Effect of positive end-expiratory pressure ventilation on central venous pressure and intraoperative blood loss in patients undergoing laparoscopic hepatectomy

• Main Authors: Tao Qi, Xiong-Xiong Pan
• Format: Article
• Language: English
• Published: Editorial Board of Journal of Hainan Medical University 2020-12-01
• Series: Journal of Hainan Medical University
• Subjects: positive end-expiratory pressure; laparoscopic surgery; hepatectomy; central venous pressure
• Online Access: http://www.hnykdxxb.com/PDF/202023/06.pdf

Objective: Tto investigate the effects of positive end-expiratory pressure (PEEP) ventilation on central venous pressure (CVP) and intraoperative blood loss in patients undergoing laparoscopic hepatectomy. Methods: 46 cases of patients undergoing laparoscopic hepatectomy , 25 cases of male, female 21 cases, ASA 栺~栿 level, were randomly divided into two groups. In group A tidal volume was set to 6 ml/kg (Predicted Body Weight, PBW) and PEEP was set to 0 cmH2O. The tidal volume of group B was set as group A, PEEP was set to 8 cmH2O. CVP, MAP, and Ppeak were recorded in the supine position after intubation (T0), supine position after pneumoperitoneal (T1), anti-trendelenberg position after pneumoperitoneal (T2), supine position after surgery (T3), and Ddyn was calculated. The amount of nitroglycerin and the amount of blood loss were recorded. Results: Compared with group A, the CVP of group B was significantly increased at T1 and T2 (P<0.05). Compared to T2 with T1 in group A and group B, CVP was decreased significantly (P<0.05). At T3, Cdyn in group B was significantly higher than that in group A (P<0.05). The amount of nitroglycerin in group B was significantly higher than that in group A (P<0.05). There was no significant difference in intraoperative fluid rehydration and blood loss between the two groups (P>0.05). Conclusion: PEEP with 8cmH2O can improve Ddyn in patients undergoing laparoscopic hepatectomy, but increased CVP. It requires more use of controlled low central venous pressure techniques to reduce intraoperative blood loss.