The effect of different PEEP levels combined with PCV-VG ventilation mode on respiratory mechanics in elderly patients undergoing laparoscopic radical resection of colorectal cancer
Objective To explore the effect of different levels of positive end-expiratory pressure(PEEP)combined with pressure-controlled volume-guaranteed(PCV-VG)ventilation mode on respiratory mechanics in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods A total of 90 elderly patients who underwent laparoscopic radical resection of colorectal cancer in Inner Mongolia Autonomous Region People's Hospital from November 2019 to November 2020 were selected and divided into three groups based on random number table method,with 30 patients in each group:Group A had a PEEP of 0 cmH2O,Group B had a PEEP of 5 cmH2O,and Group C had individualized PEEP.Comparison of the airway plateau pressure(Pplat)and pulmonary dynamic compliance(Cdyn)at the time of intubation(T1),30 minutes after Trendelenburg position(T2),60 minutes after Trendelenburg position(T3),and at the end of surgery(T4)between the three groups of patients.The arterial blood samples before anesthesia induction(T0),T3,and 10 minutes after extubation(T5)were collected,and the values of arterial partial pressure of oxygen(PaO2)and arterial carbon dioxide partial pressure(PaCO2)were recorded compared.Results Cdyn of the three groups of patients was lower at T2,T3,and T4 than at T1,and higher at T4 than at T2 and T3.Pplat was higher at T2 and T3than at T1.Pplat was lower at T4 than at T2 and T3,and Pplat was higher at T4 than at T1 in group C.PaO2 was significantly higher at T3 and T5 than at T0,and PaO2 was significantly lower at T5 than at T3 in group A.PaCO2 was higher at T3 than at T0,with statistically significant differences(P＜0.05).At T2,T3,and T4,the Cdyn in Group C was higher than that in Group A and Group B,and at T4,the Cdyn in Group B was significantly higher than that in Group A.At T3,the PaO2 in Group C was significantly higher than that in Group A.At T5,the three groups of PaO2 were compared and ranked from high to low as Group C,Group B,and Group A,with statistically significant differences(P＜0.05).Except for PaCO2,there were differences in other indicators among all groups(P＜0.05).Conclusion The individualized titration of PEEP combined with PCV-VG ventilation mode can increase intraoperative Cdyn and PaO2 in elderly patients undergoing laparoscopic radical resection of colorectal cancer,improve intraoperative oxygenation,and reduce lung injury.
万方数据
维普
