The Effect of Different Levels of Positive End Expiratory Pressure on Oxygenation and Hemodynamics During Laparoscopic Cholecystectomy in Obese Patients

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Abstract

Background: Obesity represents a major health problem. There are multiple strategies to reduce perioperative respiratory complications, and one of these strategies is the use of intraoperative recruitment maneuvers (RM), with the addition of positive end expiratory pressure (PEEP).
Objectives: This study was aimed to compare the effect of using different levels of positive end expiratory pressure on oxygenation and hemodynamics and to determine the optimal PEEP level that provide the maximum beneficial effect on oxygenation with minimal effect on hemodynamics during laparoscopic cholecystectomy in obese patients.
Patients and Methods: This study was carried out at Zagazig University Hospitals where fifty-six male and female patients scheduled for laparoscopic cholecystectomy aged from 21 to 60 years, ASA physical status grade II and body mass index (BMI) 30-34 kg/m2. Patients were classified into four groups (14 each), underwent history taking, general examination, and laboratory investigations. Results: Regarding changes in heart rate and mean arterial pressure (MAP) at different intervals within and between the four studied groups, there was statistically significant difference between the four groups regarding heart rate and MAP after induction Ti, T1 (20 min), T2 (40 min) and T3 (60 min) with the least reported heart rate and MAP was significantly found in group 9 (PEEP9) in relation to the other groups.
Conclusions: It could be concluded that PEEP 7 H2O is the optimal PEEP level with maximum beneficial effect on oxygenation without affecting hemodynamics during laparoscopic cholecystectomy in obese patients.
 

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The Egyptian Journal of Hospital Medicine
Volume 87, Issue 1
April 2022
Pages 1248-1254

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