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Revista Cubana de Anestesiología y Reanimación

2015, Number 3

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Revista Cubana de Anestesiología y Reanimación 2015; 14 (3)

Ventilatory pattern in patients with chronic obstructive pulmonary disease for laparoscopic cholecystectomy

Labrada DA

Language: Spanish
References: 20
Page:
PDF size: 229.10 Kb.


ABSTRACT

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive process, characterized by the presence of a chronic and not totally reversible obstruction to airflow and which for a long time constituted a relative contraindication for laparoscopic procedures.
Objective: to compare two ventilatory patterns in COPD patients for laparoscopic cholecystectomy.
Methods: Prospective longitudinal study in 69 patients, divided randomly into two groups, carried out in a period of four years at "Calixto García" General Hospital. Spirometric variables (FVC, FEV1, FVC/FEV1), variables of gas exchange (PaO2, PaCO2, ETCO2, SpO2), of pulmonary mechanics (P1) and hemodynamic variables (MAP, HR) were analyzed. The onset of complications before, during and after surgical intervention was also analyzed. Standard deviation and mean were used for quantitative variables; percentages, for qualitative variables. For comparison of variables between groups, the nonparametric Wilcoxon Mann-Withney test was used for independent samples, while the Chi-squared test was used for qualitative variables. The value p=0.05 was considered significant.
Results: The spirometric values showed significant differences in the immediate postoperative time. EtCO2 values and PaCO2 also presented significant differences during the intraoperative and immediate postoperative time. Hemodynamics did not show any differences, as neither did the values of peak pulmonary pressure. Perioperative complications were observed mainly in the second group.
Conclusions: There is an intraoperative ventilatory strategy that provided advantages in COPD patients for laparoscopic cholecystectomy.


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