Volume 19 Issue 6
Jun.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(6): 944-946,968
WANG Shun, WAN Hai-fang, NI Yan-hua. Effect of pressure controlled ventilation on postoperative delirium in elderly patients with spinal tuberculosis[J]. Chinese Journal of General Practice, 2021, 19(6): 944-946,968. doi: 10.16766/j.cnki.issn.1674-4152.001956
Citation: WANG Shun, WAN Hai-fang, NI Yan-hua. Effect of pressure controlled ventilation on postoperative delirium in elderly patients with spinal tuberculosis[J]. Chinese Journal of General Practice, 2021, 19(6): 944-946,968. doi: 10.16766/j.cnki.issn.1674-4152.001956
shu

Effect of pressure controlled ventilation on postoperative delirium in elderly patients with spinal tuberculosis

doi: 10.16766/j.cnki.issn.1674-4152.001956
  • 1.

    Department of Anesthesiology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003,China

Funds:

 2019KY508

  • Received Date: 2020-05-08
    Available Online: 2022-02-16
    Abstract
  •   Objective  To explore the effect of pressure-controlled ventilation (PCV) mode on postoperative delirium (POD) in elderly patients with spinal tuberculosis.  Methods  A total of 72 elderly patients suffering from spinal tuberculosis and admitted to a hospital from September 2018 to September 2019 were included in the study. They were randomly divided into observation and control groups with a simple random number table method, and each group contained 36 patients. Patients in the observation group received PCV mode ventilation [initial parameters: VT=8 mL/kg, oxygen flow=2 L/min, RR=12 times/min, FiO2=60%, I∶E=1∶1.5. FiO2; were maintained during the operation; I∶E was unchanged, VT was adjusted to 6 mg/kg+5 cm H2O (1 cm H2O=0.098 kPa) and PetCO2 was maintained at 33-36 mm Hg (1 mm Hg=0.133 kPa) level). The control group received conventional positive pressure ventilation (VT=8 mL/kg, RR=12 times/min, I∶E=1∶2, PEEP=0 cm H2O). Within 1 week after surgery, the rate of postoperative delirium in both groups was evaluated with the consciousness confusion assessment method. For patients with POD after symptomatic treatment, no case of death due to POD was recorded, and the outcome of delirium in the two groups was analysed.  Results  The incidence rate of POD in the observation group was 19.44%(7/36), lower than that in the control group (41.67%, 15/36). The difference was statistically significant (χ2=4.189, P=0.041). POD continued despite that the time was shorter than that in the control group, and the difference was not statistically significant (t=1.504, P=0.137). The POD outcome of the observation group was better than that of the control group, and the difference was statistically significant (Z=-2.799, P=0.005). The outcome of the observation group was 100.00% (7/7), better than that of the control (53.33%, 8/15). Statistically significant differences were found (χ2=4.791, P=0.029).  Conclusion  Pressure control ventilation during the operation of elderly patients with spinal tuberculosis can help reduce the incidence of postoperative delirium and increase the postoperative delirium outcome rate and is thus suitable for clinical application.

     

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