Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation
Background The installation of pneumoperitoneum alters mechanical ventilation mechanics, which can lead to an increase in mechanical power and lead to Ventilator-Induced Lung Injury (VILI) and postoperative pulmonary complications and reintubation. Aim: To analyse the repercussions of pneumoperit...
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| Format: | Article |
| Language: | English |
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Society of Mechanical Ventilation
2025-06-01
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| Series: | Journal of Mechanical Ventilation |
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| Online Access: | https://www.journalmechanicalventilation.com/repercussions-of-pneumoperitoneum-for-laparoscopic-cholecystectomy-on-mechanical-power-with-volume-controlled-ventilation/ |
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| author | Claudio Luciano Franck Letícia Lopes Machado Felipe Lopes de Moraes Pironatto Rodrigo Soares |
| author_facet | Claudio Luciano Franck Letícia Lopes Machado Felipe Lopes de Moraes Pironatto Rodrigo Soares |
| author_sort | Claudio Luciano Franck |
| collection | DOAJ |
| description | Background
The installation of pneumoperitoneum alters mechanical ventilation mechanics, which can lead to an increase in mechanical power and lead to Ventilator-Induced Lung Injury (VILI) and postoperative pulmonary complications and reintubation. Aim: To analyse the repercussions of pneumoperitoneum on mechanical power during general anaesthesia for cholecystectomy, verify changes in the parameters of the components of ventilatory mechanics and their repercussions on mechanical power before, during and after pneumoperitoneum emptying.
Methods
Analytical, cross-sectional and observational study carried out between 2022 and 2023, in Sixty patients undergoing general anaesthesia for video laparoscopic cholecystectomy. The parameters of the components of the ventilatory mechanics were collected, such as RR, VT, Ppeak, Plateau, PEEP, ΔP, resistance and compliance, and the mechanical power during the intraoperative period, ten minutes before the pneumoperitoneum was performed, during the pneumoperitoneum and ten minutes after the pneumoperitoneum. When the hypothesis of equality of means in the three evaluation moments was rejected, these moments were compared two by two considering the LSD test. P < 0.05 indicated statistical significance.
Results
The variables RR, Pplateau, ∆P, and compliance showed significant differences in three-by-three comparisons (P < 0.001) but not PEEP (P = 0.217) and VT (P = 0.338). The parameters Ppeak, resistance and mechanical power, in addition to presenting significant differences in the three-by-three comparisons (P < 0.001) also presented significant differences in the two-by-two comparison before and during, before and after, during and after the pneumoperitoneum.
Conclusion
Pneumoperitoneum during cholecystectomy surgery resulted in an increase in mechanical power above values considered protective during volume-controlled ventilation, due to reduced compliance and increased resistance, which tend to normalize after emptying. |
| format | Article |
| id | doaj-art-c0569ae74fb44c4ba72e3f3aa4bcceaf |
| institution | Kabale University |
| issn | 2694-0450 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Society of Mechanical Ventilation |
| record_format | Article |
| series | Journal of Mechanical Ventilation |
| spelling | doaj-art-c0569ae74fb44c4ba72e3f3aa4bcceaf2025-08-20T03:47:13ZengSociety of Mechanical VentilationJournal of Mechanical Ventilation2694-04502025-06-0162657010.53097/JMV.10124Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilationClaudio Luciano FranckLetícia Lopes MachadoFelipe Lopes de Moraes PironattoRodrigo SoaresBackground The installation of pneumoperitoneum alters mechanical ventilation mechanics, which can lead to an increase in mechanical power and lead to Ventilator-Induced Lung Injury (VILI) and postoperative pulmonary complications and reintubation. Aim: To analyse the repercussions of pneumoperitoneum on mechanical power during general anaesthesia for cholecystectomy, verify changes in the parameters of the components of ventilatory mechanics and their repercussions on mechanical power before, during and after pneumoperitoneum emptying. Methods Analytical, cross-sectional and observational study carried out between 2022 and 2023, in Sixty patients undergoing general anaesthesia for video laparoscopic cholecystectomy. The parameters of the components of the ventilatory mechanics were collected, such as RR, VT, Ppeak, Plateau, PEEP, ΔP, resistance and compliance, and the mechanical power during the intraoperative period, ten minutes before the pneumoperitoneum was performed, during the pneumoperitoneum and ten minutes after the pneumoperitoneum. When the hypothesis of equality of means in the three evaluation moments was rejected, these moments were compared two by two considering the LSD test. P < 0.05 indicated statistical significance. Results The variables RR, Pplateau, ∆P, and compliance showed significant differences in three-by-three comparisons (P < 0.001) but not PEEP (P = 0.217) and VT (P = 0.338). The parameters Ppeak, resistance and mechanical power, in addition to presenting significant differences in the three-by-three comparisons (P < 0.001) also presented significant differences in the two-by-two comparison before and during, before and after, during and after the pneumoperitoneum. Conclusion Pneumoperitoneum during cholecystectomy surgery resulted in an increase in mechanical power above values considered protective during volume-controlled ventilation, due to reduced compliance and increased resistance, which tend to normalize after emptying.https://www.journalmechanicalventilation.com/repercussions-of-pneumoperitoneum-for-laparoscopic-cholecystectomy-on-mechanical-power-with-volume-controlled-ventilation/mechanical ventilationmechanical powervideo laparoscopypneumoperitoneum |
| spellingShingle | Claudio Luciano Franck Letícia Lopes Machado Felipe Lopes de Moraes Pironatto Rodrigo Soares Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation Journal of Mechanical Ventilation mechanical ventilation mechanical power video laparoscopy pneumoperitoneum |
| title | Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation |
| title_full | Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation |
| title_fullStr | Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation |
| title_full_unstemmed | Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation |
| title_short | Repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume-controlled ventilation |
| title_sort | repercussions of pneumoperitoneum for laparoscopic cholecystectomy on mechanical power with volume controlled ventilation |
| topic | mechanical ventilation mechanical power video laparoscopy pneumoperitoneum |
| url | https://www.journalmechanicalventilation.com/repercussions-of-pneumoperitoneum-for-laparoscopic-cholecystectomy-on-mechanical-power-with-volume-controlled-ventilation/ |
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