Effect of ventilation with low tidal volume and positive end-expiratory pressure in different periods on postoperative pulmonary function and short-term prognosis in elderly patients with abdominal surgery
- VernacularTitle:低潮气量联合不同阶段呼气末正压通气对老年患者开腹术后肺功能的影响
- Author:
Guoxiang FAN
;
Guanguo XUE
;
Ruyang ZHANG
;
Jie SUN
;
Zhengnian DING
- Keywords:
In different periods;
Positive end-expiratory pressure;
Aged;
Abdominal sur-gery;
Pulmonary function;
Short-term prognosis
- From:
The Journal of Clinical Anesthesiology
2017;33(9):852-855
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of ventilation with low tidal volume and positive end-expiratory pressure (PEEP)in different periods on the postoperative pulmonary function and short-term prognosis in aged patients undergoing abdominal surgery.Methods Sixty aged patients undergoing selective open abdominal surgery scheduled for general anesthesia,21 males and 39 fe-males,were randomized into 3 groups (n =20).Patients in group A received PEEP 1 h after the be-ginning of surgery;patients in group B received PEEP 1 h before tracheal extubation;patients in group C received PEEP intraoperatively.The secretion score in preoperative,postoperative 24 h and 72 h respectively,and the arterial blood gas analysis indexes (PaCO 2 ,PaO 2 ,A-aDO 2 ,PaO 2/FiO 2 calculation)in postoperative 1 h and 24 h were recorded.Results Compared with preoperative,in postoperative 1 h,PaCO 2 increased obviously in all groups,PaO 2 decreased in group B,A-aDO 2 in-creased in group A (P <0.05);in postoperative 24 h,PaCO 2 was significantly increased in group B and C,PaO 2/FiO 2 decreased in group B (P <0.05).Compared with postoperative 1 h,in postopera-tive 24 h,PaCO 2 and A-aDO 2 decreased obviously in group A (P <0.05).There were no differences in postoperative secretions score in between the 3 groups.Conclusion Low tidal volume combined short-range PEEP in different periods of surgery may improve postoperative pulmonary oxygenation. But they had no obvious help with postoperative pulmonary complications.
