It is unknown which is the best ventilatory approach in patients scheduled for gynecological robotic surgery in Deep Trendelenburg position in terms of respiratory mechanics. 40 patients were enrolled: 20 patients received a standard ventilation and 20 patients received a protective ventilation. Gas exchanges, respiratory mechanics and hemodynamic parameters were recorded. No significant differences were found between the two groups in terms of respiratory mechanics. In both groups, there was a significant reduction of static compliance between Baseline and Extubation Time (p < 0.01), and a significant increase of pulmonary pressure at the same times (p < 0.01). In both groups, a significant reduction of pH (p < 0.01) and a significant increase of PaCO2 (p < 0.01) were observed between Baseline and Extubation Time. At the Extubation time, PaCO2 was significantly higher during protective ventilation compared to standard ventilation. In this particular surgical setting, a protective ventilation strategy did not improve the respiratory mechanics compared to the standard ventilation strategy and was ineffective on post-operative gas exchanges.
Keywords: Airway pressure; Gynecological surgery; Pneumoperitoneum; Protective ventilation; Recruitment maneuvers; Respiratory mechanics.
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