The Perioperative Efficacy of Driving Pressure-guided Lung-Protective Ventilation in Patients with Acute Type A Aortic Dissection
Objective To explore the perioperative efficacy of driving pressure-guided lung-protec-tive ventilation in the patients with acute type A aortic dissection(ATAAD).Methods Patients with AT A AD who underwent open-chest surgery under general anesthesia were enrolled in this study and divid-ed into two groups according to the perioperative ventilation strategies:the driving pressure-guided lung-protective ventilation group(group D)and the conventional lung-protective ventilation group(group C).The primary outcomes included the frequency and the incidence of the perioperative hypoxemia,and the secondary outcomes included the postoperative complications,the perioperative tendency of partial pres-sure of arterial oxygen/fraction of inspired oxygen ratio,the total postoperative intensive care unit stay,the total postoperative invasive ventilator-assisted time,and the safety evaluation.Results The intraop-erative driving pressure in the patients of group D was significantly lower than that in group C,while the end-expiratory positive pressure,peak airway pressure,and dynamic lung compliance in the patients of group D were significantly higher.Early postoperative oxygenation function was better than in group C.Compared with group C,less cases of postoperative pulmonary complications,shorter duration of post-operative ventilation assistance and shorter length of stay in intensive care unit were observed in group D.Conclusion The application of a driving pressure-guided lung-protective ventilation strategy may con-tribute to improve oxygenation function in the early postoperative period in patients with ATAAD,reduce the incidence of postoperative pulmonary complications,and also be associated with shorter intensive care unit stays and invasive ventilator-assisted time.
万方数据
维普
