During general anaesthesia there is a decrease of functional residual capacity (FRC) and changes of pulmonary gas exchange. The goal of the study was to evaluate the influence of ventilation strategy during general anaesthesia on chosen pulmonary function parameters and postoperative course in the patients who underwent large surgical procedure. The prospective randomized study enrolled 67 patients. The patients of control group (group K, n=34) were ventilated during anaesthesia in VCV ventilation mode with low PEEP (3 cmH2O). In the second group of patients (group RMP, n=33) modified recruitment maneuver was performed after 15 min from the induction of anaesthesia and then patients were ventilated in VCV ventilation mode with PEEP of 6–8 cmH2O according to body size. Followed groups did not differ in the basic demographic parameters, mode of anaesthesia and intraoperative values of SaO2, EtCO2, FiO2 and N2O, halothane and isoflurane inspired concentrations. The duration of procedure was significantly longer in RMP group (220/187.5; 320/min vs 180/140; 257/min, P=0.026). K group compared to RMP group had progressive increase of tidal volume during anaesthesia (562.5±141.7 vs 658.8±178.3 ml before the beginning of spontaneous breathing, P=0.018). The use of recruitment maneuver and higher PEEP increased effective compliance in RMP group. The recruitment maneuver in 5 of 33 patients was associated with decrease of blood pressure lower than 20% of baseline value and in 4 patients the decrease of blood pressure was bigger than 20% of baseline value. Between the groups there were not differences in the incidence of postoperative complications and the length of stay in hospital. The use of intraoperative ventilatory strategy based on the „open lung“ concept is associated with better lung compliance during general anaesthesia. The positive influence on the postoperative course of followed population was not demonstrated.

        Key words: compliance – PEEP – recruitment – anaesthesia – postoperative complications