Effect of dynamic lung compliance-guided PEEP titration on lung injury in elderly patients undergo-ing robot-assisted radical prostatectomy
10.3760/cma.j.issn.0254-1416.2019.03.004
- VernacularTitle:Cydn指导PEEP滴定对机器人辅助前列腺癌根治术老年患者肺损伤的影响
- Author:
Xin YUAN
1
;
Shouyuan TIAN
;
Xin WANG
;
Lixia NIE
;
Xuesen SU
;
Rui ZHANG
;
Chao LI
;
Shu-Fang LIU
Author Information
1. 山西医科大学麻醉学系
- Keywords:
Lung compliance;
Positive-pressure respiration;
Prostatic neoplasms;
Respirato-ry function tests
- From:
Chinese Journal of Anesthesiology
2019;39(3):264-267
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of dynamic lung compliance ( Cydn)-guided positive end-expiratory pressure (PEEP) titration on lung injury in the patients undergoing robot-assisted radical prostatectomy. Methods Forty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 65-80 yr, with body mass index of 19-28 kg∕m2 , scheduled for elective robot-assisted radical prosta-tectomy under general anesthesia, were divided into 2 groups ( n=20 each) using a random number table method: control group (group C) and PEEP group (group P). Mechanical ventilation was performed ac-cording to preset parameters after tracheal intubation in group C, and PEEP was set by a double titration method after tracheal intubation and after pneumoperitoneum in group P. At 4 min after intubation (T1), 4 min, 1 h and 2 h after establishing pneumoperitoneum-Trendelenburg position ( T2-4 ) , and 1 and 30 min after extubation ( T5,6 ) in group C or at 4 min after completing the first PEEP titration ( T1 ) , 4 min, 1 h and 2 h after completing the second PEEP titration (T2-4) and T5,6 in group P, blood samples were collect-ed from the radial artery for determination of club cell protein 16, surfactant protein-D, tumor necrosis fac-tor-alpha and interleukin-6 concentrations in serum ( by enzyme-linked immunosorbent assay) . Results Compared with group C, the serum concentrations of club cell protein 16 at T2-6 and surfactant protein-D, tumor necrosis factor-alpha and interleukin-6 at T3-6 were significantly decreased in group P (P<0. 05). Conclusion Cydn-guided PEEP titration can reduce the lung injury in patients undergoing robot-assisted radical prostatectomy.
