Protective effects of lung protective ventilation on lungs in patients undergoing radical resection for esophageal cancer / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the protective effects of lung protective ventilation on the lungs in patients undergoing radical resection for esophageal cancer.Methods Sixty-eight patients of both sexes,aged 40-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index 17-40 kg/m2,scheduled for elective radical resection for esophageal cancer,were randomly divided into conventional ventilation group (CV group,n =34) and protective ventilation group (PV group,n =34) using a random number table.Double lumen tube was inserted after induction of anesthesia,an anesthesia machine was connected,and the patients were mechanically ventilated.In group CV,VT was set at 10 ml/kg during two-lung ventilation,and VT was set at 7 ml/kg,and I ∶ E was set at 1 ∶ 2 during one-lung ventilation.In group PV,VT was set at 7 ml/kg during two-lung ventilation,VT was set at 5 ml/kg,I ∶ E was set at 1 ∶ 2,and PEEP was set at 10 cmH2O during one-lung ventilation,and bilateral lung recruitment maneuver was performed every 45 min.Before induction of anesthesia,and at days 1,3,and 5 after surgery,blood gas analysis was performed,and Clinical Pulmonary Infection Score was recorded.Before induction of anesthesia,and at 5 days after surgery,point-of-care testing for pulmonary function was performed,and percentages of maximum ventilatory volume (MVV％),forced vital capacity (FVC％),and forced expiratory volume in 1 second (FEV1％) were recorded,and FEV1/FVC was calculated.The development of respiratory failure,pulmonary atelectasis and incision infection was recorded within 5 min after surgery.Results Compared with group CV,MVV％,FVC％,FEV1％ and FEV1/FVC were significantly increased,Clinical Pulmonary Infection Score was decreased at each time point after surgery,SaO2 and PaO2 were increased,and no significant changes were found in pulmonary atelectasis and incision infection in group PV.Conclusion Lung protective ventilation can effectively protect the lungs in the patients undergoing radical resection for esophageal cancer.