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June 29, 2023Egyptian Journal of AnaesthesiaOpen Access

Individualized stepwise lung recruitment maneuvers reduce postoperative pulmonary complications versus control.

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Why the study?

Recruitment maneuvers as part of lung-protective ventilation may improve lung mechanics and oxygenation, but definitive guidelines for their intraoperative application have not been established.

Does individualized stepwise lung recruitment maneuver reduce postoperative pulmonary complications in patients undergoing non-laparoscopic upper abdominal surgeries under general anesthesia?

Comparison

Stepwise recruitment maneuvers and individualized PEEP titration vs PEEP of 5 cmH2O without recruitment maneuvers

Design

Prospective, single-blinded, randomized clinical trial

Key result

Individualized stepwise lung recruitment maneuvers significantly decreased the incidence of postoperative pulmonary complications compared to control (P=0.03).

Authors

MSMohammad SalamaEEEzzat Mohamed El-TaherAAAhmad Hamed Abdel-Rahman Al-Touny

Discussion

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Overview

Supports individualized recruitment with lung-protective ventilation in upper abdominal surgery; extends evidence to non-laparoscopic procedures.

Study Design

Type

RCT (n=66)

Blinding

Single-blind

Structured PICO

Does individualized stepwise lung recruitment maneuver reduce postoperative pulmonary complications in patients undergoing non-laparoscopic upper abdominal surgeries under general anesthesia?

P
Population
66 subjects undergoing non-laparoscopic upper abdominal surgeries under general anesthesia.
I
Intervention
Tidal volume of 8 ml/kg predicted body weight (PBW) with stepwise recruitment maneuvers (RMs) and individualized PEEP titration after each RM
C
Comparator
Tidal volume of 8 ml/kg PBW and positive end expiratory pressure (PEEP) of 5 cmH2O without RM
O
Outcome
Postoperative pulmonary complications (POPCs)hard clinical

Main Result

p-value: p=0.03

Individualized stepwise lung recruitment maneuvers added to lung protective ventilation significantly decrease postoperative pulmonary complications in patients undergoing non-laparoscopic upper abdominal surgeries.

Cite This Study

Salama et al. (2023) conducted an RCT in Non-laparoscopic upper abdominal surgeries under general anesthesia (n=66). Individualized stepwise lung recruitment maneuvers (RM) and PEEP titration vs. Tidal volume of 8 ml/kg PBW and PEEP of 5 cmH2O without RM was evaluated on Postoperative pulmonary complications (POPCs) (p=0.03). Individualized stepwise lung recruitment maneuvers significantly decreased the incidence of postoperative pulmonary complications compared to control (P=0.03).

synapsesocial.com/papers/6aa215b7d2b6e29a16d3cdcdhttps://doi.org/10.1080/11101849.2023.2230050
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Effect of Recruitment Maneuver on Static Lung Compliance in Patients Undergoing General Anesthesia for Laparoscopic Cholecystectomy: A Single-Centre Prospective Clinical Intervention Study2024 · 1 citations
  2. 2The effect of alveolar recruitment maneuver on intraoperative hemodynamics2026
  3. 3Effect of the alveolar recruitment maneuver during laparoscopic colorectal surgery on postoperative pulmonary complications: A randomized controlled trial2024
  4. 4Effects of recruitment manoeuvre on perioperative pulmonary complications in patients undergoing robotic assisted radical prostatectomy: A randomised single-blinded trial2017 · 49 citations
  5. 5The Effects of Different Oxygen Concentrations on Recruitment Maneuver During General Anesthesia for Laparoscopic Surgery2014 · 10 citations