Implementation of a Perioperative Lung Protective Ventilation Protocol for Robotic-Assisted Surgeries-Implementation of a Perioperative Lung Protective Ventilation Protocol for Robotic-Assisted Surgeries

Implementation of a Perioperative Lung Protective Ventilation Protocol for Robotic-Assisted Surgeries

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The study explored the implementation of a Lung Protective Ventilation (LPV) protocol during robotic-assisted surgeries to reduce postoperative pulmonary complications (PPCs). It aimed to educate providers on LPV benefits, implement this protocol, and evaluate adherence in adult robotic-assisted surgeries. The study involved a six-month pre/post quality improvement design with chart reviews and periodic surveys on knowledge, attitude, and practice among healthcare providers. <br /><br />Data analyzed from electronic medical records and provider surveys showed significant improvements in adherence to LPV protocol parameters, such as tidal volume, respiratory rate, and driving pressure post-implementation. Provider confidence and knowledge regarding LPV also increased after educational interventions.<br /><br />Robotic-assisted surgeries, although minimally invasive with benefits like reduced blood loss and pain, can increase PPC risk due to factors like positioning, insufflation, and anesthesia effects. LPV protocols, which involve specific ventilator settings, show promise in mitigating VILI (ventilator-induced lung injury) and PPCs.<br /><br />The study highlights the significance of individualized PEEP (positive end-expiratory pressure) settings and keeping FiO2 levels moderate to maintain pulmonary homogeneity and reduce atelectasis. Dynamic driving pressure (DP) has recently emerged as an effective measure for LPV success, emphasizing the need for individualized ventilator settings.<br /><br />Several barriers to LPV implementation were identified, including equipment limitations and resistance from other practitioners. Continuous education on LPV protocols was suggested to increase provider comfort and adherence.<br /><br />Overall, the research advocates for the benefits of LPV in reducing hospital stays and costs by enhancing patient outcomes in robotic-assisted surgeries, emphasizing the importance of continuous education and protocol adherence in clinical practice.

Keywords

Lung Protective Ventilation

robotic-assisted surgeries

postoperative pulmonary complications

provider education

protocol adherence

ventilator-induced lung injury

individualized PEEP settings

dynamic driving pressure

barriers to implementation

continuous education