Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARD...Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARDS) patients. However, the effects that pressure-controlled inverse ration ventilation in patients undergoes endotracheal intubation general anesthesia have not been assessed. Objective: To investigate whether pressure-controlled inverse ratio ventilation (PIV) would improve ventilatory and oxygenation parameters as well as lung function compared to conventional ventilation in patients undergoing open abdominal surgery. Interventions: In the conventional ventilation (CV) group, the ventilation strategy involved zero end-expiratory pressure and volume-controlled ventilation. In the pressure-controlled inverse ratio ventilation (PIV) group, the strategy involved P high starting at 7 cm H<sub>2</sub>O, P low starting at 4 cm H<sub>2</sub>O, T high at 4 s, T low at 2 s, and an inspiratory-to-expiratory time ratio of 2:1. The ΔP value was adjusted according to VT. Pressure levels were increased by 2 cm H<sub>2</sub>O until a maximal V<sub>T</sub> was observed. Inspired oxygen fraction (FIO<sub>2</sub>) was 1.0 and tidal volume (V<sub>T</sub>) was 6 mL/kg in both groups. Main Outcome Measures: The primary outcome is pulmonary function tests. Hemodynamic, ventilatory and oxygenation parameters were measured;visual analog scale (VAS) scores, and nausea and vomiting scores were also measured. Results: The PIV group tolerated pressure-controlled inverse ratio ventilation without significant hemodynamic instability. Mean airway pressure and static compliance were significantly higher in the PIV group than those in CV group (P P 2 h was well tolerated and improved respiratory compliance and lung function on the first postoperative day.展开更多
文摘Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARDS) patients. However, the effects that pressure-controlled inverse ration ventilation in patients undergoes endotracheal intubation general anesthesia have not been assessed. Objective: To investigate whether pressure-controlled inverse ratio ventilation (PIV) would improve ventilatory and oxygenation parameters as well as lung function compared to conventional ventilation in patients undergoing open abdominal surgery. Interventions: In the conventional ventilation (CV) group, the ventilation strategy involved zero end-expiratory pressure and volume-controlled ventilation. In the pressure-controlled inverse ratio ventilation (PIV) group, the strategy involved P high starting at 7 cm H<sub>2</sub>O, P low starting at 4 cm H<sub>2</sub>O, T high at 4 s, T low at 2 s, and an inspiratory-to-expiratory time ratio of 2:1. The ΔP value was adjusted according to VT. Pressure levels were increased by 2 cm H<sub>2</sub>O until a maximal V<sub>T</sub> was observed. Inspired oxygen fraction (FIO<sub>2</sub>) was 1.0 and tidal volume (V<sub>T</sub>) was 6 mL/kg in both groups. Main Outcome Measures: The primary outcome is pulmonary function tests. Hemodynamic, ventilatory and oxygenation parameters were measured;visual analog scale (VAS) scores, and nausea and vomiting scores were also measured. Results: The PIV group tolerated pressure-controlled inverse ratio ventilation without significant hemodynamic instability. Mean airway pressure and static compliance were significantly higher in the PIV group than those in CV group (P P 2 h was well tolerated and improved respiratory compliance and lung function on the first postoperative day.
基金financially supported by the National Natural Science Foundation of High-end Foreign Experts Introduction Plan(G2022039008L)the Key Project of the National Natural Science Foundation of China-Yunnan Joint Fund(U2102215)Yunnan Major Scientific and Technological Projects(202202AG050016)。
基金supported by the National Natural Science Foundation of China(51762029)the Applied Basic Research Key Program of Yunnan Province(2018FA026)the Key Project of the National Natural Science Foundation of China-Yunnan Joint Fund(U2102215)。