To Evaluate the Effect of Individualized Dynamic Titration of Driving Pressure-directed Positive End-expiratory Pressure on Postoperative Atelectasis in Elderly Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer Based on Lung Ultrasoun
Objective:To investigate the application effect of individualized dynamic titration of positive end-expira-tory pressure(PEEP)guided by lung ultrasound in elderly patients undergoing laparoscopic radical resection of colo-rectal cancer,and to evaluate the occurrence of atelectasis by lung ultrasound score.Methods:According to the dif-ferent PEEP titration,60 elderly patients who underwent laparoscopic radical resection of colorectal cancer in our hospital from April 2021 to April 2023 were divided into control group(n=30)with fixed PEEP of 5cmH2O and ex-perimental group(n=30)with individualized dynamic PEEP guided by driving pressure.The lung ultrasound score,the number of atelectasis,ventilation mechanics and lung injury were compared.Results:Before extubation and 30 min after extubation,the lung ultrasound scores of the two groups were higher than before anesthesia,the experimental group was lower than control group(P＜0.05).The incidence of atelectasis in the experimental group was lower than control group(P＜0.05).At 30 min after PEEP and at the end of operation,the driving pressure and Clara cell protein 16 in the two groups were higher than 5 min after intubation,the experimental group was low-er than control group(P＜0.05).Conclusion:The individualized dynamic titration of PEEP guided by driving pres-sure can reduce lung injury,improve intraoperative ventilation mechanics,and reduce the incidence of lung ultra-sound score and atelectasis in elderly patients undergoing laparoscopic radical resection of colorectal cancer.
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