Clinical Application Of Lung Ultrasound-Guided Recruitment Manoeuvres In Post-Laparoscopic Cholecystectomy Pulmonary Atelectasis

Objectives:1.To evaluate the incidence of perioperative pulmonary atelectasis in Laparoscopic cholecystectomy(LC);2.To assess the effect of lung ultrasound-guided recruitment manoeuvresonpostoperative pulmonary atelectasis in patients undergoing LC.Methods:Sixty patients with LC.The patients were randomly divided into two groups:LUG-RM group(lung ultrasound-guided recruitment manoeuvres group,n=30).C group(n=30).Aconsistentanesthetic protocol was implemented for all patients participating in the experiment,and the same ventilator parameters and ventilation mode were set intraoperatively.All patients underwent three lung ultrasound examinations.The three lung ultrasound examinations were performed after entering the operating room(T0),before tracheal extubation(T1),and 24 hours after the end of the procedure(T2).Patients in the LUG-RM group received lung ultrasound-guided recruitment manoeuvres.No lung ultrasound-guided recruitment manoeuvres was implemented for patients in C group.The primary observations were the incidence of pulmonary atelectasis and the lung ultrasound score at both T1 and T2 time points.The secondary observations were the Saturation of Pulse Oximetry(SpO2)in the post-anaesthesia care unit room(PACU),the length of hospital stay,and the occurrence of postoperative respiratory adverse events in the two groups.Results:The incidence of pulmonary atelectasis was significantly lower in the LUG-RM group than in the C group at T2(20%vs 60%P=0.002).At the T2 time point,the lung ultrasound score was 3(2.75-4)in the LUG-RM group and 5(4-6)in the C group,and the lung ultrasound score was significantly lower in the LUG-RM group than in the C group,P=0.001.The incidence of pulmonary atelectasis was 86.7%in the LUG-RM group and 83.3%in the C group at time point T1,with no significant difference between the two groups,P=0.500.There was also no remarkable difference in the lung ultrasound scores between the two groups at the T1 time point(7(5-7)vs 7(5.75-8),P=0.534).After tracheal extubation and admission to the PACU,patients in the LUG-RM group were found to have higher SpO2than those in the C group(98.93±0.91 vs.98.23±0.86,P=0.003).There was no significant difference in the length of stay between the two groups(2.55±0.49 vs2.50±0.57,P=0.719).Meanwhile there was no adverse respiratory events for the two groups in the postoperative period.Conclusion:Lung ultrasound-guided recruitment manoeuvres significantly reduces the incidence of 24-hour postoperative pulmonary atelectasis in patients undergoing LC.