The application of lung protective ventilation strategy in laparoscopic surgery of obese patients
10.3760/cma.j.issn.1008-1372.2017.04.048
- VernacularTitle:肺保护性通气策略在肥胖患者腹腔镜手术中的应用
- Author:
Mingxia XU
;
Bo FANG
- Keywords:
Pulmonary ventilation;
Obesity/SU;
Laparoscopy;
Review
- From:
Journal of Chinese Physician
2017;19(4):622-625
- CountryChina
- Language:Chinese
-
Abstract:
With the ventilator associated lung injury (VALI) atracting more and more attention,lung protective ventilation strategy (LPVS) has gradually been applied to clinical practice.Obese patients are at higher risk in VALI for laparoscopic surgery,mechanical ventilation induced atelectasis is an important reason for low oxygen in intraoperative and postoperativen procedure.In laparoscopic surgery,high abdominal pressure causes the elevation of diaphragm,and increases airway pressure.The excessive pressure increases the amount of alveolar dead space and airway pressure,reduces lung compliance,and increases the possibility of barotrauma and colotrauma.In addition,carbon dioxide pnenmoperitoneum indces hypercapnia.Both of them influence the recovery of postoperative lung function.To optimize intraoperative management and improve the prognosis of patients with general anesthesia,the application of LPVS attracts more attention,including small tidal volume,positive end-expiratory pressure,and recruitment maneuvers,etc.However,LVPS may also cause lung injury.This article is a review on the application of LPVS in laparoscopic surgery of obese patients.
