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conventional I:E ratio group, inspiratory time : expiratory time = 1:1

1:1 I:E ratio group, inspiratory time : expiratory time = 1:1

inverse ratio group, inspiratory time : expiratory time = 2:1

I:E ratio of 1:2 with external PEEP of 5 cm H2O

conventional I:E ratio of 1:2 is applied.

conventional I:E ratio

1:1 ratio

2:1 group

external positive end-expiratory pressure of 5 cmH2O is applied.

external PEEP

Tae Soo Hahm, M.D.,Ph.D.

Won Ho Kim, M.D.

In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal pressure. The investigators tried to evaluate the effect of various inspiratory to expiratory ratio on pulmonary gas exchange by randomized controlled trial.

In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal pressure. During the laparoscopic surgery with abdominal gas insufflation, gas exchange disturbance such as CO2 retention, hypoxemia occurs in addition to high plateau airway pressure. The usual strategy against these kinds of problem is pressure-controlled ventilation. However, the gas exchange problem especially CO2 retention can not be solved in some cases. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater than expiratory time, can be applied for adult respiratory distress syndrome. The efficacy of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar recruitment. There have been several clinical investigations which applied IRV during general anesthesia. However, there have been debates about the effect of IRV during general anesthesia. Therefore, we tried to apply the IRV for subjects undergoing laparoscopic surgery, and evaluate the effect of different I:E ratio on the pulmonary gas exchange and respiratory mechanics.

The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position

systolic/ diastolic blood pressure, heart rate, mean blood pressure

physiologic dead space / tidal volume (VD/VT)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position	NCT01379313	Uterine Myoma Ovarian Cyst Laparoscopic Gy...	conventional I:... 1:1 ratio 2:1 group external PEEP	20 Years - 65 Years	Samsung Medical Center
The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position	NCT01379313	Uterine Myoma Ovarian Cyst Laparoscopic Gy...	conventional I:... 1:1 ratio 2:1 group external PEEP	20 Years - 65 Years	Samsung Medical Center

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