ABSTRACT
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.
Subject(s)
Humans , Infant , Cystadenoma , Therapeutics , Lung , One-Lung Ventilation , Positive-Pressure Respiration , ThoracoscopyABSTRACT
Objective To investigate the effects of inverse ratio ventilation on pulmonary function and ce-rebral oxygen saturation in elderly patients with single lung ventilation.Methods Sixty patients scheduled for elec-tive radical resection of esophageal cancer were divided into 2 groups(n=30 for each group)using a random num-ber table:the experiment group(group A)and the control group(group B). During the two lung ventilation,the ventilator parameters were set as tidal volume(VT)7 mL/kg,inspiratory to expiratory ratio 1:2. During one lung ventilation,the I:E ratio was 1.5:1 in the group A and 1:2 in the group B. At 15 min after two lung ventilation (T1),20 min after one lung ventilation(T2),60 min after one lung ventilation(T3)and 15 min after restarting two-lung ventilation(T4),the blood gas analysis was measured and recorded for the hemodynamics,respiratory me-chanics index and cerebral oxygen saturation respectively. Results Compared with the B group,the Ppeak and VD/VT at T2~T4in the group A were lower while PaO2,Pmean and Cdyn were higher(P<0.05).During one lung ventilation,the incidence of rSO2< 50% or rSO2decreased more than 20% in the group A was lower than that in the group B(P<0.05).The PaO2,Cdyn and rSO2of the two groups at T2~T4were significantly lower and Ppeak, Pmean,PaCO2,VD/VT were significantly higher than the baseline(T1)(P < 0.05). Conclusion During one-lung ventilation,prolonged inspiratory time can improve pulmonary function and lung compliance without increas-ing peak airway pressure,reduce the decline of rSO2 at the same time.
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.