Work

Clinical application of a ventilation strategy based on the P-V curve in obese patients undergoing gynaecological laparoscopic surgery

Year: 2025

Type: article

Abstract: OBJECTIVE: To explore the clinical value of pressure-controlled ventilation-volume guaranteed (PCV-VG) strategy based on the pressure-volume cur ve method in obese patients undergoing gynaecological laparoscopic surger y. METHODS: The retrospective study was conducted in December 2021 after approval from the ethics review committee of Huzhou Maternal and Child Health Hospital, China, and comprised clinical records of obese patients who underwent elective gynaecological laparoscopic surgery between Januar y 2020 and October 2021. The patients were divided into study group A, who under went surger y with PC V-VG, and control group B, who underwent surgery without the PCV-VG. Ventilation parameters in group A were individually set according to the pre-pneumoperitoneum pressurevolume curves. Respirator y parameters, peak air way pressure, end-tidal carbon dioxide par tial pressure, mean arterial pressure and patients' postoperative comfor t scores were compared between the groups after tracheal intubation, pneumoperitoneum, and postural positioning. Data was analysed using SPSS 22. RESULTS: Of the 200 patients, 40(20%) were cases of laparoscopy myomectomy, 152(76%) cases of ovarian cystectomy, and 8(4%) cases of hysterectomy. There were 100(50%) females in group A with a mean age of 43.15±4.24 years, and 100(50%) were in group B with a mean age of 42.69±4.01 years (p=0 .12). The peak airway pressure, mean arteri al pressure, pneumoperitoneum pressure, and head-down tilt of the patients in group A were significantly lower postpneumoper itoneum and post-positioning (p<0.05). At the same time, the respirator y rate was considerably higher (p<0.05) than that in group B. The end-tidal carbon dioxide partial pressure value at all time points was not significantly different between the groups (p>0.05). Postoperative comfort scores of patients in group A were significantly higher than those of group B (p<0.05). CONCLUSIONS: PCV-VG, based on the pressure-volume curve, significantly reduced intraoperative peak airway pressure, was associated with smoother haemodynamic, and regulated intraoperative pneumoperitoneal pressure and position in obese patients undergoing gynaecological laparoscopic surgery. The ventilation method also significantly improved the patients' postoperative comfort.

Source: Journal of the Pakistan Medical Association

DOI: 10.47391/jpma.20946

Authors: Zhixia, Guofang Fei, Qi Zhang, Yi Ru

Institution: Huzhou Women and Children's Hospital

Language: English

Topic: Respiratory Support and Mechanisms

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $650