Respiratory failure & ventilation
Recruitment-to-inflation ratio to assess response to PEEP during laparoscopic surgery: A physiologic study
Authors' conclusion
Trendelenburg pneumoperitoneum yields variable derecruitment: PEEP capability to revert these phenomena varies significantly among individuals. High R/I identifies patients in whom higher PEEP mostly reduces dynamic strain with limited static strain increases
Study context
- Population
- ASA I–III patients receiving robot-assisted prostatectomy during Trendelenburg pneumoperitoneum
- Participants
- 17 patients
- Comparison
- PEEP 12 vs 4 cmH2O during Trendelenburg pneumoperitoneum
- Outcome
- Pneumoperitoneum-induced derecruitment, PEEP-induced recruitment (PEEP 12 vs 4 cmH2O), strain changes and R/I
Methodological detailssequential study
- Sequential study
Main finding
As reported in the abstract
- Pneumoperitoneum reduced end-expiratory lung volume (EELV), median [IQR], mL (p < 0.001; CoV = 70%)
- 410 mL [80-770]
- Pneumoperitoneum increased dynamic strain, median [IQR] (p < 0.001; CoV = 88%)
- 0.04 [0.01-0.07]
- PEEP 12 vs 4 cmH2O recruitment, median [IQR] (CoV = 101%)
- 139 mL [96-366]
- PEEP 12 vs 4 cmH2O dynamic strain median decrease [IQR] (p = 0.002; CoV = 86%)
- 0.02 [0.01-0.04]
- PEEP 12 vs 4 cmH2O static strain median increase [IQR] (p = 0.01, CoV = 33%)
- 0.05 [0.04-0.07]
- R/I, median [IQR]
- 1.73 [0.58-3.35]
- R/I correlation with PEEP-induced decrease in dynamic strain (p ≤0.001)
- r = −0.90
- R/I correlation with PEEP-induced increase in static strain (p = 0.009)
- r = −0.73
Original publication
Recruitment-to-inflation ratio to assess response to PEEP during laparoscopic surgery: A physiologic study. J Clin Anesth. Published 5 August 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →