Efek Perbedaan Ventilasi Mekanik Positive End Expiratory Pressure (PEEP) Low dan Moderate terhadap Rasio PaO2/FiO2 Pascabedah pada Kraniotomi Elektif

Abstract

Background and Objective: Elective craniotomy is associated with high incidence of postoperative pulmonary complications (PPC, 25%) and mortality (10%). We determined to study the effect of Positive End Expiratory Pressure (PEEP) 5 cmH2O and 8 cmH2O to postoperative PaO2 / FiO2 ratio (PF ratio) in elective craniotomy. Subject and Methods: This randomized clinical trial was at a university hospital in Indonesia. Fifty two elective craniotomy patients (ages 17–55 years, surgical duration> 4 hours, normal lung) were randomized into 2 intervention groups: perioperative mechanical ventilation with low PEEP (5 cmH2O) or moderate PEEP (8 cmH2O). The hypothesis of this study is that the ratio of PaO2 / FiO2 in the moderate PEEP group is higher than low PEEP. Blood gas analysis was performed 24 hours post induction. Results: This study did not show a significant difference in the PaO2/FiO2 ratio between the low PEEP and moderate PEEP groups. The PaO2 / FiO2 ratios of the low PEEP and moderate PEEP groups were respectively: at 24 hours post induction, 429.34 ± 72.25 mmHg and 458.59 ± 71.11mmHg (p = 0.147). Conclusions: Comparison of low PEEP and moderate PEEP in perioperative mechanical ventilation did not result in a significant difference in the value of the PaO2/FiO2 ratio at 24 hours post induction