Comparison of influence of lung protective ventilation strategy and conventional volume controlled ventilation on blood gas analysis indicators during hematoma removal in patients with craniocerebral injury
Objective To investigate the influence of lung protective ventilation strategy(LPVS)and conventional volume controlled ventilation(VCV)on blood gas analysis indicators during hematoma removal in patients with craniocerebral injury.Methods Sixty patients with craniocerebral injury who received hematoma removal in the hospital were enrolled from June 2021 to December 2023.According to different ventilation methods,they were divided into VCV group and LPVS group,with 30 cases in each group.The blood gas analysis indicators[arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2),blood oxygen saturation(SpO2),oxygenation index(PaO2/FiO2)]were compared between groups at different time points[before anesthesia induction(T0),at the beginning of mechanical ventilation(T1),closing skull after the end of surgery(T2),at 24 h after surgery(T3)].The hemodynamics[heart rate(HR),mean arterial pressure(MAP)]at different time points,treatment outcomes(mechanical ventilation time,ICU stay time,6-month survival rate)and occurrence of complications were compared between the two groups.Results ①Blood gas analysis indicators:In both groups,the PaCO2,PaO2,SpO2 and PaO2/FiO2 conformed to spherical distribution(P＞0.05).Compared with T0,PaCO2 in the two groups showed a trend of decreasing first and then increasing at T1-T3(P＜0.05),and at T1-T2,the PaCO2 in LPVS group was significantly lower than that in VCV group(P＜0.05).Compared with T0,PaO2,SpO2 at T1-T3 showed a continuous upward trend(P＜0.05),and PaO2/FiO2 in the two groups increased first and then decreased at T1-T3(P＜0.05),and SpO2 at T2 and PaO2,PaO2/FiO2 at T1-T2 in LPVS group were significantly higher than those in VCV group(P＜0.05).②Hemodynamics:In both groups,the HR,MAP conformed to spherical distribution(P＞0.05).Compared with T0,the HR in the two groups showed a trend of decreasing first and then increasing at T1-T3(P＜0.05),and HR at T2-T3 in LPVS group were significantly higher than those in VCV group(P＜0.05).Compared with T0,the MAP at T1-T3 in the two groups showed a decreasing trend(P＜0.05),and the MAP at T1-T2 in LPVS group were significantly higher than those in VCV group(P＜0.05).③Treatment outcomes and complications:The mechanical ventilation time in LPVS group was shorter than that in VCV group(P＜0.05),but there were no significant difference in ICU stay time and 6-month survival rate between groups(P＞0.05).The total incidence rate of complications in LPVS group was lower than that in VCV group(P＜0.05).Conclusion Compared with VCV,LPVS can significantly improve the perioperative blood gas status,regulate the hemodynamics,shorten the mechanical ventilation time,and reduce the risk of postoperative lung complications in patients with craniocerebral injury.
万方数据
维普
