Ventilation with a low tidal volume vs. an intermediate tidal volume during pleural decortication

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COD: 17_2021_3418-1 Categorie: ,

Zhi-Guo Shi, Tao Liu, Bin Chen, Xiao-Man Cao, Wei Liu

Ann. Ital. Chir., 2021 92, 6: 702-708

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OBJECTIVE: This study aims to evaluate the effects of low tidal volume and positive end expiratory pressure (PEEP) combined with pressure-controlled ventilation-volume guaranteed (PCV-VG) ventilation on one lung ventilation (OLV) in patients with tuberculous destroyed lung (TDL). METHODS: Patients of two groups were all treated with volume controlled ventilation (VCV) on two-lung ventilation,
and the tidal volume was set to 8 ml/kg according to standard body weight, breath rate was set to 10-14 times/min, inspiration and expiration ratio was set to 1:1.5. During OLV, VCV was used in group C, and the tidal volume was set to 8 ml/kg; PCV-VG was given to group P patients, and the tidal volume was set to 6 ml/kg, followed by PEEP at 7 cm H2O. Breath rate was set to 12-16 times/min, and inspiration and expiration ratio was set to 1:1.5 in both groups on OLV. RESULTS: Pplat, Ppeak and intrapulmonary shunt (Qs/Qt) were lower at T2 and T3 in group P, when compared to group C (P<0.05). At T2, T3 and T4, the oxygenation index (OI) increased, Qs/Qt decreased and arterial carbon dioxide partial pressure (PaCO2) increased in group P (P<0.05). At T5, the concentration of IL-6, TNF-α and BNP decreased in group P. CONCLUSION: Low tidal volume and PEEP combined with PCV-VG ventilation might be helpful for alleviating pulmonary injury in OLV, and reducing airway pressure and Qs/Qt during OLV in surgery.