EFFECT OF PRE- EMPTIVE ALVEOLAR RECRUITMENT STRATEGY BEFORE PNEUMORERITONEUM ON ARTERIAL OXYGENATION DURING LAPAROSCOPIC SURGERIES

Dr. C. Pranab Nirmal, Dr. P. Deepthi

Abstract


The physiological changes during laprascopic surgeries causes decreases compliance of lung and arterial oxygenation.
This atelectasis produced by pneumoperitoneum can be overcome by Alveolar recruitment strategy(ARS) and PEEP. To
avoid additional increase in airway pressure during pneumoperitoneum, ARS and PEEP were applied before pneumoperitoneum. After
intubation, 50 patients were randomly allocated to receive either tidal volume 10 ml/kg with no positive end-expiratory pressure (group C) or
alveolar recruitment strategy of 10 breaths with peak inspiratory pressure (PIP) 40 cmH20 plus positive end-expiratory pressure (PEEP) 15
cmH20 before gas insufflation (group P). During pneumoperitoneum, group P was ventilated with the same setting as group C (FiO2=0.35, tidal
volume 10 ml/kg). Pa02 measured during peumoperitoneum was higher in group P than in group C (210.4mmHg vs 144.84mmHg at 15 minutes,
P0.001 170.6 mmHg vs 135.44mmHg at 30 minutes, P- 0.001).


Keywords


Pneumoperitoneum, Alveolar Recruitment Strategy, Laprascopic Surgery

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