Application of pressure-controlled ventilation-volume guaranteed in obese patients with obstructive sleep apnea syndrome / 实用医学杂志

ABSTRACT

Objective To explore the clinical effectiveness of pressure-controlled ventilation-volume guar-anteed(PCV-VG)in obese patients with obstructive sleep apnea syndrome(OSAS)during uvulopalatopharyngo-plasty. Methods 40 obese patients(BMI≥30 kg/m2)with OSAS scheduled for uvulopalatopharyngoplasty under general anesthesia were randomly divided into two groups of volume-controlled ventilation(group V,n = 20)and pressure-controlled ventilation-volume guaranteed(group P,n=20). The heart rate(HR),mean arterial pressure (MAP),arterial partial pressure of oxygen(PaO2)and arterial partial pressure of carbondioxide(PaCO2)were recorded before induction of anesthesia without oxygen inhalation(T0),30 min(T1)and 1 h(T2)after tracheal intubation,and 30 min after extubation(T3). The peak airway pressure(Ppeak),airway resistance(Raw),thoracic compliance (CL),oxygenation index (OI) and respiratory index (RI) were also calculated at T1 and T2 under observation of recovery. Results There were no obvious differences between the two groups of patients before anesthesia and after recovery. Compared with the group V ,PaCO2 ,PPEAK ,Raw at T1 ,T2 and RI at T1 ~ T3 of the group P decreased(P<0.05),while CL at T1,T2 and PaO2,OI at T1~T3 increased(P<0.05). There were no sig-nificant differences in HR ,MAP at the above time points. Conclusions Compared with volume-controlled venti-lation,PCV-VG can effectively enhance thoracic compliance,lower inspiratory pressure and airway resistance ,and decrease intrapulmonary shunt ,which is conductive to improve arterial oxygenation and gas exchange in obese patients with OSAS.