The Effect of Equal Ratio Ventilation on Oxygenation, Respiratory Mechanics, and Cerebral Perfusion Pressure During Laparoscopy in the Trendelenburg Position.
The aim of this study was to investigate the effects of equal ratio ventilation (ERV) on oxygenation, respiratory mechanics, and the cerebral perfusion pressure during pneumoperitoneum in the Trendelenburg position. Thirty patients undergoing laparoscopic low anterior resection (25 to 65 y) were enrolled. Mechanical ventilator was set to volume-controlled mode at an inspiratory to expiratory (I:E) ratio of 1:2 with a tidal volume of 8 mL/kg of ideal body weight with a 5 cm H2O positive end-expiratory pressure. Twenty minutes after pneumoperitoneum in the Trendelenburg position, the I:E ratio was changed to 1:1 for 20 minutes and then restored to 1:2. No significant changes in arterial oxygen tension and respiratory compliance after adopting ERV. Mean arterial pressure and cerebral perfusion pressure decreased significantly over time after adopting the Trendelenburg position during pneumoperitoneum (P=0.014 and 0.005, respectively). In conclusion, there was no improvement in oxygenation or respiratory mechanics with ERV.
*Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University, Incheon †Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Yonsei University, Seoul, Republic of Korea.
Youn Yi
YY
Jo
Ji Young
JY
Kim
Young Jin
YJ
Chang
Sehwan
S
Lee
Hyun Jeong
HJ
Kwak
D000328:Adult; D000368:Aged; D062186:Arterial Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000009:adverse effects; D002496:Central Venous Pressure / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D018475:Head-Down Tilt / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011175:Positive-Pressure Respiration / Q000379:methods; D015656:Respiratory Mechanics / Q000502:physiology*
D002245:Carbon Dioxide; D010100:Oxygen