| Ventilation strategy in obese patients undergoing laparoscopic sleeve gastrectomy |
| Received:July 10, 2023 Revised:September 14, 2023 Click here to download the full text |
| Citation of this paper:DING Ning-jing,YU Qiong.Ventilation strategy in obese patients undergoing laparoscopic sleeve gastrectomy[J].Chinese Journal of Clinical Medicine,2023,30(5):840-845 |
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| Abstract:Objective To explore the ideal ventilation strategy for obese patients undergoing laparoscopic sleeve gastrectomy (LSG). Methods Data of obese patients undergoing LSG from January 1, 2012 to January 31, 2017 in Huashan Hospital, Fudan University were retrospectively collected from the hospital DoCare system. According to the mean tidal volume (VT) relative to the ideal body weight (IBW), the patients were divided into three groups: low VT group (average VT＜10 mL/kg IBW), medium VT group (average VT 10-12 mL/kg IBW) and high VT group (average VT＞12 mL/kg IBW). The general data, peak airway pressure (Ppeak), positive end-expiratory pressure (PEEP), oxygenation index (OI), pulmonary dynamic compliance (Cdyn) during pneumoperitoneum and postoperative respiratory complications were compared among the three groups. Results A total of 81 patients were included, of which 97.5% (79/81) patients were ventilated with pressure-controlled ventilation (PCV) mode and 64.2% (52/81) patients received VT ≥10 mL/kg IBW during pneumoperitoneum. Compared with the low VT group, the Cdyn in the middle VT group and the high VT group increased significantly, and the Ppeak and OI in the high VT group increased significantly (P＜0.01). There was no significant difference in PEEP, extubation time and postoperative pulmonary complications among the three groups. Conclusions Compared with VT＜10 mL/kg IBW and VT＞12 mL/kg IBW, obese patients receiving LSG with VT 10-12 mL/kg IBW had better lung compliance and no significant increase in airway pressure, which could be used as a ventilation strategy for this kind of surgery. |
| keywords:obesity tidal volume pulmonary compliance peak ventilator pressure oxygenation index laparoscopic sleeve gastrectomy |
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