Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study
Background: Positive end-expiratory pressure (PEEP) is used to attenuate the changes in respiratory parameters because of pneumoperitoneum during laparoscopic (LAP) surgery. As the ideal level of PEEP during LAP in children is not known, this study compared the effect of 5- and 10–cm H2O of PEEP on...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Saudi Journal of Anaesthesia |
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| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2022;volume=16;issue=4;spage=430;epage=436;aulast=Bhardwaj |
| _version_ | 1811239841708376064 |
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| author | Neerja Bhardwaj Soumya Sarkar Sandhya Yaddanapudi Divya Jain |
| author_facet | Neerja Bhardwaj Soumya Sarkar Sandhya Yaddanapudi Divya Jain |
| author_sort | Neerja Bhardwaj |
| collection | DOAJ |
| description | Background: Positive end-expiratory pressure (PEEP) is used to attenuate the changes in respiratory parameters because of pneumoperitoneum during laparoscopic (LAP) surgery. As the ideal level of PEEP during LAP in children is not known, this study compared the effect of 5- and 10–cm H2O of PEEP on oxygenation, ventilator, and hemodynamic parameters during pediatric LAP.
Method: After obtaining approval from the Institute Ethics Committee and written informed parental consent, 30 American Society of Anesthesiologists (ASA) I and II children aged 2–10 years, undergoing LAP were randomized to receive PEEP of 5- or 10–cm H2O during pneumoperitoneum. Baseline hemodynamic and ventilatory parameters, PaO2, and PaCO2 were measured 2 min after tracheal intubation, 2 min and 1 h after pneumoperitoneum, and after deflation of pneumoperitoneum. Oxygenation index, dynamic compliance, and alveolar-arterial oxygen gradient (D (A-a) O2) were calculated at the above-mentioned time points. Data were analyzed using Student's t-test and repeated measures ANOVA with Bonferroni correction.
Results: The oxygenation index and D(A-a)O2 decreased in PEEP 5 Group and increased in PEEP 10 Group after pneumoperitoneum, the difference between the two groups being statistically significant (P = 0.001). The dynamic compliance decreased in PEEP 5 Group and increased or remained the same in PEEP 10 Group after pneumoperitoneum, the difference between the two groups being significant (P = 0.001). There were no significant changes in the hemodynamic parameters in the two groups.
Conclusion: Use of 10-cm H2O PEEP during pneumoperitoneum in children improves ventilation and oxygenation, without significant hemodynamic changes. |
| first_indexed | 2024-04-12T13:08:15Z |
| format | Article |
| id | doaj.art-7dea751ea57d4080b77ffcf9a2131c1a |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-04-12T13:08:15Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-7dea751ea57d4080b77ffcf9a2131c1a2022-12-22T03:31:56ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2022-01-0116443043610.4103/sja.sja_445_22Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled studyNeerja BhardwajSoumya SarkarSandhya YaddanapudiDivya JainBackground: Positive end-expiratory pressure (PEEP) is used to attenuate the changes in respiratory parameters because of pneumoperitoneum during laparoscopic (LAP) surgery. As the ideal level of PEEP during LAP in children is not known, this study compared the effect of 5- and 10–cm H2O of PEEP on oxygenation, ventilator, and hemodynamic parameters during pediatric LAP. Method: After obtaining approval from the Institute Ethics Committee and written informed parental consent, 30 American Society of Anesthesiologists (ASA) I and II children aged 2–10 years, undergoing LAP were randomized to receive PEEP of 5- or 10–cm H2O during pneumoperitoneum. Baseline hemodynamic and ventilatory parameters, PaO2, and PaCO2 were measured 2 min after tracheal intubation, 2 min and 1 h after pneumoperitoneum, and after deflation of pneumoperitoneum. Oxygenation index, dynamic compliance, and alveolar-arterial oxygen gradient (D (A-a) O2) were calculated at the above-mentioned time points. Data were analyzed using Student's t-test and repeated measures ANOVA with Bonferroni correction. Results: The oxygenation index and D(A-a)O2 decreased in PEEP 5 Group and increased in PEEP 10 Group after pneumoperitoneum, the difference between the two groups being statistically significant (P = 0.001). The dynamic compliance decreased in PEEP 5 Group and increased or remained the same in PEEP 10 Group after pneumoperitoneum, the difference between the two groups being significant (P = 0.001). There were no significant changes in the hemodynamic parameters in the two groups. Conclusion: Use of 10-cm H2O PEEP during pneumoperitoneum in children improves ventilation and oxygenation, without significant hemodynamic changes.http://www.saudija.org/article.asp?issn=1658-354X;year=2022;volume=16;issue=4;spage=430;epage=436;aulast=Bhardwajalveolar-arterial oxygen gradientdynamic compliancelaparoscopic surgeryoxygenation indexpositive-end-expiratory pressure |
| spellingShingle | Neerja Bhardwaj Soumya Sarkar Sandhya Yaddanapudi Divya Jain Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study Saudi Journal of Anaesthesia alveolar-arterial oxygen gradient dynamic compliance laparoscopic surgery oxygenation index positive-end-expiratory pressure |
| title | Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study |
| title_full | Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study |
| title_fullStr | Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study |
| title_full_unstemmed | Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study |
| title_short | Effect of two different levels of positive end-expiratory pressure (PEEP) on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children: A randomized controlled study |
| title_sort | effect of two different levels of positive end expiratory pressure peep on oxygenation and ventilation during pneumoperitoneum for laparoscopic surgery in children a randomized controlled study |
| topic | alveolar-arterial oxygen gradient dynamic compliance laparoscopic surgery oxygenation index positive-end-expiratory pressure |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2022;volume=16;issue=4;spage=430;epage=436;aulast=Bhardwaj |
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