The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations
Fatma Çiçek, Canan Ün, Oya Kılcı, Mehmet Gamlı, Dilşen Örnek 1 * , Derya Türkaslan, Bayazit Dikmen
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1 Ankara Numune Eğitim-Araştırma Hastanesi, Anestezi ve Reanimasyon Bölümü, Ankara, Turkey* Corresponding Author


Objective: The effects of 10cmH2O Positive End-expiratory Pressure (PEEP) on respiratory mechanics, arterial oxygenation and hemodynamics in laparoscopic cholecystectomy operation were investigated.
Methods: The study was planned on ASA I-II, 18-65 years old, forty patients scheduled for laparoscopic cholecystectomy under general anesthesia. The patients were divided into two groups which PEEP implemented Group 0 and 10 cmH2O PEEP applied Group P (Group 0, n=20; Group P, n=20). Heart rate, Mean arterial blood pressure, arterial oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PEtCO2), Peak inspiratory pressure (PİP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2 ) values were evaluated at 5 minutes after induction, 5 minutes after CO2 insufflation, after the head-up position and the right side in the 10th and 30th minutes, After 10 minutes desufflation and in the recovery room. The Alveolar–arterial oxygen pressure gradient (P(A-a) O2), the ratio of physiologic dead space over tidal volume (VD/VT), Arterial to End Tidal CO2 gradient (P(a-et) CO2), static compliance (CS), dynamic compliance (CD) were assessed same times.
Results: The assessment between the groups, there were not statistical differences about mean blood pressure, heart rate, SpO2, PetCO2, PaO2, plateau pressure, and P (A-a) values (p>0.05). Peak inspiratory pressure was higher in Group P (p<0.05). Peak inspiratory pressure and plateau pressure increased with CO2 insufflation in both groups. PaCO2 and P(a-et) CO2 were higher statistically significantly in Group 0 (p<0.05). There was no difference between the groups in terms of the PetCO2 values. VD/VT ratios were statistically significantly lower in the Group P (p<0.05). There was no difference at static compliance values between the groups, dynamic compliance was lower in Group P. According to the initial values, there was a decrease in compliance in both groups after CO2 insufflation.
Conclusion: 10 cmH2O PEEP was shown to improve oxygenation and respiratory mechanics without causing any hemodynamic side effect in laparoscopic cholecystectomy operation.


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Article Type: Research Article

J Clin Exp Invest, 2014, Volume 5, Issue 3, 397-402

Publication date: 09 Sep 2014

Article Views: 2120

Article Downloads: 843

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