Ultrasonographic evaluation of the effect of recruitment maneuvers and positive end-expiratory pressure on diaphragmatic functions in obese patients undergoing laparoscopic sleeve gastrectomy: A randomized controlled study

Ellatif, Shereen E Abd; Mowafy, Sherif M S

doi:10.1080/11101849.2020.1762281

Cited by 2 publications

(10 citation statements)

References 37 publications

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“…The reasons for the 183 exclusions were as follows: 105 were non-RCTs, 7 were non-adult studies, 18 reported open abdominal surgery, 13 did not report PPCs, 33 were animal experiments and 7 did not compare recruitment maneuvers to conventional mechanical ventilation. Finally, 17 RCTs with a total of 3480 patients were examined [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. The details of the included studies are presented in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Due to the completeness of the outcome data and lack of selective reporting, the risks of attrition bias and reporting bias were likewise evaluated as low. Five trials did not provide information on allocation concealment [ 18 , 26 , 28 , 31 , 32 ]. Twelve studies did not report the blinding of the outcome evaluators [ 15 , 18 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five trials did not provide information on allocation concealment [ 18 , 26 , 28 , 31 , 32 ]. Twelve studies did not report the blinding of the outcome evaluators [ 15 , 18 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Seven studies showed a high risk of “other bias” owing to the small sample sizes [ 16 , 18 , 24 , 26 , 28 , 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies did not report the blinding of the outcome evaluators [ 15 , 18 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Seven studies showed a high risk of “other bias” owing to the small sample sizes [ 16 , 18 , 24 , 26 , 28 , 30 , 31 ]. We did not detect publication bias for each index using Begg’s test and Egger’s test with Stata (version 17.0, StataCorp, College Station, TX, USA).…”

Section: Resultsmentioning

confidence: 99%

“…In addition to patient characteristics, the RM itself is worthy of further discussion. Some experiments used single RM [ 18 , 23 , 26 , 29 , 30 ], while others employed repeated RMs [ 16 , 17 , 19 , 20 , 21 , 22 , 24 , 25 , 27 , 28 ]. The results showed that both methods reduced PPCs.…”

Section: Discussionmentioning

confidence: 99%

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Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Pei

Wei

Yang

et al. 2022

JCM

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Background: Lung-protective ventilation strategies are recommended for patients undergoing mechanical ventilation. However, there are currently no guidelines to follow regarding recruitment maneuvers (RMs). We attempted to identify the effects of RMs on patients undergoing laparoscopic abdominal surgery. Methods: We searched for randomized controlled trials (RCTs) in PubMed, the Cochrane Library databases, Embase, Web of Science and the ClinicalTrials.gov registry for trials published up to December 2021. The primary outcome was postoperative pulmonary complications (PPCs). The secondary outcomes consisted of the static lung compliance, driving pressure (DP), intraoperative oxygenation index (OI), OI in the post-anesthesia care unit (PACU), mean arterial pressure (MAP) and heart rate (HR). Seventeen RCTs with a total of 3480 patients were examined. Results: Patients who received RMs showed a considerable reduction in PPCs (risk ratio (RR) = 0.70; 95% confidence interval (CI): 0.62 to 0.79; p < 0.01), lower DP (weighted mean difference (WMD) = −3.96; 95% CI: −5.97 to −1.95; p < 0.01), elevated static lung compliance (WMD = 10.42; 95% CI: 6.13 to 14.71; p < 0.01) and improved OI (intraoperative: WMD = 53.54; 95% CI: 21.77 to 85.31; p < 0.01; PACU: WMD = 59.40; 95% CI: 39.10 to 79.69; p < 0.01) without substantial changes in MAP (WMD = −0.16; 95% CI −1.35 to 1.03; p > 0.05) and HR (WMD = −1.10; 95% CI: −2.29 to 0.10; p > 0.05). Conclusions: Recruitment maneuvers reduce postoperative pulmonary complications and improve respiratory mechanics and oxygenation in patients undergoing laparoscopic abdominal surgery. More data are needed to elucidate the effect of recruitment maneuver on the circulatory system.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Pei

Wei

Yang

et al. 2022

JCM

View full text Add to dashboard Cite

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Ventilation Strategies During General Anesthesia for Noncardiac Surgery: A Systematic Review and Meta-Analysis

Bolther¹,

Henriksen²,

Holmberg

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: The optimal ventilation strategy during general anesthesia is unclear. This systematic review investigated the relationship between ventilation targets or strategies (eg, positive end-expiratory pressure [PEEP], tidal volume, and recruitment maneuvers) and postoperative outcomes. METHODS: PubMed and Embase were searched on March 8, 2021, for randomized trials investigating the effect of different respiratory targets or strategies on adults undergoing noncardiac surgery. Two investigators reviewed trials for relevance, extracted data, and assessed risk of bias. Meta-analyses were performed for relevant outcomes, and several subgroup analyses were conducted. The certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: This review included 63 trials with 65 comparisons. Risk of bias was intermediate for all trials. In the meta-analyses, lung-protective ventilation (ie, low tidal volume with PEEP) reduced the risk of combined pulmonary complications (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.28–0.49; 9 trials; 1106 patients), atelectasis (OR, 0.39; 95% CI, 0.25–0.60; 8 trials; 895 patients), and need for postoperative mechanical ventilation (OR, 0.36; 95% CI, 0.13–1.00; 5 trials; 636 patients). Recruitment maneuvers reduced the risk of atelectasis (OR, 0.44; 95% CI, 0.21–0.92; 5 trials; 328 patients). We found no clear effect of tidal volume, higher versus lower PEEP, or recruitment maneuvers on postoperative pulmonary complications when evaluated individually. For all comparisons across targets, no effect was found on mortality or hospital length of stay. No effect measure modifiers were found in subgroup analyses. The certainty of evidence was rated as very low, low, or moderate depending on the intervention and outcome. CONCLUSIONS: Although lung-protective ventilation results in a decrease in pulmonary complications, randomized clinical trials provide only limited evidence to guide specific ventilation strategies during general anesthesia for adults undergoing noncardiac surgery.

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Ultrasonographic evaluation of the effect of recruitment maneuvers and positive end-expiratory pressure on diaphragmatic functions in obese patients undergoing laparoscopic sleeve gastrectomy: A randomized controlled study

Abstract: 2020) Ultrasonographic evaluation of the effect of recruitment maneuvers and positive end-expiratory pressure on diaphragmatic functions in obese patients undergoing laparoscopic sleeve gastrectomy: A randomized controlled study,

Cited by 2 publications

References 37 publications

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Recruitment Maneuver to Reduce Postoperative Pulmonary Complications after Laparoscopic Abdominal Surgery: A Systematic Review and Meta-Analysis

Ventilation Strategies During General Anesthesia for Noncardiac Surgery: A Systematic Review and Meta-Analysis

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