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Abstract

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. Current literature recommends utilizing lung protective ventilation (LPV) strategies to reduce the incidence of PPCs, particularly in high-risk patients like the group described. One strategy described in the literature is the use of tidal volumes of 6-8 milliliters per kilogram of ideal body weight. Despite the evidence, 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 tidal volume strategies in obese patients undergoing laparoscopic surgery. A survey was sent to anesthesia providers at a large urban trauma center. Results indicated that most participants have current knowledge of lung protective tidal volume recommendations and use them in their practice, although areas for improvement were identified. Recommendations include continued education and emphasis on evidence-based lung protective tidal volume recommendations for anesthesia providers.

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