title: Effect of recruitment maneuver on arterial oxygenation in patients undergoing robot-assisted laparoscopic prostatectomy with intraoperative 15 cmH2O positive end expiratory pressure.
abstract: BACKGROUND
  This randomized, controlled study was designed to compare the effects of recruitment maneuvers (RMs) with a 15 cmH2O positive end-expiratory pressure (PEEP) on the systemic oxygenation and lung compliance of patients with healthy lungs following robot-assisted laparoscopic prostatectomy (RALP).
  
  
  METHODS
  Sixty patients undergoing a RALP with an intraoperative 15 cmH2O PEEP were randomly allocated to an RM or a Control group. The patients in the RM group received a single RM through the application of a continuous positive airway pressure of 40 cmH2O for 40 s 15 min after being placed in the Trendelenburg position. The arterial oxygen tension (PaO2, primary endpoint) and the pulmonary dynamic and static compliances (secondary endpoints) were measured 10 min after the anesthetic induction (T1), 10 min after establishment of the pneumoperitoneum (T2), 10 min after establishment of the Trendelenburg position (T3), 10 min after the RM (T4), 60 min after the RM (T5), and 10 min after deflation of the pneumoperitoneum in the supine position (T6).
  
  
  RESULTS
  The intergroup comparisons of the PaO2showed significantly higher values in the RM group than in the Control group at T4 and T5 (193 ± 35 mmHg vs. 219 ± 33 mmHg, P = 0.015, 188 ± 41 mmHg vs. 214 ± 42 mmHg, P = 0.005, respectively). However, the PaO2at T6 was similar in the two groups (211 ± 39 mmHg vs. 224 ± 41 mmHg, P = 0.442). Moreover, there were no statistical differences between the groups in the dynamic and static compliances of the lungs at any time point.
  
  
  CONCLUSIONS
  The arterial oxygenation of the patients with a healthy lung function who had undergone a RALP with intraoperative 15 cmH2O PEEP was improved by a single RM. However, this benefit did not last long, and it did not lead to an amelioration of the lung mechanics.
authors.affiliation: Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Sowoon
authors.identifier: 0000-0002-2990-528X
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu, Daegu, Korea.
authors.forename: Sung Hye
authors.identifier: 0000-0002-9287-5087
authors.initials: SH
authors.lastname: Byun
authors.affiliation: Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Haeyoon
authors.initials: H
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Koo
authors.affiliation: Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Jong Chan
authors.identifier: 0000-0001-7051-905X
authors.initials: JC
authors.lastname: Kim
keywords: Pneumoperitoneum; Recruitment maneuver; Robot-assisted laparoscopic prostatectomy; Steep Trendelenburg position