Pediatric anesthesia & critical care
Effect of an Individualized Lung Protective Ventilation on Lung Strain and Stress in Children Undergoing Laparoscopy: An Observational Cohort Study
Authors' conclusion
Capnoperitoneum increased lung strain in healthy children undergoing laparoscopy. Lung recruitment and optimized PEEP during capnoperitoneum decreased lung strain but slightly increased lung stress.
Study context
- Population
- Healthy children aged 3 to 7 yr scheduled for laparoscopic surgery in a community hospital
- Participants
- 20 children
- Exposure
- Lung strain and stress across ventilation phases: before capnoperitoneum (positive end-expiratory pressure (PEEP) 5 cm H2O) vs during capnoperitoneum before and after lung recruitment and optimized PEEP vs after capnoperitoneum
- Outcome
- Impact of capnoperitoneum on lung strain-stress and effects of individualized protective ventilation
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Lung strain (VT/end-expiratory lung volume)
| Group | Value | 95% CI |
|---|---|---|
| Before capnoperitoneum | mean 0.20 (SD 0.07) | 0.17 to 0.23 |
| During capnoperitoneum | mean 0.29 (SD 0.13) | 0.23 to 0.35 |
| After capnoperitoneum | mean 0.18 (SD 0.04) | 0.16 to 0.20 |
Value
Before capnoperitoneummean 0.20 (SD 0.07)
During capnoperitoneummean 0.29 (SD 0.13)
After capnoperitoneummean 0.18 (SD 0.04)
95% CI
Before capnoperitoneum0.17 to 0.23
During capnoperitoneum0.23 to 0.35
After capnoperitoneum0.16 to 0.20
- During capnoperitoneum vs Before capnoperitoneum: P < 0.001 — strain increased
- Capnoperitoneum + optimized PEEP vs Before capnoperitoneum: P = 0.318 — returned to values before capnoperitoneum
- After capnoperitoneum vs Before capnoperitoneum: P = 0.090 — strain decreased
- Lung collapse during capnoperitoneum
- 18
Observational data: associations, not effects.
Further findings
| Outcome | Before capnoperitoneum | During capnoperitoneum | Capnoperitoneum + optimized PEEP | After capnoperitoneum | P value |
|---|---|---|---|---|---|
| Lung stress (end-inspiratory transpulmonary pressure)During capnoperitoneum vs Before capnoperitoneum · mean, cm H2O | 5.68 (SD 2.83) | 5.92 (SD 3.18) | 7.25 (SD 3.01) | P = 0.374 | |
| 95% CI | 4.44 to 6.92 | 4.53 to 7.31 | — not stated in the abstract | 5.92 to 8.57 | |
| Lung stress (end-inspiratory transpulmonary pressure)Capnoperitoneum + optimized PEEP vs Before capnoperitoneum · stress increased | P = 0.020 | ||||
| Lung stress (end-inspiratory transpulmonary pressure)After capnoperitoneum vs Before capnoperitoneum · stress remained higher | P = 0.024 | ||||
| Optimized PEEP during capnoperitoneum | mean 8.3 (SD 2.2) cm H2O | ||||
| 95% CI | — not stated in the abstract | — not stated in the abstract | 7.3 to 9.3 | — not stated in the abstract |
— not stated in the abstract
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effect of an Individualized Lung Protective Ventilation on Lung Strain and Stress in Children Undergoing Laparoscopy: An Observational Cohort Study. Anesthesiology. Published 8 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →