The effect of inverse ratio ventilation on cardiopulmonary function in obese laparoscopic surgery patients: A systematic review and meta-analysis

Abstract

This study aimed to evaluate the effect of inverse ratio ventilation (IRV) strategy on cardiopulmonary function in obese patients under general anesthesia. Databases such as China National Knowledge Infrastructure (CNKI), Wangfang, WeiP, Web of Science, the Cochrane Library, and PubMed were systematically searched. All randomized controlled trials' literature on IRV during laparoscopic surgery in obese patients under general anesthesia was collected. After data were extracted and cross-checked, Rev Man 5.3 software was used for meta-analysis. Finally, five randomized controlled clinical trials (RCTs) were included in the meta-analysis, with a total of 312 patients. Compared with the conventional ventilation group, the inspiratory peak pressure was lower at pneumoperitoneum 30 min and pneumoperitoneum 60 min; the PaO2 and oxygenation index were higher at pneumoperitoneum 60 min, and mean airway pressure was higher at pneumoperitoneum 30 min and pneumoperitoneum 60 min; the dynamic lung compliance was superior at pneumoperitoneum 30 min and pneumoperitoneum 60 min. IRV applied to laparoscopic surgery in obese patients under general anesthesia not only reduces peak airway pressure and improves intraoperative oxygenation index and PaO2 but also enhances mean airway pressure and dynamic lung compliance, which has a specific lung protective effect. It can be used as an option for the mechanical ventilation model in obese patients in clinical practice.