Which Ventilatory Strategy is Better for Lung in Upper Abdominal Surgeries?

Ultrasonographic Assessment of Atelectasis in Major Upper Abdominal Surgeries With Different Ventilatory Strategies

Ventilated Patients especially those undergoing upper abdominal surgeries are prone to lung atelectasis. They are at risk of adverse effects secondary to inadequate lung ventilation.

Applied PEEP and Recruitment maneuver are thought to enhance lung aeration under general anesthesia which could be assessed by ultrasound.

The aim of our study is to assess the effect of using PEEP with and without recruitment maneuver on atelectasis and lung aeration during open upper abdominal surgeries by ultrasonography.

Application of PEEP improves intraoperative oxygenation and thus could minimize the incidence of postoperative atelectasis and respiratory complications during abdominal surgeries.

A recent study found that PEEP and RM prevented intraoperative aeration loss, which didn't persist after extubation when comparing effects of positive end-expiratory pressure/recruitment maneuvers with zero end-expiratory pressure on atelectasis during open gynecological surgery by ultrasonography

Inclusion Criteria:

• American Society of Anesthesiologists' physical status grades I, II, and III.

Exclusion Criteria:

• Patient refusal.
• Psychiatric diseases.
• Body Mass Index > 35 Kg/m2.
• Previous intrathoracic procedures.
• History of severe obstructive pulmonary disease.
• History of severe restrictive lung disease.
• Pulmonary arterial hypertension ( systolic pulmonary arterial pressure >40 mmHg).
• Pregnancy.