Lung Protective Ventilation Applied In Elderly Patients Undergoing Spinal Operation In Prone Position

Objective:To investigate effect of the protective lung ventilation on respiration and circulation in elderly patients performed spinal operation in prone position.Methods:Sixty patients undergoing elective spine surgery were divided into control group: [with VT of 10 ml/kg(PBW) and RR of 10 ~ 12/ min] and test group[with VT of 6 ml/kg +RMs+PEEP:5 cmH2O(PBW) and RR of 12~ 18/ min].Recruitment maneuver was performed once every30 min. HR, MAP, Ppeak, PPlat, PaO2/FiO2, Sp O2, PaCO2, WBC, NEUT%, CRP, VAS, pulmonary complications risk score, clinicalpulmonary infection score were recorded before the operation,upon entry in the operation room, at 5 min before and 30 min, 1 h, 3 h after changing into the prone position,and the change prone position,and 1 day, 3 days after the operation.Results:Pulmonary complications risk score, HR, MAP,WBC, NEUT%, PaCO2 between the two groups were all comparable between the two groups(P> 0.05); PpeaK and Pplat of the test group were lower than those of the control group after entering the operation room and at 5 min before and 30 min, 1 h, 3 h after changing into the prone position(p <0.05);Compared with those in control group, the oxygenation index at 1day after the operation was significantly higher and CRP and postoperative clinical pulmonary infection score at 1 day, 3 days after the operation were significantly lower in the test group(p<0.05).Conclusion:Lung protective ventilation strategy can decrease the risk of barotrauma, decrease lung inflammation, and increase postoperative oxygenation in elderly patients undergoing spinal surgery in the prone position without affecting intraoperative hemodynamics or causing carbon dioxide retention.