The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial

Kim, Min Soo; Kim, Na Young; Lee, Ki-Young; Choi, Young Deuk; Hong, Jung Hwa; Bai, Sun Joon

doi:10.1007/s12630-015-0383-2

Cited by 22 publications

(46 citation statements)

References 27 publications

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“…5,9,15,16,23–25 The included articles consisted of 4 randomized parallel-group trials, 5,9,15,25 2 randomized crossover trials, 16,24 and 1 nonrandomized single-group trial. 23 The characteristics of the included trials are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…In crossover trials and a nonrandomized single-group trial, the time period of the application of each ratio was 20 23 or 30 16,24 minutes, and data collection for each ratio was thus established only once. In all of the included parallel-group trials, 5,9,15,25 data collection was conducted at 30 and 60 minutes after applying specific interventions such as OLV or laparoscopy according to the surgical procedures. The results at the first assessment point, that is, at 30 minutes, were used for primary analyses of crossover trials.…”

Section: Resultsmentioning

confidence: 99%

“…One enrolled trial comparing ERV and CRV measured cardiac output noninvasively, and no significant difference was observed between ERV and CRV. 15 Intraoperative oxygen indices, the primary outcomes in this meta-analysis, were provided as PaO 2 in most of the included articles, 9,15,16,23–25 except one article that presented PaO 2 /FiO 2 . 5 …”

Section: Resultsmentioning

confidence: 99%

“…All of the included articles contained comparisons of intraoperative oxygenation indices, including PaO 2 9,15,16,23–25 or PaO 2 /FiO 2 5 between the ratios. The overall analysis did not show any differences in intraoperative oxygenation (SMD 0.193, 95% confidence interval (CI) −0.094 to 0.481, P = 0.188, I 2 = 56.6%, D-L random), and publication bias was not suspected in Egger test ( P = 0.370).…”

Section: Resultsmentioning

confidence: 99%

“…5,7,13,15,16 Thus, we performed a systematic review and meta-analysis to confirm the clinical efficacy of the prolonged I:E ratio of 1:1 for intraoperative oxygenation and respiratory mechanics compared with the conventional I:E ratio of 1:2.…”

Section: Introductionmentioning

confidence: 99%

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Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures

Park

Lee

Lee³

et al. 2016

Medicine

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Prolonged inspiratory to expiratory (I:E) ratio ventilation has been researched to reduce lung injury and improve oxygenation in surgical patients with one-lung ventilation (OLV) or carbon dioxide (CO2) pneumoperitoneum.We aimed to confirm the efficacy of the 1:1 equal ratio ventilation (ERV) compared with the 1:2 conventional ratio ventilation (CRV) during surgical procedures.Electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched.Prospective interventional trials that assessed the effects of prolonged I:E ratio of 1:1 during surgical procedures.Adult patients undergoing OLV or CO2 pneumoperitoneum as specific interventions depending on surgical procedures.The included studies were examined with the Cochrane Collaboration's tool. The data regarding intraoperative oxygenation and respiratory mechanics were extracted, and then pooled with standardized mean difference (SMD) using the method of Hedges.Seven trials (498 total patients, 274 with ERV) were included. From overall analysis, ERV did not improve oxygenation at 20 or 30 minutes after specific interventions (SMD 0.193, 95% confidence interval (CI): −0.094 to 0.481, P = 0.188). From subgroup analyses, ERV provided significantly improved oxygenation only with laparoscopy (SMD 0.425, 95% CI: 0.167–0.682, P = 0.001). At 60 minutes after the specific interventions, ERV improved oxygenation significantly in the overall analysis (SMD 0.447, 95% CI: 0.209–0.685, P < 0.001) as well as in the subgroup analyses with OLV (SMD 0.328, 95% CI: 0.011–0.644, P = 0.042) and laparoscopy (SMD 0.668, 95% CI: 0.052–1.285, P = 0.034). ERV provided lower peak airway pressure (Ppeak) and plateau airway pressure (Pplat) than CRV, regardless of the type of intervention.The relatively small number of the included articles and their heterogeneity could be the main limitations.ERV improved oxygenation at all of the assessment points during laparoscopy. In OLV, oxygenation improvement with ERV was observed 1 hour after application. ERV could be beneficial to reduce the Ppeak and Pplat.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures

Park

Lee

Lee³

et al. 2016

Medicine

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Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

Young

Harris

Vacchiano

et al. 2019

British Journal of Anaesthesia

260

218

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Postoperative pulmonary complications (PPCs) occur frequently and are associated with substantial morbidity and mortality. Evidence suggests that reduction of PPCs can be accomplished by using lung-protective ventilation strategies intraoperatively, but a consensus on perioperative management has not been established. We sought to determine recommendations for lung protection for the surgical patient at an international consensus development conference. Seven experts produced 24 questions concerning preoperative assessment and intraoperative mechanical ventilation for patients at risk of developing PPCs. Six researchers assessed the literature using questions as a framework for their review. The modified Delphi method was utilised by a team of experts to produce recommendations and statements from study questions. An expert consensus was reached for 22 recommendations and four statements. The following are the highlights: (i) a dedicated score should be used for preoperative pulmonary risk evaluation; and (ii) an individualised mechanical ventilation may improve the mechanics of breathing and respiratory function, and prevent PPCs. The ventilator should initially be set to a tidal volume of 6e8 ml kg À1 predicted body weight and positive end-expiratory pressure (PEEP) 5 cm H 2 O. PEEP should be individualised thereafter. When recruitment manoeuvres are performed, the lowest effective pressure and shortest effective time or fewest number of breaths should be used.

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Lung protective ventilation strategy to reduce postoperative pulmonary complications (PPCs) in patients undergoing robot-assisted laparoscopic radical cystectomy for bladder cancer: A randomized double blinded clinical trial

Huang

Zhou

et al. 2021

Journal of Clinical Anesthesia

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The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial

Cited by 22 publications

References 27 publications

Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures

Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures

Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

Lung protective ventilation strategy to reduce postoperative pulmonary complications (PPCs) in patients undergoing robot-assisted laparoscopic radical cystectomy for bladder cancer: A randomized double blinded clinical trial

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