Comparison of lung protective ventilation versus conventional ventilation strategies on postoperative pulmonary complications in major abdominal surgery: a prospective randomized study.
DOI:
https://doi.org/10.51168/sjhrafrica.v7i3.2610Keywords:
Lung protective ventilation, Conventional ventilation, Postoperative pulmonary complications, Major abdominal surgery, Positive end-expiratory pressure, Driving pressure, Atelectasis, Ventilator-induced lung injuryAbstract
Introduction
Objective: To compare the effect of lung protective ventilation versus conventional ventilation on postoperative pulmonary complications in patients undergoing major abdominal surgery.
Material and methods
Over the course of nine months, 120 adult patients receiving major abdominal surgery participated in this prospective, randomized comparative study. Patients were divided into two groups of sixty at random. Lung protective ventilation (tidal volume 6–8 mL/kg predicted body weight, PEEP 5–8 cm H2O, driving pressure <15 cm H2O, with recruitment maneuvers) was administered to Group A. Group B was given standard ventilation (PEEP 0–5 cm H2O, tidal volume 10–12 mL/kg).
Results
Pulmonary complications were significantly lower in Group A compared to Group B (15.0% vs 31.7%; p=0.03). Group A also showed reduced ICU stay, total hospital stay, and duration of postoperative mechanical ventilation. Intraoperative driving pressure was significantly lower in the lung protective group (10.9±1.8 vs 18.4±2.6 cm H₂O; p<0.001). No significant differences were observed in 30-day mortality or vasopressor requirement.
Recommendation
Lung protective ventilation should be routinely implemented during major abdominal surgery, especially in high-risk patients, to reduce postoperative pulmonary complications and improve recovery outcomes.
Conclusion
Lung protective ventilation significantly reduces postoperative pulmonary complications in major abdominal surgery.
References
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