Effects of positive end-expiratory pressure/recruitment manoeuvres compared with zero end-expiratory pressure on atelectasis in children

Background Atelectasis is a common postoperative complication. Peri-operative lung protection can reduce atelectasis; however, it not clear whether this persists into the period. Objective To evaluate to what extent lung-protective ventilation reduces peri-operative atelectasis in children undergoing nonabdominal surgery. Design Randomised, controlled, double-blind study. Setting Single tertiary hospital, 25 July 2019 18 January 2020. Patients A total of 60 patients aged 1 6 years, American Society Anesthesiologists physical status or 2, planned for surgery under general anaesthesia (?2 h) with mechanical ventilation. Interventions The were assigned randomly either zero end-expiratory pressure no recruitment manoeuvres (control) group. Lung entailed 5 cmH2O positive and every 30 min. Both groups received volume-controlled tidal volume ml kg-1 body weight. ultrasound was conducted before induction, immediately after tracheal extubation, 15 min, 3 h, 12 h 24 extubation. Main outcome measures difference score between at each interval. higher indicates worse aeration. Results group exhibited lower median [IQR] scores compared control surgery, 4 [4 5] vs. 8 6], (95% confidence interval values -4 -4, Z = -6.324) extubation [3 4] 4], 95% CI -1 0, -3.161. This did persist from min onwards. aeration returned normal both Conclusions reduced provided by does Further studies are needed determine if yields better results other types Trial registration Chictr.org.cn (ChiCTR2000033469).