Ultrasound-Guided Recruitment Maneuver versus Individualized Positive End Expiratory Pressure in Pediatric Patients Undergoing Laparoscopic Abdominal Surgery: Review Article

Background:Atelectasis is a prevalent postoperative complication, particularly in children due to their unique respiratory physiology and increased susceptibility to hypoxemia. Ultrasound-guided recruitment maneuver (US-RMs) and individualized positive end-expiratory pressure (PEEP) strategies were assessed for their impact on oxygenation, respiratory mechanics, and the prevention of postoperative respiratory complications (PRCs). Ultrasound offers a non-invasive, radiation-free method to guide these interventions, providing real-time imaging of lung dynamics. Key findings indicate that US-RMs effectively reopen collapsed alveoli and enhance respiratory compliance, while individualized PEEP minimizes ventilator-induced lung injury by optimizing transpulmonary pressure. Both techniques demonstrate significant reductions in PRCs, though their efficacy depends on precise monitoring and titration tailored to patient-specific factors. The study emphasized the critical role of lung-protective strategies in pediatric anesthesia, highlighting the potential of ultrasound to refine respiratory management in this vulnerable population.
Objective: This article aimed to highlight the effect of ultrasound-guided recruitment maneuvers against individualized PEEP on oxygenation and the prevention of respiratory complications in kids having laparoscopic abdominal operations.
Methods: We searched PubMed, Google Scholar, and Science Direct for Pediatric anesthesia, Lung ultrasound, Atelectasis management and Recruitment maneuvers. Only the most recent or thorough investigation, from 1995 to 2022, was taken into account. The writers evaluated relevant literature references as well. Documents written in languages other than English have been ignored. Papers that were not regarded as significant scientific research included dissertations, oral presentations, conference abstracts, and unpublished manuscripts were excluded.
Conclusion: Both individualized PEEP and US guided RM improved oxygenation and lung mechanics more than fixed PEEP with comparable hemodynamic profile and postoperative pulmonary complications.