Intraoperative Protective Ventilation for Obese Patients Undergoing Gynaecological Laparoscopic Surgery

Intraoperative Protective Ventilation for Obese Patients Undergoing Gynaecological Laparoscopic Surgery. A Single-centre Randomized, Controlled Trial

Background. The use of a comprehensive strategy providing low tidal volumes, peep and recruiting maneuvers in patients undergoing open abdominal surgery improves postoperative respiratory function and clinical outcome. It is unknown whether such ventilatory approach may be feasible and/or beneficial in patients undergoing laparoscopy, as pneumoperitoneum and Trendelenburg position may alter lung volumes and chest-wall elastance.

Objective. The investigators designed a randomized, controlled trial to assess the effect of a lung-protective ventilation strategy on postoperative oxygenation in obese patients undergoing laparoscopic surgery.

Inclusion Criteria:

• scheduled for gynaecological laparoscopic surgery in the Trendelenburg position
• Obesity with body mass index>35 kg/m^2
• written informed consent

Exclusion Criteria:

• Clinical history or signs of chronic heart failure
• history of neuromuscular disease
• history of thoracic surgery
• pregnancy
• chronic respiratory failure requiring long-term oxygen administration