Reduction of lung atelectasis in bariatric surgery with focus on alveolar recruitment maneuvers by using lung ultrasound score

Abstract

Bariatric surgery has been shown to be the most efficient and long-lasting method for treating severe obesity, surpassing existing treatments according to extensive meta-analyses. Recruitment maneuver (RM) stands for an intentional temporal increase in transpulmonary pressure (airway pressure _ pleural pressure) above the value used during mechanical ventilation, aiming to re-open the non-aerated or poorly aerated alveolar unit to improve oxygenation, ventilation, and lung mechanics. RM increases the lung mass aeration, thus reducing lung heterogeneity while increasing the baby’s lung size. It also minimizes the repetitive terminal respiratory units opening and closing. RMs also increase pulmonary compliance and improve arterial oxygenation intraoperatively and postoperatively. Moreover, RM with positive end-expiratory pressure has shortened hospitalization. It has also been established as an effective preventive measure for post-laparoscopic shoulder pain.