During minimally invasive surgery, a pneumoperitoneum is created to facilitate surgical visualization. Although effective in facilitating the procedure, there are respiratory consequences of the pneumoperitoneum, which significantly increases intra-abdominal pressure (IAP) up to 20 cmH2O. The increased IAP can decrease functional residual capacity and increase closing capacity resulting in increased resistance, decreased compliance, and increased ventilation-perfusion mismatch. In a randomized, cross-over design, this study will evaluate in sequential order, 3 modes of ventilation during laparoscopic bariatric surgery to determine which is better able to support oxygenation and ventilation while limiting the peak inflating pressure (PIP).
Study Type
OBSERVATIONAL
Enrollment
30
For pressure controlled ventilation, the peak inflating pressure (PIP) is set for each tidal breath.
For volume controlled ventilation, the tidal volume is set.
Pressure-regulated, volume-controlled (PRVC) is an auto-regulated pressure-controlled mode of mechanical ventilation with a user-selected tidal volume target.
Nationwide Children's Hospital
Columbus, Ohio, United States
Change in heart rate
Heart rate will be assessed every 5 mins. during each 30 minute mode of ventilation.
Time frame: Baseline to 30 mins.
Change in blood pressure
Blood pressure will be recorded every 5 mins. during each 30 minute mode of ventilation.
Time frame: Baseline to 30 mins.
Blood gas
Blood gas will be obtained at the end of each 30 minute mode of ventilation.
Time frame: 30 mins.
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