{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T08:40:07Z","timestamp":1750408807987,"version":"3.41.0"},"reference-count":27,"publisher":"IOP Publishing","issue":"4","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/page\/copyright"},{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Biomed. Phys. Eng. Express"],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Increased intra-abdominal pressure (IAP) that is frequently found on patients requiring mechanical ventilation in the intensive care unit (ICU) can disrupt splanchnic perfusion and ventilation management. Elevated IAP, resulting from various factors including hemorrhage or abdominal masses, can lead to multi-organ dysfunction if not managed effectively. Interestingly, IAP is also prevalent in healthy individuals undergoing laparoscopic surgery, making it a valuable model for studying ventilation strategies applicable to critically ill patients. This study investigates the effects of varying positive end-expiratory pressure (PEEP) levels on end-expiratory lung impedance (EELI) during laparoscopic procedures, hypothesizing that alterations in PEEP can significantly influence EELI, particularly in dependent lung regions. Conducted at Cipto Mangunkusumo Hospital, this prospective cohort study included adult patients without severe pulmonary or cardiovascular conditions, assessing EELI through electrical impedance tomography (EIT). EIT was used to assess global and regional EELI changes at PEEP levels of 5, 8 11 and 14 cmH<jats:sub>2<\/jats:sub>O following CO<jats:sub>2<\/jats:sub> insufflation. The findings indicated that insufflation raised global EELI (\u0394EELI-G) following PEEP adjustments, which contradicts expectations from increased IAP. Regional analysis highlighted that dependent lung areas exhibited more significant changes, suggesting a complex relationship between PEEP and lung mechanics during elevated IAP. Despite no adverse respiratory complications observed, obesity notably influenced EELI post-anesthesia, underscoring the necessity for tailored PEEP strategies to enhance pulmonary function in at-risk populations. This study advances understanding of optimal ventilatory management in patients with altered IAP and calls for further investigation into individualized PEEP applications and the exploration of advanced imaging modalities for lung assessment.<\/jats:p>","DOI":"10.1088\/2057-1976\/ade159","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T22:47:50Z","timestamp":1749163670000},"page":"045018","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["End-expiratory lung impedance as a tool for PEEP optimization in patients with intra-abdominal hypertension: a laparoscopic surgery model"],"prefix":"10.1088","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0191-912X","authenticated-orcid":true,"given":"Fildza Sasri","family":"Peddyandhari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7216-4763","authenticated-orcid":true,"given":"Andi Ade Wijaya","family":"Ramlan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0974-5864","authenticated-orcid":true,"given":"Sidharta Kusuma","family":"Manggala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-1610","authenticated-orcid":true,"given":"Achmad Kemal","family":"Harzif","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0829-7302","authenticated-orcid":true,"given":"Amina","family":"Nada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5272-6025","authenticated-orcid":true,"given":"Theodorus Samuel","family":"Rahardja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"266","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"bpexade159bib1","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13613-019-0522-y","article-title":"Ventilation in patients with intra-abdominal hypertension: what every critical care physician needs to know","volume":"9","author":"Regli","year":"2019","journal-title":"Annals of Intensive Care"},{"key":"bpexade159bib2","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2015.00113","article-title":"Low versus standard pressures in gynecologic laparoscopy: a systematic review","volume":"20","author":"Kyle","year":"2016","journal-title":"JSLS"},{"key":"bpexade159bib3","doi-asserted-by":"publisher","first-page":"629","DOI":"10.4187\/respcare.07055","article-title":"Ventilator-induced lung injury: classic and novel concepts","volume":"64","author":"Katira","year":"2019","journal-title":"Respir Care"},{"key":"bpexade159bib4","article-title":"PulmoVista 500 for monitoring ventilation in critical care","author":"National Institute for Health and Care Excellence","year":"2019","unstructured":"National Institute for Health and Care Excellence 2019 PulmoVista 500 for monitoring ventilation in critical care ( https:\/\/nice.org.uk\/advice\/mib203\/chapter\/The-technology )"},{"key":"bpexade159bib5","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.4187\/respcare.08957","article-title":"End-expiratory lung volumes during spontaneous breathing trials in tracheostomized subjects on prolonged mechanical ventilation","volume":"66","author":"Cheng","year":"2021","journal-title":"Respir Care"},{"key":"bpexade159bib6","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s00408-016-9892-1","article-title":"End-expiratory lung volume in patients with acute respiratory distress syndrome: a time course analysis","volume":"194","author":"Kalenka","year":"2016","journal-title":"Lung"},{"key":"bpexade159bib7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-023-29860-x","article-title":"Electric impedance tomography and protective mechanical ventilation in elective robotic-assisted laparoscopy surgery with steep Trendelenburg position: a randomized controlled study","volume":"13","author":"Buonanno","year":"2023","journal-title":"Sci. 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All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2025-03-25","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-06-05","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2025-06-20","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}