{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:22:51Z","timestamp":1792628571993,"version":"4.5.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Pneumoperitoneum creation for laparoscopic surgery increases the intraabdominal pressure and causes alveolar atelectasis. We investigated the influence of an increase in intra-abdominal pressure (IAP) on ventilatory mechanical power (MP) delivery during pneumoperitoneum creation for laparoscopic cholecystectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>\n                      In a prospective cohort design, we enrolled 42 patients undergoing laparoscopic cholecystectomy. During pneumoperitoneum creation, the IAP was sequentially raised to three predefined IAP levels (8, 11 and 14 mmHg), keeping identical ventilatory settings (timepoints T1, T2, and T3). After that, positive end-expiratory pressure (PEEP) was sequentially raised from 5 to 8 to 11 cmH\n                      <jats:sub>2<\/jats:sub>\n                      O (timepoint T4 and T5). The primary outcome included ventilatory MP delivery at each timepoint. Other variables included respiratory driving pressure (DP), airway resistance (AR), and respiratory compliance (RC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The MP increased linearly with a rise in IAP from T1 to T3 (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.71,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); the MP increased by 0.19 per unit rise in IAP (effect size 0.90,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). A similar positive correlation was also observed between DP and IAP from T1 to T3 (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.73,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); the DP increased by 0.72 per unit rise in IAP (effect size 0.89,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The MP increased significantly on increasing PEEP from T3 to T5, while the DP decreased concomitantly (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The AR increased significantly from T1 to T3, while RC decreased concomitantly; vice-versa was observed at T4 and T5 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The ventilatory MP delivery rises linearly with an increase in IAP. Targeting an IAP-guided MP level could be an attractive approach to minimize lung injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_45_23","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T18:21:42Z","timestamp":1711563702000},"page":"516-522","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Influence of intra-abdominal pressure on ventilatory mechanical power delivery and respiratory driving pressure during laparoscopic cholecystectomy: A prospective cohort study"],"prefix":"10.4103","volume":"40","author":[{"given":"Unnikannan","family":"Shaji","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debendra Kumar","family":"Tripathy","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navin","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilotpal","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/ALN.0000000000002458","article-title":"Positive end-expiratory pressure and mechanical power","volume":"130","author":"Collino","year":"2019","journal-title":"Anesthesiology"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"e13396","DOI":"10.1097\/MD.0000000000013396","article-title":"Comparison of the effects of different positive end-expiratory pressure levels on respiratory mechanics and oxygenation in laparoscopic surgery:A protocol for systematic review and network meta-analyses","volume":"97","author":"Wang","year":"2018","journal-title":"Medicine"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/EJA.0000000000001601","article-title":"Intra-operative ventilator mechanical power as a predictor of postoperative 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volatile anesthetic agents in patients undergoing laparoscopic cholecystectomy;A prospective, randomized, clinical trial","volume":"46","author":"Arinalp","year":"2016","journal-title":"Turk J Med Sci"},{"key":"R15-20240830","doi-asserted-by":"crossref","first-page":"244","DOI":"10.4097\/kjae.2013.65.3.244","article-title":"Optimal positive end-expiratory pressure during robot-assisted laparoscopic radical prostatectomy","volume":"65","author":"Lee","year":"2013","journal-title":"Korean J Anesthesiol"}],"container-title":["Journal of Anaesthesiology Clinical 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