Eur J Anaesthesiol: Intraoperative lung ventilation protective strategy reduces postoperative complications after laparoscopic colorectal cancer resection: a randomized controlled trial

background

The role of the combined application of positive end-expiratory pressure (PEEP) and expanded lung (LRM) (known as protective lung ventilation strategy, OLS) in intraoperative mechanical ventilation is still unclear

Purpose

It aims to determine whether the open lung strategy of moderate PEEP (6-8cmH2O) and repetitive LRMs can prevent postoperative complications in high-risk patients undergoing laparoscopic colorectal cancer resection under low tidal volume

Test design

A prospective, blinded evaluator, randomized controlled trial

Range setting

It was performed in a single-center university hospital from January 2017 to October 2018

Subject population

Included 280 patients at risk of pulmonary complications, under general anesthesia and low tidal volume (6-8ml kg-1 ideal body weight) under laparoscopic colorectal cancer resection

Intervention factors

The patients were randomly divided into two groups (1:1), the PEEP was 6-8cmH2O, the OLS group with LRMs repeated every 30 minutes and the non-OLS group without LRMs and PEEP was zero

Main observation index determination

The main observation index is the main pulmonary and extrapulmonary complications that occurred within 7 days after surgery

result

A total of 130 patients in each group were included in the preliminary result analysis

in conclusion

In high-risk patients undergoing laparoscopic colorectal cancer resection under low tidal volume ventilation, the lung opening strategy with PEEP of 6-8 cmH2O and repeated LRMs reduced postoperative complications compared with the strategy of using zero PEEP and not using LRMs

Original source:

Hong LiM, Zhi-Nan ZhengM, Nan-Rong Zhang, et al.