Minerva anestesiologica
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Minerva anestesiologica · Feb 2018
Physiological effects of the open lung approach during laparoscopic cholecystectomy: focus on driving pressure.
During laparoscopy, respiratory mechanics and gas exchange are impaired because of pneumoperitoneum and atelectasis formation. We applied an open lung approach (OLA) consisting in lung recruitment followed by a decremental positive-end expiratory pressure (PEEP) trial to identify the level of PEEP corresponding to the highest compliance of the respiratory system (best PEEP). Our hypothesis was that this approach would improve both lung mechanics and oxygenation without hemodynamic impairment. ⋯ In patients undergoing laparoscopic cholecystectomy, the OLA was suitable for bedside PEEP setting, improved lung mechanics and gas exchange without significant adverse hemodynamic effects.