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 abdominal insufflation required for this surgical approach.
Background: 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 is to explore anesthesia providers’ knowledge and utilization of lung protective alveolar recruitment maneuvers (ARMs) in obese patients undergoing laparoscopic surgery.
Clinical question: “In a large urban trauma center, what are anesthesia providers’ knowledge and utilization of lung-protective alveolar recruitment maneuvers (ARMs) in obese (BMI>30kg/m2) patients aged 18 and older undergoing laparoscopic surgeries?”
Methods: The descriptive design of this project aimed to investigate anesthesia providers’ knowledge and use of LPV alveolar recruitment maneuvers 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 physician anesthesiologists (MDAs) was used. The survey was disseminated via email and available by QR code. Data was evaluated and 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 utilize lung protective ARMs.
Conclusions: Anesthesia provider utilization of LPV strategies remains inconsistent. Education regarding implementation of evidence-based lung protective ARMs in obese patients undergoing laparoscopic surgery is warranted.