Effect of dynamic lung compliance-guided PEEP titration on extravascular lung water in elderly pa-tients undergoing robot-assisted radical prostatectomy
10.3760∕cma.j.issn.0254-1416.2019.04.009
- VernacularTitle:Cdyn指导PEEP滴定对机器人辅助前列腺癌根治术老年患者血管外肺水的影响
- Author:
Xuesen SU
1
;
Shouyuan TIAN
;
Xin WANG
;
Lixia NIE
;
Xin YUAN
;
Rui ZHANG
;
Chao LI
;
Shu-Fang LIU
Author Information
1. 山西医科大学麻醉学系
- Keywords:
Positive-pressure respiration;
Extravascular lung water;
Prostatic neoplasms;
Robotic surgical procedures
- From:
Chinese Journal of Anesthesiology
2019;39(4):415-417
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of dynamic lung compliance ( Cdyn) -guided positive end-expiratory pressure (PEEP) titration on extravascular lung water in elderly patients undergoing robot-assisted radical prostatectomy. Methods Forty American Society of Anesthesiologists physical statusⅡ orⅢ patients, aged 65-80 yr, with body mass index of 19-28 kg∕m2 , scheduled for elective robot-assisted radical prostatectomy, were divided into 2 groups ( n=20 each) using a random number table method:control group (group C) and PEEP group (group P). In group P, immediately after endotracheal intuba-tion, immediately after establishing pneumoperitoneum-Trendelenburg position and after restoring the supine position, PEEP was set starting from the lowest PEEP allowed by the machine, increasing by 2 cmH2 O ev-ery 4 min until the maximum Cdyn was obtained. PEEP was not set in group C. Immediately after establis-hing the invasive blood pressure monitoring ( T1 ) , at 10 min after the first successful PEEP titration ( T2 ) , 10 min, 1 h and 2 h after the second successful PEEP titration ( T3-5 ) , 10 min after the third successful PEEP titration (T6), and 30 min after tracheal extubation (T7) in group P, or at T1, 10 min after intu-bation ( T2 ) , 10 min, 1 h and 2 h after establishing pneumoperitoneum-Trendelenburg position ( T3-5 ) , 10 min after restoring the supine position ( T6 ) and T7 in group C, blood samples were collected from the radial artery for blood gas analysis, and the oxygenation index was calculated. The B-line score was recor-ded at T1 and T7 . Results Compared with group C, the B-line score was significantly decreased at T7 , and the oxygenation index was increased at T5-7 in group P (P<0. 05). Conclusion Cdyn-guided PEEP titration can decrease the formation of extravascular lung water in elderly patients undergoing robot-assisted radical prostatectomy.
