The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations

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

Keywords

• Laparoscopic cholecystectomy, positive end-expiratory pressure, respiratory mechanics, oxygenation

The effects of 10 cmH 2 O positive end-expiratory pressure on arterial oxygenation, respiratory mechanics and hemodynamic parameters in laparoscopic cholecystectomy operations

Öz

Amaç: Laparoskopik kolesistektomi operasyonlarında hastalarda uygulanan 10 cmH2O PEEP\'in solunum mekaniği, arteriyel oksijenizasyon ve hemodinami üzerine olan etkilerinin araştırılması. Yöntemler: Araştırma genel anesteziyle laparoskopik kolesistektomi ameliyatı geçirecek ASA I–II grubu 18-65 yaş arasında 40 hasta üzerinde planlandı. Hastalar PEEP uygulanmayan Grup 0 ve 10 cmH2O PEEP uygulanan Grup P olarak ikiye ayrıldı. Kalp atım hızı (KAH), ortalama kan basıncı (OAB), arteriyel oksijen satürasyonu (SpO2), end-tidal karbondioksit parsiyel basıncı (PEtCO2), tepe inspiratuar basınç (PİP), plato basıncı (Pplato), arteriyel kanda parsiyel oksijen basıncı (PaO2), arteriyel parsiyel karbondioksit basıncı (PaCO2) değerleri indüksiyondan sonra 5. dakikada, CO2 insüflasyonu sonrası 5. dakika, başyukarı ve sağ yan pozisyondan sonra 10. ve 30. dakikalarda, desüflasyon sonrası 10. dakika ve derlenme odasında alınarak kaydedildi. Aynı zamanlarda alveolo-arteriyel oksijen basınç gradiyenti (P(A-a) O2), ölü boşluk değişiklikleri (VD/VT), arter ve end tidal parsiyel karbondioksit basıncı farkı (P(a-et) CO2), statik kompliyans (CS), dinamik kompliyans (CD) hesaplanarak yazıldı. Bulgular: Gruplar arası değerlendirmede, KAH, OAB, SpO2, PetCO2, PaO2, plato basıncı ve P(A-a)O2 değerleri arasında istatistiksel fark görülmedi (p>0,05). Pik inspiratuvar basınç Grup P de daha yüksek idi (p

Anahtar Kelimeler

• Laparoskopik kolesistektomi, PEEP, akciğer mekanikleri, oksijenizasyon

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