Effects of apneic oxygen insufflation combined with low inspired fraction of oxygen on oxygenation and postoperative pulmonary complications in elderly patients undergoing one-lung ventilation
Objective To explore the effects of apneic oxygen insufflation(AOI)combined with low inspired fraction of oxygen(FiO2)on the oxygenation and postoperative pulmonary complications in elderly patients undergoing one-lung ventilation(OLV).Methods A total of 90 elderly patients undergoing elective thoracoscopic radical surgery for lung cancer under OLV were randomly divided into three groups with 30 cases each.The patients in group C had 100％FiO2 on the ventilated side lung during OLV,while the non-ventilated side lung was kept to open to the atmosphere.The patients in group A had 100％FiO2 on the ventilated side during OLV,while AOI was performed on the non-ventilated side.The patients in group B had 60％FiO2 on the ventilated side during OLV,while AOI was implemented on the non-ventilated side.The general information,surgery indicators,postoperative clinical pulmonary infection score(CPIS)and pulmonary-related complications within 7 days after surgery were recorded.The oxygenation index(OI)and intrapulmonary shunt rate(Qs/Qt)at 1 minute before OLV(T0),45 minutes during OLV(T1)and 30 minutes after OLV(T2)were compared among the three groups.Results Compared with T0,OI was decreased and Qs/Qt was increased in the three groups at T1(P＜0.05).Compared with T1,OI was increased and Qs/Qt was decreased in the three groups at T2(P＜0.05).At T1 and T2,OI in groups of A and B was higher than that in group C,while Qs/Qt was lower than that in group C(P＜0.05).The postoperative CPIS and the incidence of pulmonary complications in group B was lower than those in groups of A and C(P＜0.05).Conclusion AOI combined with low FiO2 can improve the oxygenation and reduce the incidence of postoperative pulmonary complications in elderly patients undergoing OLV.
One-lung ventilationApneic oxygen insufflationInspired fraction of oxygenOxygenation index
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