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

Abstract

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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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Research Article

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

https://doi.org/10.5799/ahinjs.01.2014.03.0427

Publication date: 09 Sep 2014

Article Views: 2339

Article Downloads: 973

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