Abstract
<i>Background:</i> Surgery is accompanied by postoperative pulmonary functions impairment especially in the prone position. There is evidence suggested that using low tidal volume during general anesthesia may decrease post-operative lung injury. This study aimed to evaluate the effect of low tidal volume on lung functions during mechanical ventilation for general anesthesia while patients lying in the prone position. A prospective clinical trial was performed on 88 patients ASA I&II scheduled for elective surgery while patients lying prone and were randomly assigned to either protective ventilation group A with tidal volume; 5-7 ml/kg, 10 cm H<sub>2</sub>O positive end expiratory pressure (PEEP) with recruitment maneuver (RM) or conventional group B with Tidal Volume; 10-12 ml/kg, without both PEEP and RM. The primary efficacy variables were assessed by pulmonary function tests, performed before surgery, and 6, 12 and 24 hours postoperatively. Improvement of lung functions were found in the first post-operative 6 and 12 hours in the low tidal volume group and significant difference was found in all parameters P value 0.001 except PaO<sub>2</sub>/FIO<sub>2</sub> ratio P value 0.4. After 24 hours there were significant difference in the FVC, predicted FEV1 and FVC and FEV1/FVC ratio being higher in the low tidal volume group with P value 0.001. Patients in both groups showed similar rates of postoperative chest complications without significant difference. Lung protective ventilation improved lung functions in the first post-operative 24 hours. There was no significant postoperative chest complications difference between the two groups.
Highlights
Postoperative pulmonary complications, especially postoperative respiratory failure, are important causes of preoperative morbidity and mortality
[3] After induction of general anesthesia, atelectasis develops within minutes and is a direct source of intra-operative gas exchange abnormalities
The aim of this study was to evaluate the effect of low VT, high positive end expiratory pressure (PEEP) and recruitment maneuver (RM) on lung functions during mechanical ventilation for general anesthesia (GA) while patients lying in prone position
Summary
Postoperative pulmonary complications, especially postoperative respiratory failure, are important causes of preoperative morbidity and mortality. [3] After induction of general anesthesia, atelectasis develops within minutes and is a direct source of intra-operative gas exchange abnormalities These areas of atelectasis can be functionally restored by lung recruitment maneuver followed by a substantial level of positive end expiratory pressure (PEEP), which has been known to improve intra-operative oxygenation. This study aimed to evaluate the effect of low tidal volume on lung functions during mechanical ventilation for general anesthesia while patients lying in the prone position. Improvement of lung functions were found in the first post-operative 6 and 12 hours in the low tidal volume group and significant difference was found in all parameters P value 0.001 except PaO2/FIO2 ratio P value 0.4. There was no significant postoperative chest complications difference between the two groups
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