Anesthesiology: Comparison of individualized and immobilized positive end-expiratory pressure during intraoperative mechanical ventilation in obese patients: a secondary analysis

background

General anesthesia may cause atelectasis and worsening of oxygenation in obese patients
.
The authors hypothesized that, compared with a fixed positive end expiratory pressure (PEEP), individualized positive end expiratory pressure can improve intraoperative oxygenation and ventilation distribution

method

This secondary analysis included all obese patients in the multi-center intraoperative protective ventilation (PROBESE) trial (n=42) and the local single-center trial (n=54) for obese patients conducted at Leipzig University Hospital
.
The selection criteria for both trials were selective laparoscopic abdominal surgery, with a body mass index greater than or equal to 35kg/m2.

result

After combining the two lower PEEP groups, 90 patients were divided into three groups for evaluation
.
The median of individualized PEEP is 18 (interquartile range 16-22; range, 10-26) cmH2O

in conclusion

This second analysis of obese patients undergoing laparoscopic surgery found that through the use of personalized PEEP electrical impedance tomography measurement, better oxygenation, lower driving pressure, and ventilation to the dependent lung area can be obtained.
Distribution
.
However, the effect of this on the prognosis of patients is unclear

Original source:

Philipp Simon, et al.