Evaluation of the effect of lung recruitment and positive end-expiratory pressure (PEEP) on anesthesia induced atelectasis using lung ultrasound in children undergoing major abdominal surgery : A randomized controlled trial / Ahmed Nabih Youssef Abo Omar ; Supervised Iman Riad Abdaal , Riham Hussein Saleh , Mohamed Elayashy Mohamed

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Background: Atelectasis is a side effect of general anesthesia which can be found in all types of interventions and patients of all ages. Lung ultrasound has shown reliable sensitivity and specificity for diagnosing anaesthesia-induced atelectasis. The aim of this randomized blind study was to evaluate the effect of lung recruitment and positive end- expiratory pressure (PEEP) on anesthesia induced atelectasis using intraoperative lung ultrasound in children under going major abdominal surgery. Materials and methods: Forty children aged from one to four years presented for major abdominal surgery were recruited for this study and randomly allocated into 2 groups: Group (REC) recruitment group; in this group, lung recruitment manoeuvre was performed in patients using continuous positive airway pressure( CPAP) (30) cm H2O for (40) seconds after induction of anesthesia then patient converted to pressure controlled mode again with PEEP 5 cm H2O. In group (C) non recruitment group, patient ventilation maintained without recruitment but with PEEP 5cm H2O. Lung ultrasound examinations was performed at different time-points immediately before induction of anesthesia, 5, 15 minutes following induction of general anesthesia, before extubation and after extubation at recovery room to detect and monitor atelectasis. Arterial blood samples were collected simultaneously to measure P/F ratio. The sum of surface area of atelectatic regions and the number of recruitment attempts to recruit atelectatic areas were recorded

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