The Impact of Driving Pressure-Guided Positive End-Expiratory Pressure Ventilation on Cerebral Blood Flow and Pulmonary Function in Patients Undergoing Laparoscopic Radical Prostatectomy.

Purpose: To examine the impact of driving pressure-guided positive end-expiratory pressure ventilation on cerebral blood flow and pulmonary function in patients undergoing laparoscopic radical prostatectomy.

Methods: A retrospective analysis was conducted on clinical data from patients who underwent laparoscopic radical prostatectomy at our hospital between June 2022 and June 2023. The patients were divided into two groups, namely the conventional ventilation group and the driving pressure-guided positive end-expiratory pressure ventilation group. Measurements and analyses were performed on cerebral blood flow, neurological status, and pulmonary function parameters.

Results: A total of 105 patients were included in this single-centre retrospective study, with 51 patients in the conventional ventilation group and 54 patients in the driving pressure-guided positive end-expiratory pressure ventilation group. The driving pressure-guided positive end-expiratory pressure ventilation group demonstrated significantly higher cerebral blood flow, cerebral autoregulation index, cerebrovascular resistance, and cerebral oxygen saturation compared to the conventional ventilation group (p < 0.05). Additionally, patients in the driving pressure-guided positive end-expiratory pressure ventilation group exhibited improved neurological outcomes, a higher partial pressure of oxygen/fraction of inspired oxygen ratio, increased lung compliance, decreased peak expiratory flow, elevated respiratory rate, and a lower lung injury score compared to the conventional ventilation group (p < 0.05).

Conclusions: The findings suggest that driving pressure-guided positive end-expiratory pressure ventilation might positively influence cerebral blood flow and pulmonary function parameters in patients undergoing laparoscopic radical prostatectomy.