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Randomized Controlled Trial
. 2022 May 2;22(1):134.
doi: 10.1186/s12871-022-01664-y.

The efficacy of different alveolar recruitment maneuvers in holmium laser lithotripsy surgery under general anesthesia using a laryngeal mask

Fu-Rong Bai  1 , Hong-Mei Li  1 , Ming-Liang Yi  1 , Hong Yin  1 , Wei Wu  2   3
Affiliations
Randomized Controlled Trial

The efficacy of different alveolar recruitment maneuvers in holmium laser lithotripsy surgery under general anesthesia using a laryngeal mask

Fu-Rong Bai et al. BMC Anesthesiol. .

Abstract

Background: Alveolar recruitment maneuvers (ARMs) is an important part of lung-protective ventilation strategies (LPVSs), but the optimal duration and interval Remain unclear.

Methods: Patients:252 patients who underwent holmium laser lithotripsy surgery and meet inclusion criteria were included and randomized into three groups based on the duration and frequency of ARMs (Regular, one 30 s ARM (RARMs); Improved and intermittent, three 10s ARMs (IARMs); and Control (C), no ARMs).

Interventions: Groups R and I received ARMs at 20 cmH2O pressures every 30 min. All patients received the same anesthesia and mechanical ventilation.

Measurements: Outcomes included heart rate and mean arterial pressure changes during ARMs and postoperative pulmonary complications (PPCs) within the first 7 postoperative days.

Main results: Incidences of PPCs in groups R(7.1%) and I (5.0%)were slightly lower than those in group C (8.9%).This indicated the potential to reduce lung injury. Heart rate and mean arterial pressure fluctuations during ARMs were significantly higher in groups R and I than in group C (P < 0.01). The rate of blood pressure decrease was significantly higher in group R than in group I (P < 0.01).

Conclusions: IARMs can reduce cycle fluctuations than RARMs in patients Undergoing holmium laser lithotripsy surgery with laryngeal mask general anesthesia. Low tidal volume ventilation and low PEEP combined with ARM did not significantly reduce the incidence of PPCs in healthy lung patients, but tended to reduce lung injury.

Trial registration: The study was registered on the Chinese Clinical Trial Registry. ( ChiCTR2000030815 ,15/03/2020). This study was approved by the ethics committee of Chengdu Fifth People's Hospital with approval number(2020-005(Study)-1).

Keywords: Alveolar recruitment maneuvers; Laryngeal mask; Lung protective ventilation strategy; Postoperative pulmonary complications.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram
Fig. 2
Fig. 2
Cardiovascular system changes during ARM in the 3 groups Legend:“*“Comparison between the two groups, P < 0.05
See this image and copyright information in PMC

References

    1. Kronenberg P, Somani B. Advances in Lasers for the Treatment of Stones—a Systematic Review [J] Curr Urol Rep. 2018;19(6):1–11. doi: 10.1007/s11934-018-0807-y. - DOI - PubMed
    1. Yang D, Grant MC, Stone A, et al. A meta-analysis of intraoperative ventilation strategies to prevent pulmonary complications: is low tidal volume alone sufficient to protect healthy lungs? [J] Ann Surg. 2016;263(5):881–887. doi: 10.1097/SLA.0000000000001443. - DOI - PubMed
    1. Fernandez-Bustamante A, Frendl G, Sprung J, et al. Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: A Multicenter Study by the Perioperative Research Network Investigators [J] JAMA Surgery. 2017;152(2):157–166. doi: 10.1001/JAMASURG.2016.4065. - DOI - PMC - PubMed
    1. Young Christopher C, Harris Erica M. Vacchiano Charles,et al. Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations.[J]. Br J Anaesth. 2019;123(6). 10.1016/j.bja.2019.08.017.
    1. Spieth PM, Giildner A, Uhlig C, et al. Variable versus conventional lung protective mechanical ventilation during open abdominal surgery: Study protocol for a randomized controlled trial [J] Trials. 2014;15:155–156. doi: 10.1016/j.bja.2017.11.078. - DOI - PMC - PubMed

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