TY - JOUR
T1 - Optimizing peroperative compliance with PEEP during upper abdominal surgery
T2 - Effects on perioperative oxygenation and complications in patients without preoperative cardiopulmonary dysfunction
AU - Wetterslev, J.
AU - Hansen, E. G.
AU - Roikjaer, O.
AU - Kanstrup, I. L.
AU - Heslet, L.
PY - 2001/12/1
Y1 - 2001/12/1
N2 - Background and objective: Late postoperative hypoxaemia after upper abdominal surgery is common even among cardiopulmonary healthy patients. Atelectasis may develop after intubation and persist into or reveal a disposition for atelectasis in the postoperative period. Positive end-expiratory pressure (PEEP) eliminates peroperative atelectasis but the effect on perioperative oxygenation is controversial. This study evaluated the effect of peroperative PEEP optimized pulmonary compliance on perioperative oxygenation and complications. Methods: Forty patients assessed by electrocardiography, spirometry, functional residual capacity and diffusion capacity were randomly assigned to receive positive end-expiratory pressure (PEEP) or zero end-expiratory pressure (ZEEP) during surgery. PaO2, SPO2 and complications in the postoperative period were evaluated without knowledge of peroperative PEEP or ZEEP application. Results: Peroperative arterial oxygenation improved for all patients receiving PEEP, mean 2.1 kPa (0.7-3.5 kPa). There was no difference in postoperative median PaO2 between the groups. The differences in the incidence of late prolonged postoperative hypoxaemia and complications were 25% (-5% to 55%) and -1% (-31% to 29%) between the ZEEP and the PEEP group, but were not statistically significant.
AB - Background and objective: Late postoperative hypoxaemia after upper abdominal surgery is common even among cardiopulmonary healthy patients. Atelectasis may develop after intubation and persist into or reveal a disposition for atelectasis in the postoperative period. Positive end-expiratory pressure (PEEP) eliminates peroperative atelectasis but the effect on perioperative oxygenation is controversial. This study evaluated the effect of peroperative PEEP optimized pulmonary compliance on perioperative oxygenation and complications. Methods: Forty patients assessed by electrocardiography, spirometry, functional residual capacity and diffusion capacity were randomly assigned to receive positive end-expiratory pressure (PEEP) or zero end-expiratory pressure (ZEEP) during surgery. PaO2, SPO2 and complications in the postoperative period were evaluated without knowledge of peroperative PEEP or ZEEP application. Results: Peroperative arterial oxygenation improved for all patients receiving PEEP, mean 2.1 kPa (0.7-3.5 kPa). There was no difference in postoperative median PaO2 between the groups. The differences in the incidence of late prolonged postoperative hypoxaemia and complications were 25% (-5% to 55%) and -1% (-31% to 29%) between the ZEEP and the PEEP group, but were not statistically significant.
KW - Anaesthesia General, Anaesthesia Inhalation, isoflurane
KW - Anaesthesia, epidural
KW - Anaesthetics, Local, bupivacaine
KW - Anoxaemia
KW - Atelectasis
KW - Pneumonia
KW - Positive-Pressure Respiration
KW - Postoperative Complications
UR - http://www.scopus.com/inward/record.url?scp=0035740787&partnerID=8YFLogxK
U2 - 10.1046/j.0265-0215.2000.00842.x
DO - 10.1046/j.0265-0215.2000.00842.x
M3 - Journal article
C2 - 11412288
AN - SCOPUS:0035740787
SN - 0265-0215
VL - 18
SP - 358
EP - 365
JO - European Journal of Anaesthesiology
JF - European Journal of Anaesthesiology
IS - 6
ER -