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Efficacy of ventilation with selective lobar collapse for thoracic surgery in elderly patients with chronic obstructive pulmonary disease / 中华麻醉学杂志
Article in Chinese | WPRIM | ID: wpr-427000
Responsible library: WPRO
ABSTRACT
Objective To investigate the efficacy of ventilation with selective lobar collapse for thoracic surgery in elderly patients with chronic obstructive pulmonary disease (COPD).Methods Thirty ASA Ⅱ or Ⅲ patients with COPD,aged 65-80 yr,with a body mass index of 16-28 kg/m2,undergoing radical resection of esophagus cancer,were randomly divided into 2 groups (n=15 each)one-lung ventilation (OLV) group and ventilation with selective lobar collapse group (group SLC).In group OLV,OLV was performed,while in group SLC,the balloon of the blocker was placed at 0.5 cm below the opening of the upper lobe bronchus and the lower lobe was collapsed when chest was open.The patients were mechanically ventilated (VT =7-8 ml/kg,RR =14-16 bpm,I∶E=1∶1.5-2.0,FiO2 =100%).Peak pressure (Ppeak),plateau pressure (Pplat),airway resistance (Raw),and dynamic lung compliance (Cd) were measured at 10 min of two-lung ventilation in supine position (T0),at 5,45 and 90 min of OLV or selective lobar collapse (T1-3) and at 10 min of two-lung ventilation in lateral position after the end of operation (T4).Arterial blood samples were obtained at To,T3 and T4 for blood gas analysis.Oxygenation index (OI),alveolar-arterial oxygen gradiant (P(A-a)O2),and respiratory index (RI) were calculated.Results Ppeak,Pplat and Raw were significantly lower at T2-4,while Cd was significantly greater at T1-4,OI was significantly higher at T3,4,and P(A-a)O2 and RI were significantly lower at T3,4 in group SLC than in group OLV.Conclusion The thoracic operation can be completed safely using ventilation with selective lobar collapse and OLV,however,ventilation with selective lobar collapse can improve oxygenation and provides better ventilatory efficacy than OLV in elderly patients with COPD.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Anesthesiology Year: 2012 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Anesthesiology Year: 2012 Type: Article