ABSTRACT
Objective To investigate the effects of inverse ratio ventilation with positive end expiratory pressure (PEEP) on pulmonary function and inflammatory cytokine in patients undergoing pulmonary lobectomy during one-lung ventilation.Methods Eighty patients with one-lung ventilation,52 males,28 females,aged 37-65 years,BMI 21-29 kg/m2,ASA grade Ⅱ,were randomly divided into inverse ratio ventilation (IRV) group and conventional ventilation (CV) group (n=40 each).Patients were all implemented into the program of general anesthesia,and ventilated with different modes.The IRV group were ventilated with a actual tidal volume (VT) of 7 ml/kg,respiratory rate of 12 breaths/min,I:E of 2:1,PEEP 5 cm H2O;in CV group with I:E of 1:2.Respiratory parameters were recorded at baseline (T0),5 min after anesthesia (T1),initiate of one-lung ventilation (T2),45 min of one-lung ventilation (T3) and the end of surgery (T4).Arterial blood was collected to analyze blood gas at T0 and T3 respectively.Meanwhile,oxygenation index was calculated.The concentrations of IL-6,IL-8 and IL-10 in bronchoalveolar lavage fluid (BALF) were measured with fiberoptic bronchoscope by enzyme-linked immunosorbent assay (ELISA).Results Compared with CV group,PaO2was significantly increased and levels of IL-6,IL-8 and IL-10 in BALF were significantly decreased at T3 in IRV group (P<0.05);Ppeak and Pplat were significantly decreased at T1-T4 in IRV group (P<0.05);PEEP,Pmean and CL at T1-T4 were significantly increased at T1-T4 in IRV group (P<0.05).Two cases (5.0%) of hypoxemia were found in CV group,one case (2.5%) of hypoxemia was found in IRV group,but there were no statistically significant differences in both groups.Two groups were not seen to complications such as delay,atelectasis and pneumothorax.Conclusion The oxygenation and hypoxemia were improved and inflammatory cytokine was released in patients with one-lung ventilation.
ABSTRACT
To explore the feasibility and effects of Cook balloon cervical dilator on full-term nulliparous parturients under epidural analgesia.The observation group (n =40) received Cook balloon cervical dilation under epidural analgesia.However, the control group (n =40) had no epidural analgesia.Latent phase of labor was shorter in observation group than that in control group [(198.7 ± 65.7) vs.(242.9 ± 78.9) min, P ＜0.05].And the incidence of cesarean section and perineal laceration was lower under epidural analgesia(8％ vs.15％, 45％ vs.50％ respectively).There were no effects on success rate of induced labor in neither group.Cook balloon could shorten latent phase of labor, relieve the pain of parturients and increase no infection rate [leukocyte count : (8.82 ± 2.74) × 109/L vs.(9.10 ± 3.06) × 109/L, C-reactive protein: (4.73 ±0.87) mg/L vs.(4.82 ±0.90) mg/L respectively].It is worth wider clinical popularization.