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
Medical Principles and Practice, cilt.26, sa.6, ss.573-578, 2018 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 26 Sayı: 6
- Basım Tarihi: 2018
- 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
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: The aim was to compare the effects of low tidal volume (VT) and moderate positive end-expiratory pressure (PEEP) with high VT 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 VT-PEEP and high VT-ZEEP groups. The patients were ventilated with a VT of 6 mL/kg and 8 cm H2O PEEP in the low VT-PEEP group and a VT of 10 mL/kg and 0 cm H2O PEEP in the high VT-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 signicant. Results: The intraoperative and postoperative arterial partial pressure of oxygen and arterial oxygen saturation values were significantly higher in the low VT-PEEP group than in the high VT-ZEEP group. At all times, the arterial-To-Alveolar oxygenation gradients were significantly lower in the low VT-PEEP group than in the high VT-ZEEP group. Preoperative RAS were similar in both groups, but the postoperative RAS was significantly lower in the low VT-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 VT-ZEEP group (p < 0.001). Conclusions: Postoperative pulmonary functions were less impaired in patients ventilated with a VT of 6 mL/kg and 8 cm H2O PEEP than in patients ventilated with a VT of 10 mL/kg and ZEEP.