Effect of Inverse Ratio Ventilation on Respiratory Mechanics and Postoperative Pulmonary Complications in Morbidly Obese Patients Under-going Laparoscopic Sleeve Gastrectomy
10.11969/j.issn.1673-548X.2024.01.033
- VernacularTitle:反比通气对病态肥胖患者腹腔镜袖状胃减容术呼吸力学和术后肺部并发症的影响
- Author:
Liping ZHU
1
;
Fan WANG
;
Chuanwu ZHANG
Author Information
1. 221000 徐州医科大学附属医院麻醉科
- Keywords:
Inverse ratio ventilation;
Morbid obesity;
Respiratory mechanics;
Laparoscopic sleeve gastrectomy;
Pulmonary compli-cations
- From:
Journal of Medical Research
2024;53(1):165-169
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of inverse ratio ventilation on respiratory mechanics and postoperative pulmonary com-plications in morbidly obese patients during laparoscopic sleeve gastrectomy Methods A total of 62 morbidly obese patients for a laparo-scopic sleeve gastrectomy were scheduled(18-65 years old,BMI≥35kg/m2 in combination with diabetes,hypertension,hyperlipemia,and other metabolic diseases,or BMI≥40kg/m2,ASA Ⅱ or Ⅲ).Patients were randomly assigned to two groups:inverse ratio ventilation group(IRV)and control group(PVG).Two groups were adjusted with an actual tidal volume(VT)of 7-8ml/kg,and respiratory rates of 12 breaths/min.In the IRV group,the ratio of I∶E was 2∶1;in the control group,the ratio of I∶E was 1∶2.We recorded the indexes of respiratory mechanics and the blood gas at the baseline(T0),5min after anesthesia(T,),15min after pneumoperitoneum(T2),30min after pneumoperitoneum(T3),60min after pneumoperitoneum(T4)and the end of surgery(T5),and the occurrence of pulmonary com-plications on day 1,day 2 after operation was observed,and the cumulative incidence of PPCs at 7 days was counted.Results Compared to the control group,the dynamic lung compliance(Cdyn),mean airway pressure(Pmean),positive end expiratory pressure(PEEP),and the PaO2 at T,-T5 of the inverse ventilation group were increased significantly(P＜0.05),the Ppeak、Pplat at T2-T5 and dynamic lung compliance(VD/VT)at T3-T5 were decreased significantly(P＜0.05),and no difference in the PaCO2 and PETCO2 in the two groups.Grade 1 pulmonary complications occurred in both groups,and there was no difference in the total occurrence of pulmonary com-plications at 7 days.Conclusion Inverse ventilation effectively may improve respiratory mechanics and oxygenation in morbidly obese pa-tients undergoing laparoscopic sleeve gastrectomy.
