Volume 20 Issue 7
Jul.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(7): 1139-1142
ZHU Guang-feng, WANG He-jie, JIANG Yi, GU Ye-chun, LI Yi-zheng. Effect of pressure-controlled ventilation-volume guaranteed on lung ventilation in elderly patients undergoing laparoscopic Trendelenburg postural colon surgery[J]. Chinese Journal of General Practice, 2022, 20(7): 1139-1142. doi: 10.16766/j.cnki.issn.1674-4152.002542
Citation: ZHU Guang-feng, WANG He-jie, JIANG Yi, GU Ye-chun, LI Yi-zheng. Effect of pressure-controlled ventilation-volume guaranteed on lung ventilation in elderly patients undergoing laparoscopic Trendelenburg postural colon surgery[J]. Chinese Journal of General Practice, 2022, 20(7): 1139-1142. doi: 10.16766/j.cnki.issn.1674-4152.002542
shu

Effect of pressure-controlled ventilation-volume guaranteed on lung ventilation in elderly patients undergoing laparoscopic Trendelenburg postural colon surgery

doi: 10.16766/j.cnki.issn.1674-4152.002542

  • Department of Anesthesiology, Wenzhou Integrated Traditional Chinese and Western Medical Hospital, Wenzhou, Zhejiang 325000, China

Funds:

 2021KY1081

 2018A04

  • Received Date: 2021-10-12
    Available Online: 2022-09-23
    Abstract
  •   Objective  To observe the effect of pressure-controlled ventilation volume guaranteed (PCV-VG) on lung ventilation in elderly patients undergoing Trendelenburg position laparoscopic colon surgery.  Methods  Total 60 patients with colon surgery in Wenzhou Integrated Traditional Chinese and Western Medical Hospital from May 2020 to April 2021 were randomly divided into volume control ventilation group (V group, n=30) and PCV-VG group (P group, n=30).The mean arterial pressure (MAP), heart rate (HR), dynamic compliance (Cdyn), inspiratory peak pressure (Ppeak), plateau airway pressure (Pplat) and the partial pressure of end- tidal carbon dioxide (PetCO2) were recorded at different time point (T1-T6). The pH, PaO2 and PaCO2 were determined by blood gas analysis and oxygenation index (OI) and pulmonary complications were calculated within 5 days after operation.  Results  There was no statistical significance in MAP and HR between V and P group. The HR at T1-T6 in both groups was higher than that in T0 (P < 0.05). Patients in both groups with T4 and T5 had lower PH compared to T1. The PaO2 and OI decreased and PaCO2 increased in both group with the increase in body position change time (P < 0.05). In T5, compared with P group, the PaO2 and OI values were decreased while PaCO2 values increased in V group. At T3-T6, Ppeak and Pplat were increased and Cdyn decreased in V group compared with p group. The Cdyn at T4-T5 in P group was decreased compared with V group. At the time point of T5: Ppeak value was (25.4±2.1) cm H2O (1 cm H2O=0.098 kPa) in V group vs. (16.3±2.1) cm H2O in P group; the Pplat value was (9.0±0.5) cm H2O in V group vs. (7.0±0.6) cm H2O in P group, and the Cdyn value was (33.2±6.3) mL/cm H2O in V group vs. (40.3±5.2) mL/cm H2O in P group. The percentage of hypercapnia in group P (3.3%, 1/30) was lower than that in group V (23.3%, 7/30), but the difference was not statistically significant (χ2=3.606, P=0.057).  Conclusion  PCV-VG can effectively reduce airway pressure of lung ventilation, improve oxygenation index and reduce postoperative complications for elderly patients undergoing laparoscopic Trendelenburg colon surgery.

     

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