This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Google Scholar Articles by Bohm, S. H. Articles by Standl, T. G. PubMed PubMed Citation Articles by Bohm, S. H. Articles by Standl, T. G. Related Collections Critical Care Physiology Ventilation

---

CRITICAL CARE AND TRAUMA

Alveolar Recruitment Strategy and High Positive End-Expiratory Pressure Levels Do Not Affect Hemodynamics in Morbidly Obese Intravascular Volume-Loaded Patients

Stephan H. Bohm, MD^*, Oliver C. Thamm, MD^*, Alexandra von Sandersleben, MD^*, Katrin Bangert, MD^*, Thomas E. Langwieler, MD, Gerardo Tusman, MD, Tim G. Strate, MD, PhD, and Thomas G. Standl, MD, PhD^*

From the Clinics of *Anesthesiology, General Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Germany; and Department of Anesthesiology, Hospital Privado de Comunidad, Mar del Plata, Argentina.

Address correspondence to Stephan H. Böhm, MD, CSEM Centre Suisse d’Electronique et de Microtechnique SA, Research Centre for Nanomedicine, Medical Sensors, Schulstr. 1, CH-7302 Landquart, Switzerland. Address e-mail to shb{at}csem.ch.

We evaluated the effect of the alveolar recruitment strategy and high positive end-expiratory pressure (PEEP) on hemodynamics in 20 morbidly obese (body mass index 50 ± 9 kg/m²), intravascular volume-loaded patients undergoing laparoscopic surgery. The alveolar recruitment strategy was sequentially performed with and without capnoperitoneum and consisted of an upward PEEP trial, recruitment with 50–60 cm H₂O of plateau pressure for 10 breaths, and a downward PEEP trial. Recruitment and high PEEP did not cause significant disturbances in any hemodynamic variable measured by systemic and pulmonary artery catheters. Transesophageal echocardiography revealed no differences in end-diastolic areas or evidence of segmental abnormalities in wall motion.

This article has been cited by other articles:

				S. H. Bohm, S. Maisch, A. von Sandersleben, O. Thamm, I. Passoni, J. M. Arca, and G. Tusman The Effects of Lung Recruitment on the Phase III Slope of Volumetric Capnography in Morbidly Obese Patients Anesth. Analg., July 1, 2009; 109(1): 151 - 159. [Abstract] [Full Text] [PDF]