| Summary: | Background: Postoperative lung function impairment is common after surgery specially in the lateral decubitus position. Evidence suggests that if we use low tidal volume during mechanical ventilation this may limit post-operative lung injury. We compared post-operative lung functions in patients put in the lateral position when ventilated with low vs. high tidal volumes.
Methods: This prospective open label clinical trial was performed on 104 patients ASA I&II scheduled for elective urological operations done in the right or left lateral position expected to last more than 2 hours. Patients were divided into two groups: group L ventilated with 5–7 ml/kg tidal volume, with positive end expiratory pressure (PEEP) 10 cm H2O and recruitment maneuver (RM) and group H ventilated with 10–12 ml/kg tidal volume with zero-end expiratory pressure and no recruitment maneuver. Pulmonary functions were measured pre-operatively and 6, 12, 24 hours after extubation.
Results: Better pulmonary functions were found in the first post-operative six hours in the low tidal volume group and significant difference was found in all parameters. FVC and FEV1/FVC were significantly higher in the low tidal volume group (P = 0.000) after 12 hours of extubation. After 24 hours we found significant difference in the predicted FEV1 and FVC and FEV1/FVC ratio (P = 0.000) being higher in the low tidal volume group.
Conclusion: In comparison with conventional mechanical ventilation using high tidal volume with zero PEEP and no RM: a lung protective strategy using low tidal volume with 5–10 cm H2O PEEP and RM did improved lung functions in the first post-operative 24 hours. The overall postoperative follow up did not show significant difference between the two groups.
|
|---|
