Inverse ratio ventilation combined with PEEP in infants undergoing thoracoscopic surgery with one lung ventilation for lung cystadenomas: a randomized control trial of 63 cases / 南方医科大学学报

OBJECTIVE@#To investigate the effect of inverse ratio ventilation (IRV) combined with positive end-expiratory pressure (PEEP) in infants undergoing thoracoscopic surgery with single lung ventilation (OLV) for lung cystadenomas.@*METHODS@#A total of 66 infants undergoing thoracoscopic surgery with OLV for lung cystadenomas in our hospital from February, 2018 to February, 2019 were randomized into conventional ventilation groups (group N, =33) and inverse ventilation group (group R, =33). Hemodynamics and respiratory parameters of the infants were recorded and arterial blood gas analysis was performed at 15 min after two lung ventilation (TLV) (T), OLV30 min (T), OLV60 min (T), and 15 min after recovery of TLV (T). Bronchoalveolar lavage fluid was collected before and after surgery to detect the expression level of advanced glycation end product receptor (RAGE).@*RESULTS@#Sixty-three infants were finally included in this study. At T and T, Cdyn, PaO and OI in group R were significantly higher ( < 0.05) and Ppeak, PaCO and PA-aO were significantly lower than those in group N ( < 0.05). There was no significant difference in HR or MAP between the two groups at T and T ( > 0.05). The level of RAGE significantly increased after the surgery in both groups ( < 0.05), and was significantly lower in R group than in N group ( < 0.05).@*CONCLUSIONS@#In infants undergoing thoracoscopic surgery with OLV for pulmonary cystadenoma, appropriate IRV combined with PEEP does not affect hemodynamic stability and can increases pulmonary compliance, reduce the peak pressure, and improve oxygenation to provide pulmonary protection.

Inverse ratio ventilation combined with PEEP in infants undergoing thoracoscopic surgery with one lung ventilation for lung cystadenomas: a randomized control trial of 63 cases / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of inverse ratio ventilation (IRV) combined with positive end-expiratory pressure (PEEP) in infants undergoing thoracoscopic surgery with single lung ventilation (OLV) for lung cystadenomas.@*METHODS@#A total of 66 infants undergoing thoracoscopic surgery with OLV for lung cystadenomas in our hospital from February, 2018 to February, 2019 were randomized into conventional ventilation groups (group N, =33) and inverse ventilation group (group R, =33). Hemodynamics and respiratory parameters of the infants were recorded and arterial blood gas analysis was performed at 15 min after two lung ventilation (TLV) (T), OLV30 min (T), OLV60 min (T), and 15 min after recovery of TLV (T). Bronchoalveolar lavage fluid was collected before and after surgery to detect the expression level of advanced glycation end product receptor (RAGE).@*RESULTS@#Sixty-three infants were finally included in this study. At T and T, Cdyn, PaO and OI in group R were significantly higher ( < 0.05) and Ppeak, PaCO and PA-aO were significantly lower than those in group N ( < 0.05). There was no significant difference in HR or MAP between the two groups at T and T ( > 0.05). The level of RAGE significantly increased after the surgery in both groups ( < 0.05), and was significantly lower in R group than in N group ( < 0.05).@*CONCLUSIONS@#In infants undergoing thoracoscopic surgery with OLV for pulmonary cystadenoma, appropriate IRV combined with PEEP does not affect hemodynamic stability and can increases pulmonary compliance, reduce the peak pressure, and improve oxygenation to provide pulmonary protection.

Protective effect of permissive hypercapnia in infants undergoing one-lung ventilation / 实用医学杂志

Objective To investigate the protective effect of permissive hypercapnia in infants undergoing one-lung ventilation(OLV). Methods A total of 64 infants were randomly divided into Group N(normocapnia group,n=32)and Group H(hypercapnia group,n=32).Arterial blood gas samples were collected at four differ-ent time points:10 minutes after intubation(T1),30 and 60 minutes after artificial pneumothorax(T2,T3),and 30 minutes after being sent to post anesthesia care unit(T4)while vital signs(HR,MAP,SpO2and temperature) and ventilation parameters(Ppeak,Vt,PEEP,RR,MVV,and FiO2)were recorded simultaneously;OI was calcu-lated by corresponding equation. Bronchoalveolar lavage fluid(BALF)was collected before and after surgery for the measurement of RAGE. Results Compared with those at T1,MAP and PaO2were significantly lower but Ppeak was obviously higher in group N,while HR,Ppeakas well as PaCO2were increased(P<0.05)and Vt,MVV,pH, PaO2as well as lactic acid were decreased in group H(P < 0.05)at T2and T3. Compared with those in group N, MAP,HR as well as PaCO2were higher while Ppeak,Vt,MVV,pH,and lactic acid were lower in group H at T2 and T3(P<0.05).There was a significant increase of RAGE in both groups after surgery and it was much higher in group N when compared with that in group H after surgery(P<0.05). Conclusion PHC not only has advantages in improving tissue oxygenation,but also has the potential of lung protection for infants undergoing OLV.