Perioperative medicine & outcomes
Positive end-expiratory pressure and emergence preoxygenation after bariatric surgery: effect on postoperative oxygenation: A randomised controlled trial
Primary result · Increase in estimated venous admixtureResult — go to the resultDifference −1.5% 95% CI −4.6 to 1.7%Authors' conclusion
Withdrawing PEEP before emergence preoxygenation, did not alter early postoperative oxygenation in obese patients undergoing laparoscopic bariatric surgery.
Study context
- Population
- Patients with BMI 35–50 kg m −2 undergoing laparoscopic bariatric surgery, single secondary hospital, Sweden, December 2019–January 2023
- Participants
- 60 patients
- Comparison
- Zero positive end-expiratory pressure (PEEP) vs maintained PEEP during emergence preoxygenation
- Primary endpoint
- Change in oxygenation (estimated venous admixture from arterial blood gases) from before awakening to 45 min postoperatively
- Follow-up
- 45 min postoperatively
Methodological detailsprospective, single-centre, Intraoperative fixed PEEP of 12 or 14 cmH 2 O depending on BMI; no recruitment manoeuvres
- Prospective
- Single-centre
- Intraoperative fixed PEEP of 12 or 14 cmH 2 O depending on BMI; no recruitment manoeuvres
Primary result
Increase in estimated venous admixture
Difference
−1.5%
95% CI −4.6 to 1.7%
P = 0.354
Change by group
PEEP maintained
9.1%
mean
Zero PEEP
10.6%
mean
PEEP maintained vs Zero PEEP
difference −1.5% (95% CI −4.6 to 1.7%); P = 0.354
As reported in the abstract
Further findings
Intraoperative driving pressure and oxygenation · Throughout anaesthesia
- Both groups had low driving pressures and superior oxygenation vs the awake state
Original publication
Positive end-expiratory pressure and emergence preoxygenation after bariatric surgery: effect on postoperative oxygenation: A randomised controlled trial. Eur J Anaesthesiol. Published 3 October 2024. doi:10.
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