/kg and 0 cm H2O PEEP in the high V-T-ZEEP group. Preoperative and postoperative spirometric measurements were done and chest X-rays were evaluated using the radiological atelectasis score (RAS). p < 0.05 was considered statistically significant. Results: The intraoperative and postoperative arterial partial pressure of oxygen and arterial oxygen saturation values were significantly higher in the low V-T-PEEP group than in the high V-T-ZEEP group. At all times, the arterial-to-alveolar oxygenation gradients were significantly lower in the low V-T-PEEP group than in the high V-T-ZEEP group. Preoperative RAS were similar in both groups, but the postoperative RAS was significantly lower in the low V-T-PEEP group (p < 0.001). Forced vital capacity, forced expiratory volume in 1 s, and peak expiratory flow rate recorded postoperatively were significantly lower in the high V-T-ZEEP group (p < 0.001). Conclusions: Postoperative pulmonary functions were less impaired in patients ventilated with a V-T of 6 mL/kg and 8 cm H2O PEEP than in patients ventilated with a V-T of 10 mL/kg and ZEEP. (C) 2017 The Author(s) Published by S. Karger AG, Basel