Lung-protective ventilation strategy to improve oxygenation function and respiratory mechanics in patients undergoing robotic bariatric surgery: A randomized double-blind trial (CONSORT)

Abstract

BACKGROUND: The respiratory effects of lung-protective ventilation strategy (LPVS) on patients undergoing robotic abdominal surgery are still controversial, and prospective studies are needed to validate the lung-protective effects of LPVS, especially in robotic bariatric surgery. METHODS: Forty-two patients undergoing robotic bariatric surgery were included in this study, of whom 20 received an LPVS and 22 received a standard ventilation strategy. Parameters were recorded at 5 intraoperative time points to assess respiratory mechanics, hemodynamics, and oxygenation. The incidence of intraoperative ventilation complications and postoperative pulmonary complications. Statistical analyses were performed using repeated measures analysis of variance and chi-square tests. RESULTS: First, we demonstrated that the LPVS using a small tidal volume, positive end-expiratory pressure ventilation, and low inspired oxygen concentration could reduce peak and plateau airway pressures in patients undergoing robotic bariatric surgery (P < .05). Second, patients' oxygenation index (P < .01) and partial pressure of oxygen (P < .05) increased considerably after lung-protective ventilation treatment, suggesting that this strategy facilitates oxygenation function in patients. Finally, we found that high inhaled oxygen concentration was an independent risk factor for postoperative pulmonary complications in robotic bariatric surgery patients (P < .05). CONCLUSIONS: This study confirms that LPVS can improve oxygenation function and respiratory mechanics in patients undergoing robotic bariatric surgery, which is of clinical significance.