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Intraoperative low tidal volume ventilation strategy has no benefits during laparoscopic cholecystectomy
- Source :
- Journal of Anaesthesiology Clinical Pharmacology, Vol 33, Iss 1, Pp 57-63 (2017)
- Publication Year :
- 2017
- Publisher :
- Wolters Kluwer Medknow Publications, 2017.
-
Abstract
- Background and Aims: Benefits of intraoperative low tidal volume ventilation during laparoscopic surgery are not conclusively proven, even though its advantages were seen in other situations with intraoperative respiratory compromise such as one-lung ventilation. The present study compared the efficacy of intraoperative low tidal volume ventilatory strategy (6 ml/kg along with positive end-expiratory pressure [PEEP] of 10 cmH2O) versus one with higher tidal volume (10 ml/kg with no PEEP) on various clinical parameters and plasma levels of interleukin (IL)-6 in patients undergoing laparoscopic cholecystectomy. Material and Methods: A total of 58 adult patients with American Society of Anesthesiologists physical status I or II, undergoing laparoscopic cholecystectomy were randomized to receive the low or higher tidal volume strategy as above (n = 29 each). The primary outcome measure was postoperative PaO2. Systemic levels of IL-6 along with clinical indices of intraoperative gas exchange, pulmonary mechanics, and hemodynamic consequences were measured as secondary outcome measures. Results: There was no statistically significant difference in oxygenation; intraoperative dynamic compliance, peak airway pressures, or hemodynamic parameters, or the IL-6 levels between the two groups (P > 0.05). Low tidal volume strategy was associated with significantly higher mean airway pressure, lower airway resistance, greater respiratory rates, and albeit clinically similar, higher PaCO2and lower pH (P < 0.05). Conclusion: Strategy using 6 ml/kg tidal volume along with 10 cmH2O of PEEP was not associated with any significant improvement in gas exchange, hemodynamic parameters, or systemic inflammatory response over ventilation with 10 ml/kg volume without PEEP during laparoscopic cholecystectomy.
Details
- Language :
- English
- ISSN :
- 09709185
- Volume :
- 33
- Issue :
- 1
- Database :
- Directory of Open Access Journals
- Journal :
- Journal of Anaesthesiology Clinical Pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.651df12c0325442ea6319c0d102b6fdc
- Document Type :
- article
- Full Text :
- https://doi.org/10.4103/0970-9185.202200