The impact of lung-protective ventilation strategy on postoperative pulmonary function and prognosis in abdominal surgery patients with a history of COVID-19 infection
10.3760/cma.j.cn431274-20250529-00764
- VernacularTitle:肺保护性通气策略对有新型冠状病毒感染病史的腹部手术患者术后肺功能及预后的影响
- Author:
Chunfeng FENG
1
;
Xinxiang FENG
1
;
Yu WANG
1
;
Tao FENG
1
Author Information
1. 永州市中心医院（南华大学附属永州医院）麻醉科，永州 425000
- Publication Type:Journal Article
- Keywords:
COVID-19;
Abdominal surgery;
Lung protective ventilation strategies
- From:
Journal of Chinese Physician
2025;27(11):1690-1693
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the impact of lung-protective ventilation strategy on postoperative pulmonary function and prognosis in abdominal surgery patients with a history of coronavirus disease 2019 (COVID-19) infection.Methods:A total of 80 patients with a history of COVID-19 who underwent emergency or elective abdominal surgery at the Central Hospital of Yongzhou from December 2023 to April 2025 were selected. They were divided into the lung-protective group ( n=40) and the traditional ventilation group ( n=40) using a random number table method. The lung-protective group was set with a tidal volume (VT) of 6 ml/kg, positive end-expiratory pressure (PEEP) of 5 cmH 2O, and lung recruitment was performed every 30 minutes; the traditional ventilation group was only set with a VT of 8-10 ml/kg. Blood gas analysis indicators [partial pressure of arterial carbon dioxide (PaCO 2) and partial pressure of arterial oxygen (PaO 2)] and pulmonary function indicators [forced expiratory volume in one second (FEV 1), forced vital capacity (FVC), and FEV 1/FVC] were compared between the two groups before surgery and 3 days after surgery. The modified clinical pulmonary infection score (MCPIS) was calculated, and the incidence of postoperative complications was statistically analyzed in both groups. Results:There were no statistically significant differences in blood gas analysis and pulmonary function indicators between the two groups before surgery (all P>0.05). Compared with preoperatively, PaCO 2 decreased and PaO 2 increased in both groups 3 days after surgery (all P<0.05); 3 days after surgery, PaCO 2 in the lung-protective group was lower than that in the traditional ventilation group, and PaO 2 was higher than that in the traditional ventilation group (all P<0.05). Compared with preoperatively, FEV 1 and FVC decreased, and FEV 1/FVC increased in both groups 3 days after surgery (all P<0.05); 3 days after surgery, FEV 1, FVC, and FEV 1/FVC in the lung-protective group were all higher than those in the traditional ventilation group (all P<0.05). The MCPIS of the lung-protective group 3 days after surgery was lower than that of the traditional ventilation group, with a statistically significant difference [(2.75±0.45) vs (4.23±0.68), t=11.479, P<0.05]. There was no statistically significant difference in the total incidence of complications between the lung-protective group and the traditional ventilation group ( P>0.05). Conclusions:Lung-protective ventilation strategy can improve postoperative blood gas analysis indicators and pulmonary function in abdominal surgery patients with a history of COVID-19, thereby improving prognosis, with good safety.
