See the published version of this preprint at BMC Anesthesiology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Susie Yoon
Seoul National University Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5281-5904
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The intraoperative alveolar recruitment maneuver (ARM) efficiently treats atelectasis, but the effect of Fio 2 during ARM on atelectasis is uncertain. Here, we investigated this effect.
Methods
Patients undergoing elective laparoscopic surgery in the Trendelenburg position were randomized to low- (Fio 2 0.4; n=44) and high-Fio 2 (Fio 2 1.0, n=46) groups. ARMs were performed 1-min post tracheal intubation and post changes between supine and Trendelenburg positions during surgery. Intraoperative Fio 2 was set at 0.4 for both groups. Modified lung ultrasound (LUS) scores were calculated to assess lung aeration after inducing anesthesia and at surgery completion. The primary outcome was modified LUS score at the end of the surgery, and secondary outcomes were the intra- and postoperative Pao 2 to Fio 2 ratio and postoperative pulmonary complications.
Results
Both groups presented similar modified LUS scores before capnoperitoneum and ARM ( P =0.747). However, the postoperative modified LUS score was significantly lower in the low- than in the high-Fio 2 group (7.0±4.1 vs 11.7±4.2, mean difference 4.7, 95% CI 2.96–6.44, P <0.001). Significant atelectasis postoperatively was more common in the high-Fio 2 group (relative risk 1.77, 95% CI 1.27‒2.47, P <0.001). Intra- and postoperative Pao 2 to Fio 2 were similar and no postoperative pulmonary complications occurred. Atelectasis occurred more frequently when ARM was performed with high than with low Fio 2 . High-Fio 2 did not benefit oxygenation.
Conclusions
In patients undergoing laparoscopic surgery in the Trendelenburg position, absorption atelectasis occurred more frequently when the ARM was performed with high rather than low Fio 2 . No oxygenation benefit was observed in the high-Fio 2 group.
Keywords
Alveolar recruitment, lung, oxygen, pulmonary atelectasis, ultrasonography
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
No community comments so far
Editorial decision: Accept
On 09 Jul, 2020
Editor assigned
On 08 Jul, 2020
Submission checks complete
On 07 Jul, 2020
Editor invited
On 07 Jul, 2020
Version 2
Posted 01 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 05 Jul, 2020
Editor assigned
On 28 Jun, 2020
Submission checks complete
On 27 Jun, 2020
Editor invited
On 27 Jun, 2020
No comments provided
Editorial decision: Major revision
On 27 May, 2020
Review #3 received
Received 26 May, 2020
Reviewer #4 agreed
On 20 May, 2020
Review #2 received
Received 14 May, 2020
Review #1 received
Received 13 May, 2020
Reviewers invited
Invitations sent on 12 May, 2020
Reviewer #1 agreed
On 12 May, 2020
Reviewer #2 agreed
On 12 May, 2020
Reviewer #3 agreed
On 12 May, 2020
Submission checks complete
On 06 May, 2020
Editor assigned
On 06 May, 2020
Editor invited
On 05 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Anesthesiology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Susie Yoon
Seoul National University Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5281-5904
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
No community comments so far
Editorial decision: Accept
On 09 Jul, 2020
Editor assigned
On 08 Jul, 2020
Submission checks complete
On 07 Jul, 2020
Editor invited
On 07 Jul, 2020
Version 2
Posted 01 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 05 Jul, 2020
Editor assigned
On 28 Jun, 2020
Submission checks complete
On 27 Jun, 2020
Editor invited
On 27 Jun, 2020
No comments provided
Editorial decision: Major revision
On 27 May, 2020
Review #3 received
Received 26 May, 2020
Reviewer #4 agreed
On 20 May, 2020
Review #2 received
Received 14 May, 2020
Review #1 received
Received 13 May, 2020
Reviewers invited
Invitations sent on 12 May, 2020
Reviewer #1 agreed
On 12 May, 2020
Reviewer #2 agreed
On 12 May, 2020
Reviewer #3 agreed
On 12 May, 2020
Submission checks complete
On 06 May, 2020
Editor assigned
On 06 May, 2020
Editor invited
On 05 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Anesthesiology.
Background
The intraoperative alveolar recruitment maneuver (ARM) efficiently treats atelectasis, but the effect of Fio 2 during ARM on atelectasis is uncertain. Here, we investigated this effect.
Methods
Patients undergoing elective laparoscopic surgery in the Trendelenburg position were randomized to low- (Fio 2 0.4; n=44) and high-Fio 2 (Fio 2 1.0, n=46) groups. ARMs were performed 1-min post tracheal intubation and post changes between supine and Trendelenburg positions during surgery. Intraoperative Fio 2 was set at 0.4 for both groups. Modified lung ultrasound (LUS) scores were calculated to assess lung aeration after inducing anesthesia and at surgery completion. The primary outcome was modified LUS score at the end of the surgery, and secondary outcomes were the intra- and postoperative Pao 2 to Fio 2 ratio and postoperative pulmonary complications.
Results
Both groups presented similar modified LUS scores before capnoperitoneum and ARM ( P =0.747). However, the postoperative modified LUS score was significantly lower in the low- than in the high-Fio 2 group (7.0±4.1 vs 11.7±4.2, mean difference 4.7, 95% CI 2.96–6.44, P <0.001). Significant atelectasis postoperatively was more common in the high-Fio 2 group (relative risk 1.77, 95% CI 1.27‒2.47, P <0.001). Intra- and postoperative Pao 2 to Fio 2 were similar and no postoperative pulmonary complications occurred. Atelectasis occurred more frequently when ARM was performed with high than with low Fio 2 . High-Fio 2 did not benefit oxygenation.
Conclusions
In patients undergoing laparoscopic surgery in the Trendelenburg position, absorption atelectasis occurred more frequently when the ARM was performed with high rather than low Fio 2 . No oxygenation benefit was observed in the high-Fio 2 group.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Loading...