Background: Lung ultrasound (LUS) represents an easily repeatable noninvasive tool for assessing lung recruitment. This study was conducted aiming to compare the efficacy of LUS versus the Pressure Volume curve to assess PEEP-induced lung recruitment during one lung ventilation (OLV) in thoracic operations.
Patients and Methods: We included a total of 36 cases who were divided into two equal groups; optimal compliance PEEP (Copt) group and ultrasound guided PEEP (LUS) group. Our primary outcome was PaO2/FiO2. Secondary outcomes included ventilation parameters (recorded PEEP, Peak inspiratory pressure, Plateau pressure, driving pressure and lung compliance), and the incidence of postoperative desaturation.
Results: The mean age of the included cases was 44.83 and 46.61 years in Copt and LUS groups respectively. Neither demographic variables, smoking pattern, and respiratory mechanics were statistically different between the two study groups. The mean duration of OLV was 113.78 and 124.61 minutes in LUS and Copt groups respectively (p = 0.0107). PaO2/FiO2 did not significantly differ between the two study groups either before, during, or after OLV (p > 0.05). Ventilation parameters including recorded PEEP, Peak inspiratory pressure, Plateau pressure, driving pressure and lung compliance were not significantly different between the study groups.
Conclusion: LUS is an effective tool in titration of PEEP during OLV in thoracic surgery. Its intraoperative use was associated with improvement of both oxygenation and lung compliance as PEEP obtained through best lung compliance.