ALVEOLAR RECRUITMENT MANEUVER FOR ROBOT-ASSISTED LAPAROSCOPIC SURGERY IN TRENDELENBURG POSITIONING
Purpose. This study aims to evaluate the effect of the alveolar recruitment maneuver on intraoperative lung function in patients undergoing robot-assisted surgery in the Trendelenburg position. Materials and methods. A prospective, single-center randomized study was conducted at University Hospital...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Peytchinski Publishing
2025-07-01
|
| Series: | Journal of IMAB |
| Subjects: | |
| Online Access: | https://www.journal-imab-bg.org/issues-2025/issue3/2025vol31-issue3_6305-6312.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Purpose. This study aims to evaluate the effect of the alveolar recruitment maneuver on intraoperative lung function in patients undergoing robot-assisted surgery in the Trendelenburg position.
Materials and methods. A prospective, single-center randomized study was conducted at University Hospital "St. Marina" – Varna from June 2023 to July 2024, after approval by the Ethic Committee (No. 128/02.03.2023). 131 patients undergoing robot-assisted surgery in the Trendelenburg position were included. All patients were ventilated with VC/AutoFlow, a tidal volume (Vt) of 6-8 ml/kg, and respiratory rate (RR) adjusted according to ETCO2, targeting 28-42 mmHg. FiO2 was reduced after anesthesia induction to maintain SpO2 > 95%. In the experimental group, an alveolar recruitment maneuver (RM) was performed twice: first after Trendelenburg positioning and before pneumoperitoneum, and second after pneumoperitoneum and leveling of the operating table. At the end of the recruitment, Vt was maintained at 6-8 ml/kg and PEEP at 5 cmH2O. Surgeries were performed by a single surgical team using the da Vinci robotic system.
Results. The performance of the alveolar recruitment maneuver significantly increased dynamic lung compliance (Cdyn), particularly in obese patients. It also reduced peak inspiratory pressures (Ppeak) and allowed for a significant reduction in FiO2.
Conclusion. The alveolar recruitment maneuver is a valuable part of modern protective ventilation strategies, especially for preventing intraoperative pulmonary atelectasis. It can be considered a safe and effective method, particularly for obese patients and those undergoing robotic surgery in the Trendelenburg position. |
|---|---|
| ISSN: | 1312-773X |