Problem Statement: Obese adults having laparoscopic surgery are at increased risk for postoperative pulmonary complications (PPCs) due to the alteration in pulmonary physiology caused by their body habitus, the use of Trendelenburg position, and the abdominal insufflation required for this surgical approach. Current literature recommends utilizing lung-protective ventilation (LPV) strategies to reduce the incidence of PPCs, but anesthesia provider implementation of LPV strategies is inconsistent. The purpose of this quality improvement project was to explore anesthesia providers’ knowledge and utilization of lung-protective positive end-expiratory pressure (PEEP) strategies in obese patients undergoing laparoscopic surgery.
Methods: The descriptive design aimed to investigate anesthesia providers’ knowledge and use of LPV PEEP strategies in obese patients (BMI > 30kg/m²) undergoing laparoscopic surgery via an anonymous, quantitative electronic survey consisting of 24 Likert-scale questions. A convenience sampling of certified registered nurse anesthetists (CRNAs) and anesthesiologists (MDAs) was used. The survey was disseminated via e-mail and available by QR code. Data was stratified by role/education, age and years of experience to evaluate for trends.
Results: Fifty-two providers completed the survey. There were significant differences in likelihood to incorporate LPV PEEP strategies across groups.
Conclusions: Anesthesia provider utilization of LPV PEEP strategies remains inconsistent. Education regarding utilization of evidence-based LPV PEEP strategies in obese patients undergoing laparoscopic surgery is warranted.
Keywords: postoperative pulmonary complications, lung-protective ventilation, positive end-expiratory pressure