Effects and risk of different FiO2 levels on postoperative pulmonary complications in elderly obese patients undergoing pulmonary protective ventilation strategy
Objective To explore the effects of different oxygen concentration fraction in inhaled air (FiO2) on postoperative pulmonary complications in elderly obese patients undergoing pulmonary protective ventila-tion strategy. Methods A total of forty-five elderly obese patients requiring tracheal intubation and general anes-thesia in Jiangxi Integrated Traditional Chinese and Western Medicine Hospital were selected as study subjects and randomly divided into Group L (FiO2:30％),Group M (FiO2:50％),and Group H (FiO2:70％) according to dif-ferent FiO2 levels. Under the same lung-protective ventilation strategy,the end-tidal carbon dioxide partial pres-sure (PETCO2),airway platform pres-sure (PPLAT),peak airway pressure (PPEAK),oxygenation index (PaO2/FiO2),and alveolar-arterial oxygen partial pressure difference (PAaO2) were compared among the three groups at the time of tracheal intubation (T0),at the beginning of surgery (T1),1 hour into surgery (T2),and at the end of surgery (T3). Blood gas indicators were com-pared among the three groups before surgery,at T2,and on the third postop-erative day. Additionally,postoperative pulmonary complications (PPCs) were compared among the three groups. Results At T1,the levels of PETCO2,PPLAT,PPEAK,PaO2/FiO2,and PAaO2 were not statistically significant between Group M and Group H (P>0.05). Compared with Group L,both Group M and Group H had lower levels of PETCO2,PPLAT,PPEAK,and PAaO2,but higher levels of PaO2/FiO2 (P<0.05). At T2,Group M exhibited lower levels of PETCO2,PPLAT,PPEAK,and PAaO2,and a higher level of PaO2/FiO2 compared with both Group L and Group H (P<0.05). At T3,the levels of PETCO2,PPLAT,and PPEAK were not statistically significant among the three groups (P>0.05). Group M had a higher level of PaO2/FiO2 and a lower level of PA-aO2 compared with Group L and Group H (P<0.05). At T2,the levels of PaO2 were higher in Group M and Group H compared with Group L,and Group M had a higher level than Group H. On the third postoperative day,Group M had a higher level of PaO2 compared with Group L and Group H (P<0.05). The levels of PaO2 were not statistically significant between Group L and Group H on the third postoperative day (P>0.05). The levels of PaCO2 were not statistically signifi-cant among the three groups at all time points (P>0.05). The incidence of PPCs was lower in Group M compared with Group L (P<0.05). The proportions of PPCs ≥ grade 2 were not statistically significant among the three groups (P>0.05). Conclusion Under the pulmonary protective ventilation strategy for elderly obese patients,FiO2 of 50％ can maintain the stability of intraoperative respiratory dynamics and improve the blood gas index,and ex-hibit good safety.
万方数据
维普
