Effect Of Lung Ultrasound-guided Recruitment Manoeuvres On Anaesthesia-induced Atelectasis In Children Undergoing Low-risk Surgery:A Randomised Controlled Trial

Background: Atelectasis occurs frequently in patients undergoing general anaesthesia and can cause ventilator-induced lung injury,pneumonia,hypoxaemia,and a prolonged hospital stay.Recruitment manoeuvres may prevent anaesthesia-induced atelectasis.However,the effect of recruitment manoeuvres in patients with healthy lungs undergoing low-risk surgery is still unknown.Our aim was to assess the effect of lung ultrasound-guided recruitment manoeuvres on anaesthesia-induced atelectasis in children.Methods: Forty children undergoing low-risk surgery with a lung ultrasound consolidation score ≥2 in any region were allocated to receive lung ultrasound-guided recruitment manoeuvres(LUG-RM group;n=20)in the post-anaesthesia care unit(PACU)before extubation.or to serve as a control group(n=20).All patients underwent three ultrasound examinations.Results: The incidence of significant anaesthesia-induced atelectasis before leaving the PACU was 5% in the LUG-RM group and 35% in the control group(P=0.018).In the control group,the lung ultrasound score was lower before leaving the PACU than after extubation(1.0 [0.0–2.0(0.0–5.0)] vs 1.5 [0.0–4.0(0.0–7.0)];P=0.003).In the LUG-RM group,thelung ultrasound scores were lower after extubation than after entering the PACU(0.0 [0.0-0.75(0.0–3.0)] vs.(5.0 [3.0–6.0(2.0–10.0)];P<0.001).There were significant between-group differences in the lung ultrasound score at various time points after extubation and before leaving the PACU.There was no significant difference in pulse oxygen saturation or length of hospital stay between the two groups.There were no postoperative pulmonary complications in either study group.Conclusions: It may not necessary to perform recruitment manoeuvres in children with healthy lungs undergoing minor surgery.Lung ultrasound-guided recruitment manoeuvres can resolve atelectasis effectively and safely.