Comparison of Effects of Pressure Controlled Ventilation and Volume Controlled Ventilation on Perioperative Blood Loss of Patients with Posterior Lumbar Interbody Fusion / 医学研究杂志

ABSTRACT

Objective To compare the effects of pressure controlled ventilation and volume controlled ventilation on perioperative blood loss of patients with posterior lumbar interbody fusion (PLIF).Methods According to the random number table method,a total of 88 patients scheduled to PLIF were allocated into two groups,44 cases per groups.Patients received respectively pressure controlled ventilation and volume controlled ventilation in pressure controlled ventilation group (PCV group) and volume controlled ventilation group (VCV group).Mean arterial blood pressure (MAP),heart rate (HR) and central venous pressure (CVP) were continuously monitored at anesthesia induction immediately (T0),10min after supine position to prone position (T1),skin suture immediately (T2),10min after prone position to supine position (T3) and when tracheal extubation (T4).Hemoglobin (Hb) and hematokrit (HCT) were tested from T0 to T4 in the two groups.Respiratory parameters were recorded from T0 to T3 in the two groups.Intraoperative blood loss and blood loss at 96h after operation patients were recorded.Allogeneic blood transfusion,volume of fluid input and the rate of secondary surgery to stop th bleeding were recorded in the two groups.Results Compared to VCV group,peak inspimtory pressure (PIP) from T1 to T3 were all significantly lower (P ＜0.05) in PCV group.There was no statistical significance (P ＞ 0.05) in MAP,HR,tidal volume,respiratory rate (RR),PaO2/FiO2 and PaCO2 between the two groups.There was no statistical significance (P ＞ 0.05) in Hb and Hct at different time points between the two groups.Compared to VCV group,intraoperative blood loss,plasma infusions and red blood cell infusions were al significantly lower (P ＜ 0.05) in PCV group.Conclusion PCV can decrease intraoperative blood loss of patients with PLIF,which may be related to lower PIP during operation.