Anesthésie et recherche clinique
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May Transient Positive End-Expiratory Pressure Ameliorate Hemodynamic Setting and Outcome After Aortic Surgery?

Enrico Giustiniano, Nadia Ruggieri, Gian Michele Battistini, Nadia Fusilli, Francesco Pellegrino, Pierluigi Giorgetti, Maria Grazia Bordoni, Valentina Bellato and Giovanni Bordone

Study objective: Patients submitted to major vascular surgery often match Metabolic Syndrome’s (MetS) risk factors and consequently they are affected by high postoperative risk of cardio circulatory, respiratory and renal dysfunctions, which can worsen the outcome. Hemodynamic variations occurring during aortic surgery may expose patients at risk for cardiac complications, particularly myocardial ischemia. Positive end-expiratory pressure applied to mechanical ventilation only during clamping phase may protect heart against stress due to augmented blood return when aorta is clamped and may reduce the sudden lowering of blood pressure if it is discontinued when circulation is restored. Further it may reduce postoperative complications rate. Design: Randomized controlled trial Setting: Vascular surgery operative room.