| Ahmed et al.(2727. Ahmed WG, Abu-Elnasr NE, Ghoneim SH. The effects of single vs.
repeated vital capacity maneuver on arterial oxygenation and compliance in obese
patients presenting for laparoscopic bariatric surgery. Ain Shams J Anesthesiol.
2012;5(1):121-32.)
|
2012 |
G1=20 patients |
Age between 20
and 50 years, BMI>35kg/m2, undergoing laparoscopy bariatric
surgery |
To determine
the effects of single or repeated ARM followed by PEEP used to prevent
atelectasis in the postoperative period |
Group I: control group |
Repeated ARM
with posterior maintenance of PEEP of 10cmH2O maintained
increased PaO2, PaO2/FiO2 and static
pulmonary compliance in obese patients undergoing bariatric surgery |
| |
|
G2=20 patients |
Group II: ARM (40cmH2O for 7 seconds) and posterior
ventilation with PEEP of 10cmH2O |
| |
|
G3=20 patients |
Group III: ARM (40cmH2O for 7 seconds, repeated every 30
minutes, repeating up to 90 minutes) and posterior ventilation with PEEP
of 10cmH2O |
| El Sayed et al.(3131. El-Sayed KM, Tawfeek MM. Perioperative ventilatory strategies for
improving arterial oxygenation and respiratory mechanics in morbidly obese patients
undergoing laparoscopic bariatric surgery. Egypt J Anaesth.
2012;28(1):9-15.)
|
2012 |
G1=19 patients |
Patients with
ASA grade II and III, morbidly obese (BMI> 50kg/m2)
patients with grade II and III ASA, undergoing laparoscopic bariatric
surgery |
To study the
efficacy and safety of two different levels of PEEP after ARM in patients
undergoing laparoscopic surgery and to evaluate the use of NIV
post-extubation compared with conventional therapy (O2) |
Group I: ARM (40cmH2O for 15 seconds) and PEEP of
10cmH2O, O2 was used after extubation |
The ARM with
PEEP of 40cmH2O, for 15 seconds, followed by the use of PEEP
of 15cmH2O improves pulmonary compliance and oxygenation in
morbidly obese patients undergoing bariatric surgery. Furthermore, NIV
after extubation was effective in maintaining oxygenation and preventing
of alveolar derecruitment |
| |
|
G2=19 patients |
Group II: ARM (40cmH2O for 15 seconds) and PEEP of
15cmH2O, O2 was used after extubation |
| |
|
G3=18 patients |
Group III: ARM (40cmH2O for 15 seconds) and PEEP of
15cmH2O, NIV was used after extubation |
| Futier et al.(3030. Futier E, Constantin JM, Pelosi P, Chanques G, Massone A, Petit A,
et al. Noninvasive ventilation and alveolar recruitment maneuver improve respiratory
function during and after intubation of morbidly obese patients. Anesthesiology.
2011;114(6):1354-63.)
|
2011 |
G1=22 patients |
Obese patients
with BMI>40kg/m2 and ASA grade II and III who were
undergoing laparoscopic gastrectomy |
To determine
whether NIV improves arterial oxygenation and end expiratory volume in
comparison with conventional oxygenation and to determine if the NIV
followed by ARM after endotracheal intubation improves oxygenation and
respiratory function compared with isolated NIV |
Group I: pre-oxygenation with O2 100% and spontaneous
ventilation |
NIV improves
oxygenation and reduces atelectasis in obese patients compared with
conventional pre-oxygenation. NIV combined with ARM is more effective in
improving respiratory function after intubation |
| |
|
G2=22 patients |
Group II: SP followed by NIV; |
| |
|
G3=22 patients |
Group III: ARM followed by NIV |
| Hemmes et al.(2929. Hemmes SN, Severgnini P, Jaber S, Canet J, Wrigge H, Hiesmayr M et
al. Rationale and study design of PROVHILO - a worldwide multicenter randomized
controlled trial on protective ventilation during general anesthesia for open
abdominal surgery. Trials. 2011;6(12):111-21.)
|
2011 |
G1=450 patients |
Patients
scheduled for non-laparoscopic abdominal surgery at high or intermediate
risk of postoperative pulmonary complications |
Comparison of
two ventilation protocols |
Group I: conventional ventilation with PEEP of 2cmH2O |
These patients
exhibited an improvement in oxygenation and respiratory mechanics in the
short term. |
| |
|
G2=450 patients |
Group II: PEEP of 12cmH2O which was increased in 4 every 3
breath cycles up to 30-35cmH2O; then, returning to PEEP of
10cmH2O |
| Remístico et al.(88. Remístico PP, Araújo S, Figueiredo LC, Aquim EE, Gomes LM, Sombrio
ML, et al. Impacto da manobra de recrutamento alveolar no pós-operatório de cirurgia
bariátrica videolaparoscópica. Rev Bras Anestesiol.
