Effect of individualized intraoperative lung recruitment maneuver on postoperative pulmonary complications in patients undergoing upper abdominal surgeries under general anesthesia

Figures & data

Table 1. Postoperative pulmonary complication as defined by EPCO⁽⁸⁾.

Complication	Definition
Respiratory infection	Patient has received antibiotics for a suspected respiratory infection and met one or more of the following criteria: new or changed sputum, new or changed lung opacities, fever, white blood cell count >12000
Respiratory failure	Postoperative PaO2 <8 kPa (60 mmHg) on room air, an SpO2 <90% and requiring oxygen therapy
Atelectasis	Chest radiograph demonstrating blunting of the costophrenic angle, loss of sharp silhouette of the ipsilateral hemidiaphragm in upright position, evidence of displacement of adjacent anatomical structures or (in supine position) a hazy opacity in one hemithorax with preserved vascular shadows
Pleural effusion	Lung opacification with a shift of the mediastinum, hilum or hemidiaphragm toward the affected area and compensatory over-inflation in the adjacent non-atelectatic lung
Pneumothorax	Air in the pleural space with no vascular bed surrounding the visceral pleura
Bronchospasm	Newly detected expiratory wheezing treated with bronchodilators
Aspiration pneumonitis	Acute lung injury after the inhalation of regurgitated gastric contents

Figure 1. CONSORT flow chart of the patients.

Table 2. Patients characteristics.

	Control group (n = 33)		Recruitment group (n = 33)		p
	No.	%	No.	%
Sex
Male	14	42.4	17	51.5	0.459 (NS)
Female	19	57.6	16	48.5
Age (years)					0.345 (NS)
Min. – Max.	21.0–60.0		23.0–59.0
Mean ± SD.	45.40 ± 11.38		47.91 ± 10.04
BMI (kg/m2)
Min. – Max.	18.0–33.0		20.0–34.0		0.146 (NS)
Mean ± SD.	26.97 ± 3.41		28.16 ± 3.22
Duration of surgery (minutes) Min. – Max. Mean ± SD.	60.0–360.0 136.97 ± 64.12		75.0–360.0 136.36 ± 49.97		0.466 (NS)
ASA physical status
I	18	54.5	14	42.4	0.325 (NS)
II	15	45.5	19	57.6
Ariscat score(9) Low Intermediate High	6 16 11	18.2 48.5 33.3	7 14 12	21.2 42.4 36.4	0.804 (NS)

Note: (NS): Statistically non-significant.

Sex, ASA physical status and Ariscat score are expressed as number (percent%).

BMI, duration of surgery and age are expressed as mean ± SD.

Figure 2. Incidence of POPCs in both groups.

*: Statistically significant at p ≤ 0.05.

Figure 3. Lung compliance in the two groups.

(NS): Statistically non-significant difference. *: Statistically significant at p ≤ 0.05. Error bars represent the standard deviation.

Table 3. Driving pressure in the two groups.

Driving pressure (cmH2O)	Control group (n = 33)	Recruitment group (n = 33)	P1
After induction Min. – Max. Mean ± SD.	8.0–16.0 12.06 ± 1.77	9.0–16.0 11.85 ± 1.60	0.611 (NS)
Before extubation
Min. – Max.	8.0–17.0	8.0–16.0	0.006*
Mean ± SD.	11.73 ± 2.40	10.25 ± 1.85
P2	0.190 (NS)	<0.001*

Note: P₁: p value for comparing driving pressure between the studied groups.

P₂: p value for comparing driving pressure after induction and before extubation within each group. *: Statistically significant at p ≤ 0.05. (NS): Statistically non-significant difference. Data are expressed as Mean ± SD.