ABSTRACT
Objective To explore the effects of different ventilation modes of tracheobronchial foreign body in children with fiberoptic operation under general anesthesia.Methods Sixty children (1ys≤ age≤3ys) undergoing fiberoptic bronchoscopy tracheal foreign body removal according to the combinations of different ventilation modes during and after fiberoptic bronchoscopy (FOB) procedures were divided into group A [volume control ventilation (VCV) + VCV,n =20],group B [pressure control ventilation (PCV) + VCV,n =20] and group C (PCV + PCV,n =20) randomly.The P mean,Pmax,and PetCO2 during and after fiberoptic bronchoscopy procedures were monitored.The SpO2,PaO2,and PaCO2 after mechanical ventilation 1.5 hours were recorded.Results Compared to group A,groups B and C had lower P max and P mean (P ＜ 0.05) during the FOB procedures.Compared to groups A and B,group C had a lower P max and P mean (P ＜0.01) after the FOB procedures.At the 1.5 hours after the procedure,all the children showed significant increase in SpO2 and PaO2 (P ＜ 0.05) and decrease in PaCO2 (P ＜ 0.05) in groups A,B,and C.Conclusions When fiberoptic bronchoscopy in tracheobronchial foreign body operation is applied in children undergoing general anesthesia,the pressure control ventilation (VCV) mode can decrease the pressure of airway (Paw) and PaCO2 than volume control mode during procedure.
ABSTRACT
Objective To investigate the effect of preoperative acute hypervolemic hemodilution with 6% hydroxyethyl starch 130/0.4(HES130/0.4)and polygeline on hemodynamic response and variance regularity of hemodynamic response in open-and close-thoracic cavity in undergoing thoracotomy patients. Methods Sixty patients undergoing thoracotomy,ASA physical status ⅠorⅡ,aged 20~65 yeansold,weighing 45~70kg,were randomly divided three group:HES130/0.4 group ( group A,n=20) ,Polygeline group ( group B,n=20) and Ringer's solution group (group C,n=20).They were respectively infused 20ml/ (kg?h) with HES130/0.4,polygeline and Ringer's solution in one hour before infuseing followed Ringer's 10ml/ (kg?h). The Blood Pressure (BP) and heart rate (HR) were recorded.RPP was calculated before induction(baseline),5min before and 10 min after open thoracic cavity,5min before and 10min after close thoracic cavity. And central venous pressure (CVP) was measured at immediately after deep venous puncture ,5min before and 10min after open thoracic cavity,5min before and 10min after close thoracic cavity. Results The changes of hemodynamics in Ringer's solution group in operation were obvious as compared with baseline before operation.HES130/0.4 and polygeline were relatively stable.Two groups had no significant difference.The CVP of HES130/0.4 and polygeline groups increased obviously before and after open thoracic cavity,but the blood pressure was relatively stable.Only systolic blood pressure increased obviously as compared with Ringer's solution group at 5min before open thoracic cavity. At 10min after open thoracic cavity,HR and CVP in three groups increased obviously as compared with 5 min before open thoracic cavity.At 5 min before close thoracic cavity,blood pressure and CVP in three groups decreased obviously as compared with 10 min after open thoracic cavity. Conclusion The preoperative acute hypervolemic hemodilution with HES 130/ 0.4 and polygeline in undergoing thoracotomy patients can keep hemodynamics more stable and improve tolerance of patients to withstand hypovolemics.