Effect of pressure support ventilation vs. spontaneous ventilation on lung atelectasis during recovery from anesthesia for laparoscopic gastric sleeve surgery

Abstract

Background & Objective: Pressure support ventilation (PSV) is a target pressure mode that offers breath by breath mode of ventilation support, started by patients, and timed to respiratory effort. The fundamental idea behind PSV is to assist spontaneous breathing in response to the patient-initiated breaths. We evaluated the effects of PSV and spontaneous ventilation during awakening from anesthesia on lung atelectasis in the patients following laparoscopic gastric sleeve surgery. Methodology: Following clearance from the institutional ethical council, we enrolled 64 patients and divided them into two groups at random; pressure support group (Group PS) to receive PSV, and control group or spontaneous group (Group S) to continue with spontaneous ventilation mode during awakening from anesthesia in the patients following laparoscopic gastric sleeve surgery. Results: In the pressure support group, atelectasis was less common than in the control group at PACU (P = 0.042). Over the first 48 h following surgery, there were substantial differences between the groups in the level of oxygen saturation as determined by pulse oximetry ≤ 92%. The incidence of SpO2 ≤ 92% during 48 h postoperatively in the Group S and Group PS was 34% vs 12% respectively. No patient needed mechanical ventilatory support during the 48 h postoperatively. Conclusions: Pressure support ventilation during the recovery from general anesthesia to patients after laparoscopic gastric sleeve surgery resulted in reduced incidence of postoperative atelectasis than those who were allowed spontaneous ventilation with occasional manual support. Abbreviations: PACU: Post-Anesthesia Care Unit; PEEP: Positive End Expiratory Pressure; PSV: Pressure support ventilation; VT: Tidal Volume. Key words: Gastric sleeve surgery; Laparoscopy; Lung atelectasis; Pressure support ventilation; Spontaneous ventilation. Citation: Aboelsuod MAA, Farhat AEA, Abdalla AM, Hassnin FSB. The effect of pressure support ventilation vs. spontaneous ventilation on lung atelectasis during recovery from anesthesia for laparoscopic gastric sleeve surgery. Anaesth. pain intensive care. 2023;27(3):301−307.DOI: 10.35975/apic.v27i3.2166 Received: March 09, 2023; Reviewed: March 20, 2023; Accepted: April 16, 2023.