Ultrasound-guided recruitment maneuver versus individualized positive end-expiratory pressure in pediatric patients undergoing laparoscopic abdominal surgery: a prospective randomized controlled study

Background Atelectasis is a frequent postanesthesia respiratory complication, with children being more susceptible than adults after general anesthesia induction. Aim To assess the impact of ultrasound-guided recruitment maneuver, it’s referred to US-guided recruitment maneuver, against individualized positive end-expiratory pressure (PEEP) on oxygenation and prevention of complications of respiration in pediatrics having abdominal laparoscopic operations. Patients and methods This investigation involved 120 pediatric patients undergoing abdominal laparoscopic surgery. Patients have been divided into three groups (40 each): group I (receive a fixed PEEP 5 cmH 2 O), group II (US-guided lung recruitment group), and group III (individualized PEEP group). Results The ratio of P/F was significantly greater in the individualized PEEP and US-guided recruitment groups than in the control group (fixed PEEP), with insignificant distinction among the individualized PEEP and US-guided groups. Static compliance (Cstat) was highest in the individualized PEEP group, followed by the US-guided group, both showing better lung mechanics than the control group. Despite these benefits, a statistically insignificant distinction in postoperative pulmonary complications (hypoxia or bronchospasm) has been observed among the groups ( P >0.05), indicating a similar safety profile across techniques. Conclusion Both individualized PEEP and US-guided recruitment maneuver improved oxygenation and lung mechanics more than fixed PEEP with comparable hemodynamic profile and postoperative pulmonary complications in pediatric cases having abdominal laparoscopic surgeries.