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Assessment of Perioperative Atelectasis Using Lung Ultrasonography in Patients Undergoing Pneumoperitoneum Surgery in the Trendelenburg Position: Aspects of Differences according to Ventilatory Mode
- Title
- Assessment of Perioperative Atelectasis Using Lung Ultrasonography in Patients Undergoing Pneumoperitoneum Surgery in the Trendelenburg Position: Aspects of Differences according to Ventilatory Mode
- Authors
- Lee, Youn Young; Han, Jong In; Kang, Bo Kyung; Jeong, Kyungah; Lee, Jong Wha; Kim, Dong Yeon
- Ewha Authors
- 한종인; 김동연; 정경아; 이종화
- SCOPUS Author ID
- 한종인; 김동연; 정경아; 이종화
- Issue Date
- 2021
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- ISSN
- 1011-8934
1598-6357
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE vol. 36, no. 50
- Keywords
- Lung Ultrasonography; Atelectasis; Gynecologic Anesthesia; Mechanical Ventilation
- Publisher
- KOREAN ACAD MEDICAL SCIENCES
- Indexed
- SCIE; SCOPUS; KCI
- Document Type
- Article
- Abstract
- Background: During robotic gynecologic pneumoperitoneum surgery in the Trendelenburg position, aeration loss leads to perioperative atelectasis. Recently developed ventilator mode pressure-controlled ventilation volume-guaranteed (PCV-VG) mode could provide adequate ventilation with lower inspiratory pressure compared to volume-controlled ventilation (VCV); we hypothesized that PCV-VG mode may be beneficial in reducing perioperative atelectasis via low tidal volume (VT) of 6 mL/kg ventilation during robotic gynecologic pneumoperitoneum surgery in the Trendelenburg position. We applied lung ultrasound score (LUS) for detecting perioperative atelectasis. We aimed to compare perioperative atelectasis between VCV and PCV-VG with a low VT of 6 mL/kg during pneumoperitoneum surgery in the Trendelenburg position using LUS. Methods: Patients scheduled for robotic gynecologic surgery were randomly allocated to the VCV (n = 41) or PCV-VG group (n = 41). LUS, ventilatory, and hemodynamic parameters were evaluated at T1 (before induction), T2 (10 minutes after induction in the supine position), T3 (10 minutes after desufflation of CO2 in the supine position), and T4 (30 minutes after emergence from anesthesia in the recovery room). Results: Eighty patients (40 with PCV-VG and 40 with VCV) were included. Demographic data showed no significant differences between the groups. The total LUS has changed from baseline to T4, 0.63 (95% confidence interval [CI], 0.32, 0.94) to 1.77 (95% CI, 1.42, 2.21) in the VCV group and 0.86 (95% CI, 0.56, 1.16) to 1.43 (95% CI, 1.08, 1.78) in the PCV-VG group (P = 0.170). In both groups, total LUS increased significantly compared to the baseline values. Conclusion: Using a low VT of 6 mL/kg during pneumoperitoneum surgery in the Trendelenburg position, our study showed no evidence that PCV-VG ventilation was superior to VCV in terms of perioperative atelectasis.
- DOI
- 10.3346/jkms.2021.36.e334
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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