Exploration of the Role of Optimizable Lung-protective Ventilation Strategies in the Perioperative Period in Patients with Moderate-to-severe Traumatic Craniocerebral Injuries
Objective:To investigate the role of optimizable lung-protective ventilation strategies in perioperative pulmonary isotope regression in patients with moderate-to-severe traumatic craniocerebral injury(TBI).Methods:52 patients with traumatic moderate-heavy craniocerebral injuries admitted to the hospital from February 2020 to February 2021 were selected as the study subjects to implement perioperative optimizable lung-protective ventilation strategy(LPVS),and all of them were ventilated with pressure-regulated volume control(PRVC).PRVC parameter was set:Vol 6～8 mL/kg,RR 10～15 bpm,Ti∶Te=1∶2,PEEP 5 cmH2O,FiO2 50%,oxygen flow rate 1～2 L/min,and pressure-controlled method(PCV)of pulmonary reexpansion was taken every 120 min.Mean arterial pressure(MAP),SPO2,PetCO2,and ICP were recorded before induction of anesthesia(T0),at the beginning of PRVC(T1),at the first monitoring of ICP after PRVC(T2),at the cranial closure after PRVC+PCV(T3),as well as at 12 h(T4),24 h(T5),48 h(T6),72 h(T7),and 5 d(T8)postoperatively,and the cerebral perfusion pressure(CPP)was measured.PaO2 and PaCO2 were recorded before and after PRVC+PCV at each observation time point,and the length of surgery,blood loss,and length of PRVC were recorded to document postoperative pulmonary regression and postoperative cerebral infarction.Results:Patients who received LPVS took PRVC and were given PCV for pulmonary reexpansion,with significantly higher PaO2,SpO2,and OI,significantly higher improvement in T7 and T8 values than T0,T1,and T2,and improvement in pulmonary oxygenation function.Conclusion:Optimizability LPVS possesses better prevention of pulmonary atelectasis,lung injury,optimization of pulmonary oxygenation function,and improved pulmonary regression,making it a more ideal management of mechanically ventilated respiration in non-physiological conditions of the lungs in the moderate-to-severe perioperative period.
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维普
