Effect of lung recruitment on atelectasis in lung-healthy patients undergoing laparoscopic cholecystectomy

Background: Recruitment maneuvers are standard practice for mitigating aeration disturbances. The literature has described a variety of recruitment techniques. In order to evaluate the efficacy of various lung recruitment maneuvers on the incidence of atelectasis in adults undergoing laparoscopic cholecystectomy surgery with lung ultrasound, the present trail was conducted. Methodology: A randomized controlled trial was conducted on 93 patients, divided equally into three groups: Control group: The parameters were maintained throughout the procedure without any modifications. Sustained inflation group: After abdominal deflation, sustained inflation was applied by adjusting the APL valve to 40 cmH2O on spontaneous mode and holding the bag for 30 sec. Stepwise PEEP increasing group: The PEEP was gradually increased by 2 cmH2O every 5 breathing cycles until it reached 12 cmH2O, and it was maintained until extubation, with a maximum airway pressure of 40 cmH2O. Results: There was a statistically significant increase in the incidence of atelectasis after abdominal deflation with significantly reduced after application of recruitment maneuver. The sustained inflation group showed more significant improvement than the stepwise PEEP increasing group. Conclusion: lung recruitment maneuvers can reduce the incidence of atelectasis in adults undergoing laparoscopic cholecystectomy surgery. The sustained inflation group was associated with better results. Keywords: Atelectasis; Cholecystectomy; Laparoscopic; Recruitment Maneuver Citation: Sultan WA, Metwally AA, Shiha HG, Saeed A. Effect of lung recruitment on atelectasis in lung-healthy patients undergoing laparoscopic cholecystectomy. Anaesth. pain intensive care 2025;29(2):202-209. DOI: 10.35975/apic.v29i2.2704 Received: October 16, 2024; Reviewed: October 26, 2024; Accepted: December 25, 2024