@article{JTD26994,
author = {Zhi-Guo Shi and Wan-Ming Geng and Guang-Kuo Gao and Chun Wang and Wei Liu},
title = {Application of alveolar recruitment strategy and positive end-expiratory pressure combined with autoflow in the one-lung ventilation during thoracic surgery in obese patients},
journal = {Journal of Thoracic Disease},
volume = {11},
number = {2},
year = {2019},
keywords = {},
abstract = {Background: The present study aims to evaluate the influence of alveolar recruitment strategy (ARS) and positive end-expiratory pressure (PEEP) combined with autoflow on respiratory mechanics, the oxygen index (OI), pulmonary shut [Qs/Qt(%)], and the concentrations of IL-6 and TNF-α in venous blood after surgery in obese patients who experienced thoracic surgery with one-lung ventilation (OLV).
Methods: A total of 36 obese patients with ASAII-III degree, who experienced selective pulmonary lobectomy, were within 36–74 years old, and had a BMI of 30–40 kg/m2, were randomly divided into two groups: control group (C group) and protective ventilation group (P group). In the P group, ARS was given once when OLV began. Then, ventilation at 7 mmHg of PEEP and autoflow were given. The Ppeak before OLV (T1), at 30 minutes after OLV (T2), and at the 5 minutes after two-lung ventilation (TLV) (T3), and the changes of Pplat and Cdyn were recorded. Then, arteriovenous blood was drawn at T1, TT2, T3 and T4 (6 hours after the operation), blood-gas indicators, including SPO2, PaCO2 and PaO2, were measured, and the value of Qs/Qt(%) was calculated. Afterwards, venous blood was collected at T1 and T5 (18 hours after surgery), and the concentrations of IL-6 and TNF-α were detected. The clinical pulmonary infection score (CPIS) was determined at the first day and seventh day after the operation.
Results: In both groups, Cdyn and OI decreased, while Pplat, Ppeak and Qs/Qt(%) increased (P},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/26994}
}