Ảnh hưởng huyết động của chiến lược PEEP kết hợp huy động phế nang dưới hướng dẫn cắt lớp trở kháng điện trong gây mê cho phẫu thuật đại trực tràng nội soi: Cardiovascular effects of EIT-guided PEEP and recruitment maneuvers during laparoscopic colorectal surgery

Abstract

This study was performed to evaluate the hemodynamic effects of an electrical impedance tomography (EIT)-guided positive end-expiratory pressure (PEEP) strategy combined with alveolar recruitment maneuvers (RM) during laparoscopic colorectal surgery. This randomized controlled clinical trial included 93 patients, with 48 patients in the PEEP 5 group and 45 patients in the EIT-guided PEEP/RM group. The analyzed parameters included systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, maintained PEEP level, number of RMs, RM-related hypotension rate, vasopressor requirement, and arrhythmias. The results showed no statistically significant differences in these hemodynamic parameters between the two groups. In the EIT-guided PEEP/RM group, the mean maintained PEEP level was 10.25 ± 2.30 cmH₂O, and the mean number of RMs was 3.69 ± 0.56. Hypotension was recorded in 34 of 169 RM episodes, accounting for 20.11%, and occurred most frequently during the fourth RM. Most episodes were mild to moderate, with a 10 – 20% decrease. Therefore, continuous hemodynamic monitoring and readiness for circulatory support remain necessary during RM.