Efficacy Of Recruitment Maneuvers In Obese Patients For Prevention Of Reexpansion Pulmonary Edema After Pulmonary Resection

Objective: To evaluate the efficacy of recruitment maneuvers in obese patients for prevention of reexpansion pulmonary edema after pulmonary resection.Methods: Forty patients of both sexes,aged 26-45 yr,with body mass index more than the 28 kg/m2,of ASA physical status?or?,scheduled for elective thoracoscope-assisted pulmonary resection,were randomly divided in to 2 groups?n=20 each?using a random number table.Control group?group C?and RM group?group R?.After induction of anesthesia,the patients were tracheally intubated and mechanically ventilated.After correct positioning was confirmed by fiberoptic bronchoscopy,one-lung ventilation was performed instead.One-lung ventilation was performed routinely in both group.Before closure of thorax,group C applied routine manipulation of pulmonary expansion,group R applied RM once.SBP?DBP?MBP?Sp O₂?HR?PETCO₂?Pa O₂?Pa CO₂ and Ppeak were recorded at the end of OLV?T1?and after recruitment maneuver?T₂?.Lung compliance was calculated,the development of pulmonary atelectasis and reexpansion pulmonary edema was recorded within 24 h after surgery.Results: At T₂ compared with control group,the Pa O₂ and lungcompliance was significantly higher in group R,lung compliance and Pao2 is better at T₂ in group R,the incidence of atelectasis and reexpansion pulmonary edema was decreased within 24 h after surgery.Conclusions: RM is better than routine manipulation of pulmonary expansion,can effectively prevent the development of reexpansion pulmonary edema in obese patients after pulmonary resection,and can improve arterial oxygenation and dynamic compliance in lungs.