Recruitment maneuvers in patients undergoing thoracic surgery: a meta-analysis
Objective Pulmonary atelectasis is a common postoperative complication that may lead to intrapulmonary shunt, refractory hypoxemia, and respiratory distress. Recruitment maneuvers may relieve pulmonary atelectasis in patients undergoing thoracic surgery. This meta-analysis of randomized controlled t...
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Veröffentlicht in: | General thoracic and cardiovascular surgery 2021-12, Vol.69 (12), p.1553-1559 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | Objective
Pulmonary atelectasis is a common postoperative complication that may lead to intrapulmonary shunt, refractory hypoxemia, and respiratory distress. Recruitment maneuvers may relieve pulmonary atelectasis in patients undergoing thoracic surgery. This meta-analysis of randomized controlled trials (RCTs) is to evaluate the effectiveness and safety of recruitment maneuvers in patients undergoing thoracic surgery.
Methods
We performed a literature search on the PubMed, Embase, and Cochrane Library databases and the ClinicalTrials.gov registry for trials published before April 2021. We investigated postoperative pulmonary atelectasis incidence, intrapulmonary shunt fraction, static lung compliance, and mean arterial pressure.
Results
Six RCTs involving 526 patients were reviewed. Patients receiving a recruitment maneuver exhibited a significant decrease in intrapulmonary shunt fraction [weighted mean difference (WMD) − 0.02, 95% CI − 0.03 to − 0.01], improved static lung compliance (WMD 2.16; 95% CI 1.14–3.18), and PaO
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/FIO
2
ratio (WMD 31.31; 95% CI 12.11–50.52) without a significant difference in mean arterial pressure (WMD − 0.64; 95% CI − 4.92 to 3.64). The incidence pulmonary atelectasis favored recruitment maneuver group, but was not statistically significant (RR 0.55; 95% CI 0.27–1.12).
Conclusions
Recruitment maneuvers may be a viable treatment for reducing intra-pulmonary shunt and improving static lung compliance and PaO
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/FIO
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ratio without the disturbance of hemodynamics in patients undergoing thoracic surgery. |
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ISSN: | 1863-6705 1863-6713 |
DOI: | 10.1007/s11748-021-01673-7 |