Pressure-controlled inverse ratio ventilation improves gas exchange in obese children undergoing laparoscopic surgery : a randomized controlled study

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BACKGROUND: Obese children undergoing laparoscopic surgery frequently experience high end-tidal carbon dioxide partial pressure (PETCO2) and respiratory acidosis. This study aimed to investigate the effects of pressure-controlled inverse ratio ventilation (IRV) with an inspiratory to expiratory ratio (I:E) of 1.5:1 on obese children undergoing laparoscopic surgery.

METHODS: Eighty children undergoing laparoscopic surgery were randomly assigned to either the IRV group (I:E=1.5:1) or the control group (I:E=1:1.5). The lungs were mechanically ventilated following tracheal intubation. The children underwent pressure-controlled ventilation with an I:E ratio of 1.5:1 or 1:1.5. Respiratory mechanics, hemodynamic values, and ventilation-related side effects were recorded.

RESULTS: Thirty minutes after establishing CO2 pneumoperitoneum, the IRV group exhibited significantly higher tidal volume (Vt) and arterial partial pressure of oxygen (PaO2) compared to the control group (97.6 ± 6.6 vs. 93.2 ± 8.0 ml, 283 ± 54 vs. 247 ± 40 mmHg, respectively) (P < 0.01). Furthermore, PaCO2 was significantly lower in the IRV group than in the control group (41.4 ± 5.8 vs. 45.5 ± 5.7 mmHg, P=0.002). The incidence of intra-operative hypercapnia was significantly decreased in the IRV group (25% vs. 42.5%, P=0.03).

CONCLUSION: Pressure-controlled IRV can reduce the incidence of hypercapnia, increasing Vt, and thereby improving CO2 elimination in obese children undergoing laparoscopy. This ventilation technique significantly improves gas exchange in this patient population. (Registration number: ChiCTR2000035589).

Medienart:

Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

American journal of translational research - 15(2023), 11 vom: 06., Seite 6551-6557

Sprache:

Englisch

Beteiligte Personen:

Gong, Yanfeng [VerfasserIn]
Liu, Lin [VerfasserIn]
Zhang, Wangping [VerfasserIn]

Themen:

Gas exchange
Hypercapnia
Inverse ratio ventilation
Journal Article
Laparoscopy
Obese children

Anmerkungen:

Date Revised 11.12.2023

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365656143