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Pressure Support versus Spontaneous Ventilation during Anesthetic Emergence-Effect on Postoperative Atelectasis: A
Heejoon Jeong1, Pisitpitayasaree Tanatporn2, Hyun Joo Ahn1
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Anesthesiology
|October 5, 2021
Summary
Pressure support ventilation during anesthesia emergence reduced postoperative atelectasis in patients undergoing laparoscopic surgery. This method also improved oxygen levels in the postanesthesia care unit (PACU).
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Respiratory Physiology
Background:
- Limited research exists on pressure support ventilation's (PSV) impact on anesthesia recovery.
- Previous studies focused on PSV for weaning from mechanical ventilation in ICUs.
- The Trendelenburg position during laparoscopic surgery may increase atelectasis risk.
Purpose of the Study:
- To investigate if PSV during emergence from anesthesia reduces postoperative atelectasis.
- To assess PSV's effect on oxygenation and saturation post-surgery.
- To evaluate PSV's safety during the emergence period.
Main Methods:
- A randomized controlled double-blinded trial involving 97 adult patients undergoing laparoscopic colectomy or robot-assisted prostatectomy.
- Patients were assigned to PSV or intermittent manual assistance during emergence (end of surgery to extubation).
- Primary outcome: atelectasis incidence via lung ultrasonography in the postanesthesia care unit (PACU); secondary outcomes: Pao2 and oxygen saturation.
Main Results:
- Lower incidence of atelectasis in the PSV group (33%) compared to the control group (57%) (P = 0.024).
- Higher Pao2 levels were observed in the PSV group (92 mmHg) versus the control group (83 mmHg) (P = 0.034).
- No significant difference in postoperative oxygen saturation <92% between groups (19% vs. 22%, P = 0.653).
Conclusions:
- Pressure support ventilation during emergence significantly reduces postoperative atelectasis in patients undergoing specific laparoscopic surgeries.
- PSV improves immediate postoperative oxygenation compared to intermittent manual assistance.
- The study found no adverse events related to the PSV protocol during emergence.
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