Trial reportMedical science monitor : international medical journal of experimental and clinical research2024
Impact of Manual Sustained Inflation vs Stepwise PEEP on Pulmonary and Cerebral Outcomes in Carotid Endarterectomy Patients.
Trial report in Medical science monitor : international medical journal of experimental and clinical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND Recruitment maneuvers (RMs) are used to reduce pulmonary atelectasis in patients under general anesthesia, but they can lead to a decrease in cerebral hemodynamics. MATERIAL AND METHODS Thirty patients undergoing carotid endarterectomy were randomized to a manual sustained inflation (SI) group or a stepwise increase in PEEP (IP) group. During both RMs, the peak airway pressure (Ppeak) was maintained at 30 cmH₂O for 30 s. Electrical impedance tomography was used to evaluate pulmonary aeration changes. Mean velocity of blood flow in the middle cerebral artery (Vm) and cerebral oxygen saturation (rScO₂) was monitored intraoperatively. RESULTS IP improved lung aeration better at Ppeak=30 cmH₂O than SI (58.2±8.4% vs 46.0±8.3%, P=0.001) and this persisted until the end of surgery. Dorsal (dependent) ventilation 30 min after extubation in the SI group was lower than that before surgery (7.7±2.6% vs 9.9±3.8%, P=0.003). Vm and rScO₂ returned to baseline immediately after RM in the SI group, while it remained below baseline in the IP group (42.5±12.6 vs 50.9±18.8 cm/s, P<0.001 and 68.1±3.5% vs 70.6±3.7%, P=0.001). Heart rate declined significantly during RM only in the SI group (55.9±6.6 vs 52.2±6.9 bpm, P=0.008). CONCLUSIONS Compared with SI, IP performed better in improving lung aeration, with greater hemodynamic stability. IP resulted in slower recovery of cerebral blood flow and oxygenation.
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