دورية أكاديمية
Comparison of lung aeration loss in open abdominal oncologic surgeries after ventilation with electrical impedance tomography-guided PEEP versus conventional PEEP: a pilot feasibility study
| العنوان: | Comparison of lung aeration loss in open abdominal oncologic surgeries after ventilation with electrical impedance tomography-guided PEEP versus conventional PEEP: a pilot feasibility study |
|---|---|
| المؤلفون: | A. R. Karthik, Nishkarsh Gupta, Rakesh Garg, Sachidanand Jee Bharati, M. D. Ray, Vijay Hadda, Sourabh Pahuja, Seema Mishra, Sushma Bhatnagar, Vinod Kumar |
| المصدر: | Korean Journal of Anesthesiology, Vol 77, Iss 3, Pp 353-363 (2024) |
| بيانات النشر: | Korean Society of Anesthesiologists, 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Anesthesiology |
| مصطلحات موضوعية: | electric impedance, feasibility studies, general anesthesia, laparotomy, lung compliance, positive-pressure respiration, pulmonary atelectasis, ultrasonography, surgical oncology, tomography, Anesthesiology, RD78.3-87.3 |
| الوصف: | Background Existing literature lacks high-quality evidence regarding the ideal intraoperative positive end-expiratory pressure (PEEP) to minimize postoperative pulmonary complications (PPCs). We hypothesized that applying individualized PEEP derived from electrical impedance tomography would reduce the severity of postoperative lung aeration loss, deterioration in oxygenation, and PPC incidence. Methods A pilot feasibility study was conducted on 36 patients who underwent open abdominal oncologic surgery. The patients were randomized to receive individualized PEEP or conventional PEEP at 4 cmH2O. The primary outcome was the impact of individualized PEEP on changes in the modified lung ultrasound score (MLUS) derived from preoperative and postoperative lung ultrasonography. A higher MLUS indicated greater lung aeration loss. The secondary outcomes were the PaO2/FiO2 ratio and PPC incidence. Results A significant increase in the postoperative MLUS (12.0 ± 3.6 vs 7.9 ± 2.1, P < 0.001) and a significant difference between the postoperative and preoperative MLUS values (7.0 ± 3.3 vs 3.0 ± 1.6, P < 0.001) were found in the conventional PEEP group, indicating increased lung aeration loss. In the conventional PEEP group, the intraoperative PaO2/FiO2 ratios were significantly lower, but not the postoperative ratios. The PPC incidence was not significantly different between the groups. Post-hoc analysis showed the increase in lung aeration loss and deterioration of intraoperative oxygenation correlated with the deviation from the individualized PEEP. Conclusions Individualized PEEP appears to protect against lung aeration loss and intraoperative oxygenation deterioration. The advantage was greater in patients whose individualized PEEP deviated more from the conventional PEEP. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2005-6419 2005-7563 |
| Relation: | http://ekja.org/upload/pdf/kja-23858.pdf; https://doaj.org/toc/2005-6419; https://doaj.org/toc/2005-7563 |
| DOI: | 10.4097/kja.23858 |
| URL الوصول: | https://doaj.org/article/d3ed12a6d96e400086bd0ea22fe0ddd9 |
| رقم الأكسشن: | edsdoj.3ed12a6d96e400086bd0ea22fe0ddd9 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 20056419 20057563 |
|---|---|
| DOI: | 10.4097/kja.23858 |