Positive end-expiratory pressure increases arterial oxygenation in elderly patients undergoing urological surgery using laryngeal mask airway in lithotomy position.

Journal of Clinical Monitoring and Computing
Doo-Hwan KimYoung-Kug Kim

Abstract

Elderly patients undergoing urological surgery in the lithotomy position may be vulnerable to perioperative hypoxemia. Positive end-expiratory pressure (PEEP) can improve arterial oxygenation. Although laryngeal mask airway (LMA) is widely utilized in urological surgery, it is not known how PEEP affects arterial oxygenation in these patients. We, therefore, evaluated the effect of PEEP on arterial oxygen partial pressure (PaO2) in elderly patients using LMA during urological surgery in the lithotomy position. Patients randomly received zero end-expiratory pressure (group Z, n = 34) or PEEP of 7 cmH2O (group P, n = 33). Ventilatory, respiratory, and haemodynamic variables were measured at 5 min (T0), 30 min (T1), and 60 min (T2) after LMA Supreme™ (sLMA) insertion. The primary outcome was the difference of PaO2 at T2 between the two groups. Atelectasis score, the incidence of a significant leak, and complications associated with sLMA insertion were also evaluated. PaO2 at T2 was significantly higher in group P than in group Z (20.0 ± 4.9 vs. 14.7 ± 3.7 kPa, P < 0.001). Atelectasis score at T2 was lower in group P than in group Z (5.3 ± 1.7 vs. 8.4 ± 2.3, P < 0.001). However, the incidence of a significant leak and complications ...Continue Reading

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