2011;61(2):163-76.)
|
2011 |
G1=15 patients |
Men and women
between 20 and 65 years old undergoing laparoscopic gastroplasty
surgery |
To assess the
impact of ARM on the incidence of postoperative pulmonary complications
in patients undergoing bariatric surgery |
Group I: conventional mechanic ventilation |
The patients
who received ARM exhibited better spirometric values, reduction of the
incidence of pulmonary complications in thoracic radiography and
improvements in range of BORG |
| |
|
G2=15 patients |
Group II: ARM (PEEP of 30cmH2O and peak pressure of
45cmH2O for 2 minutes after the pneumoperitoneum abdominal
deflation |
| Futier et al.(2626. Futier E, Constantin JM, Pelosi P, Chanques G, Kwiatkoskwi F, Jaber
S, et al. Intraoperative recruitment maneuver reverses detrimental
pneumoperitoneum-induced respiratory effects in healthy weight and obese patients
undergoing laparoscopy. Anesthesiology. 2010;113(6):1310-9)
|
2010 |
G1=30 patients |
Obese patients
with BMI>35kg/m2 and healthy individuals with
BMI<25kg/m2 who were scheduled for performing
laparoscopic surgery |
To investigate
the effects of PEEP at end-expiration on respiratory mechanics and
oxygenation in healthy individuals and obese patients during laparoscopic
surgery |
Group I: healthy individuals |
Both groups
exhibited improved respiratory mechanics as well as oxygenation,
demonstrating that the use of such protocols can avoid the deleterious
effects of pneumoperitoneum. |
| |
|
G2=30 patients |
Group II: obese patients The protocol consisted of PEEP of
10cmH2O in the case of pneumoperitoneum followed by ARM
with PEEP of 40cmH2O for 40 seconds and maintenance of PEEP of
10cmH2O |
| Weingarten et al.(2828. Weingarten TN, Whalen FX, Warner DO, Gajic O, Schears GJ, Snider MR,
et al. Comparison of two ventilatory strategies in elderly patients undergoing major
abdominal surgery. Br J Anaeth. 2010;104(1):16-22.)
|
2010 |
G1=20 patients |
Patients older
than 65 years undergoing open bariatric surgery |
To test the
hypothesis that ARM improves oxygenation and the ventilatory mechanics of
patients undergoing abdominal surgery and to compare a group which used
this strategy with a control group |
Group I: conventional ventilation |
ARM is
tolerated for patients in abdominal surgery and improves oxygenation
during the surgery, and PEEP of 12cmH2O promotes this
effect |
| |
|
G2=20 patients |
Group II: used PEEP of 20cmH2O during the maneuver and then
PEEP of 12cmH2O |
| Almarakbi et al.(2424. Almarakbi WA, Fawzi HM, Alhashemi JA. Effects of four intraoperative
ventilatory strategies on respiratory compliance and gas exchange during laparoscopic
gastric banding in obese patients. Br J Anaesth. 2009;102(6):862-8.)
|
2009 |
G1=15 patients |
Patients
between 18 and 60 years old, ASA grade II, BMI>30kg/m2,
undergoing laparoscopic bariatric surgery |
To evaluate
the best intraoperative strategy for maintaining PaO2 and
static compliance |
Group I: vented with PEEP of 10cmH2O throughout surgical
procedure |
The repeated
use of ARM followed by PEEP of 10cmH2O increased compliance,
PaO2 and decreased PaCO2. Moreover, the
beneficial effects on the oxygenation continued during the recovery
period |
| |
|
G2=15 patients |
Group II: ARM (40cmH2O for 15 seconds) and PEEP of
5cmH2O throughout surgical procedure |
| |
|
G3=15 patients |
Group III: ARM (40cmH2O for 15 seconds) and PEEP of
10cmH2O throughout surgical procedure |
| |
|
G4=15 patients |
Group IV: ARM repeated every 10 minutes (40cmH2O for 15
seconds) followed by PEEP of 10cmH2O throughout surgical
procedure |
| Cakmakkaya et al.(3232. Cakmakkaya OS , Kaya G, Altintas F, Hayirlioglu M, Ekici B.
Restoration of pulmonary compliance after laparoscopic surgery using a simple
alveolar recruitment maneuver. J Clin Anesth. 2009;21(6):422-6.)
|
2009 |
20 patients |
Obese patients undergoing open abdominal surgery |
To test the hypothesis that ARM applied before extubation can improve
pulmonary compliance |
To perform ARM with PEEP of 40cmH2O for 10 seconds |
The respiratory mechanics do not completely reverse the basal levels
after deflation; however, the pulmonary compliance was completely
restored using ARM. |
| Reinius et al.(2222. Reinius H, Jonsson L, Gustafsson S, Sundbom M, Duvernoy O, Pelosi P,
et al. Prevention of atelectasis in morbidly obese patients during general anesthesia
and paralysis: a computerized tomography study. Anesthesiology.
