Personalized positive end-expiratory pressure

Abstract

<p>Obesity and its related comorbidities reduce functional residual capacity (FRC) in surgical patients and lead to atelectasis and increased incidence of postoperative pulmonary complications (PPC). Surgical techniques used during robotic sleeve gastrectomy like pneumoperitoneum, mechanical ventilation, and muscle paralysis further restrict ventilation and increase atelectasis. Alveolar recruitment maneuvers (RM) and titration of positive end expiratory pressure (PEEP) and tidal volume (Vt) are elements of lung protective strategies used to minimize atelectasis and decrease PPC. Do obese patients undergoing laparoscopic sleeve gastrectomy surgery using abdominal insufflation who receive titrated PEEP compared with a static PEEP of 5 cmH20 develop less atelectasis and post-operative pulmonary complications in the first 24 hour post-operative period?</p>