Different ventilation techniques and hemodynamic optimization to maintain regional cerebral oxygen saturation (rScO2) during laparoscopic bariatric surgery: a prospective randomized interventional study

Different ventilation techniques and hemodynamic optimization to maintain regional cerebral... Purpose The purpose of this study was to assess the changes in regional cerebral oxygen saturation (rScO ) in response to different ventilation strategies: inspired oxygen concentration (FiO ), end-tidal carbon dioxide (EtCO ), and positive end 2 2 expiratory pressure (PEEP) in addition to optimizing mean arterial pressure (MAP) in obese patients subjected to laparoscopic bariatric surgery in the reverse trendelenburg position. Methods 50 obese patients were randomly assigned into one of two groups. Each group is 25 patients. Control patients sub- jected to a ventilation strategy aimed to maintain FiO 0.4 and E tCO 30 mmHg without PEEP. Study patients were assigned 2 2 to specific protocol; T0, baseline rScO ; T1, 5 min following induction; T2, PP/RTP (10 min after pneumoperitoneum and reverse trendelenburg position); T3, PEEP 10 cmH O; T4, FiO 1.0; T5, EtCO 40 mmHg and T6, MAP/BL; MAP back to 2 2 2 baseline in both groups. Main results 10 min after PP/RTP, there was a significant decrease in rScO in both groups. At T4, with F iO 1.0, there was 2 2 significant improvement in rScO when compared to T2. At T5, with EtCO 40 mmHg, rScO significantly enhanced when 2 2 2 compared to EtC O 30 mmHg. At http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Anesthesia Springer Journals

Different ventilation techniques and hemodynamic optimization to maintain regional cerebral oxygen saturation (rScO2) during laparoscopic bariatric surgery: a prospective randomized interventional study

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Publisher
Springer Japan
Copyright
Copyright © 2018 by Japanese Society of Anesthesiologists
Subject
Medicine & Public Health; Anesthesiology; Pain Medicine; Intensive / Critical Care Medicine; Emergency Medicine
ISSN
0913-8668
eISSN
1438-8359
D.O.I.
10.1007/s00540-018-2493-9
Publisher site
See Article on Publisher Site

Abstract

Purpose The purpose of this study was to assess the changes in regional cerebral oxygen saturation (rScO ) in response to different ventilation strategies: inspired oxygen concentration (FiO ), end-tidal carbon dioxide (EtCO ), and positive end 2 2 expiratory pressure (PEEP) in addition to optimizing mean arterial pressure (MAP) in obese patients subjected to laparoscopic bariatric surgery in the reverse trendelenburg position. Methods 50 obese patients were randomly assigned into one of two groups. Each group is 25 patients. Control patients sub- jected to a ventilation strategy aimed to maintain FiO 0.4 and E tCO 30 mmHg without PEEP. Study patients were assigned 2 2 to specific protocol; T0, baseline rScO ; T1, 5 min following induction; T2, PP/RTP (10 min after pneumoperitoneum and reverse trendelenburg position); T3, PEEP 10 cmH O; T4, FiO 1.0; T5, EtCO 40 mmHg and T6, MAP/BL; MAP back to 2 2 2 baseline in both groups. Main results 10 min after PP/RTP, there was a significant decrease in rScO in both groups. At T4, with F iO 1.0, there was 2 2 significant improvement in rScO when compared to T2. At T5, with EtCO 40 mmHg, rScO significantly enhanced when 2 2 2 compared to EtC O 30 mmHg. At

Journal

Journal of AnesthesiaSpringer Journals

Published: Apr 6, 2018

References

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