2009;111(5):979-87.)
|
2009 |
G1=10 patients |
Patients with
ASA grade II-III, BMI>40kg/m2, aged between 25 and 54 years
undergoing bariatric surgery |
To assess the
effect of general anesthesia in three different ventilation strategies in
the reduction of atelectasis and improved respiratory function |
Group I: conventional ventilation with PEEP of 10cmH2O |
ARM followed
by PEEP of 10cmH2O reduces atelectasis and improves
oxygenation in obese patients for a long period, whereas mechanical
ventilation with PEEP of 10cmH2O or ARM alone did not improve
the respiratory function |
| |
|
G2=10 patients |
Group II: ARM (PEEP of 55cmH2O, for 10 seconds) followed by
zero PEEP |
| |
|
G3=10 patients |
Group III: ARM (PEEP of 55cmH2O, for 10 seconds) followed by
PEEP of 10cmH2O |
| Souza et al.(2525. Souza AP, Buschpigel M, Mathias LA, Malheiros CA, Alves VL. Análise
dos efeitos da manobra de recrutamento alveolar na oxigenação sanguínea durante
procedimento bariátrico. Rev Bras Anestesiol. 2009;59(2):177-86.)
|
2009 |
G1=14 patients |
Patients
diagnosed with grade III obesity undergoing bariatric surgery |
To compare two
techniques of ARM and assess its response through the
PaO2/FiO2 relationship as well as the
[PaO2+PaCO2] sum in grade III obese
patients |
Group I: conventional ventilation with PEEP of 5cmH2O |
The technique
of ARM with a sudden increase of PEEP to 30cmH2O exhibited a
better response in the PaO2/FiO2 relationship
compared with the other groups |
| |
|
G2=17 patients |
Group II: ARM with progressive increase of PEEP to 10, 15 and
20cmH2O, pause of 40 seconds, and maintenance of each value
of PEEP for 2 minutes |
| |
|
G3=16 patients |
Group III: ARM with sudden increase of PEEP to 30cmH2O for 40
seconds every 2 minutes |
| Sprung et al.(3333. Sprung J, Whalen FX, Comfere T, Bosnjak ZJ, Bajzer Z, Gajic O, et
al. Alveolar recruitment and arterial desflurane concentration during bariatric
surgery. Anesth Analg. 2009;108(1):120-7.)
|
2009 |
G1=9 patients |
Morbidly obese
patients (BMI>40kg/m2) undergoing open bariatric
surgery |
To investigate
whether ARM reverses atelectasis in patients sedated with desflurane
undergoing bariatric surgery |
Group I: ventilation with PEEP of 4cmH2O |
Use of
increasing amounts of PEEP is an effective method to improve oxygenation
in patients undergoing bariatric surgery |
| |
|
G2=8 patients |
Group II: starts ventilation with PEEP of 4cmH2O, after 3
breaths, PEEP of 10cmH2O, 3 breaths PEEP of 15cmH2O
and 20cmH2O maintained for 10 respiratory cycles |
| Talab et al.(2020. Talab HF, Zabani IA, Abdelrahman HS, Bukhari WL, Mamoun I, Ashour
MA, et al. Intraoperative ventilatory strategies for prevention of pulmonary
atelectasis in obese patients undergoing laparoscopic bariatric surgery. Anesth
Analg. 2009;109(5):1511-6.)
|
2009 |
G1=22 patients |
Obese patient
with BMI between 30 and 50kg/m2, aged between 20 and 50 years,
undergoing laparoscopic bariatric surgery |
To assess the
safety and effectiveness of ARM according to the different PEEP used in
the postoperative of bariatric surgery to prevent pulmonary
atelectasis |
Group I: ARM (PEEP 40, for 7-8 seconds) and ventilated with PEEP 0 |
ARM followed
by ventilation with PEEP of 10cmH2O is effective in preventing
atelectasis and is associated with better oxygenation, shorter stay in
the recovery room, and decreased postoperative pulmonary complications in
obese patients undergoing bariatric surgery |
| |
|
G2=22 patients |
Group II: ARM (PEEP 40, for 7-8 seconds) and ventilated with PEEP
5cmH2O |
| |
|
G3=22 patients |
Group III: ARM (PEEP 40, for 7-8 seconds) and ventilated with PEEP
10cmH2O |
| Chalhoub et al.(2323. Chalhoub V, Yazigi A, Sleilaty G, Haddad F, Noun R, Madi-Jebara S,
et al. Effect of vital capacity manoeuvres on arterial oxygenation in morbidly obese
patients undergoing open bariatric surgery. Eur J Anaesthesiol.
2007;24(3):283-8.)
|
2007 |
G1=26 patients |
Morbidly obese
patients (BMI>40kg/m2) undergoing open bariatric
surgery |
To assess the
effect of ARM followed by different values of PEEP on PaO2
values in morbidly obese patients undergoing bariatric surgery |
Group I: conventional ventilation with PEEP of 8cmH2O |
The addition
of ARM followed by ventilation with PEEP of 8cmH2O improves
PaO2 in the intraoperative period in morbidly obese
patients during the open bariatric surgery |
| |
|
G2=26 patients |
Group II: ARM (PEEP of 40cmH2O, for 15 seconds) followed by
ventilation with PEEP of 8cmH2O |
