Effects Of Lung Protective Ventilation Strategy On Perianesthetic Respiratory Mechanics And Oxygenation Function In Copd Patients

Objective:To explore the effects of perianesthetic respiratory mechanics and oxygenation function when lung protective ventilation strategy apply on COPD patients.Methods:A total of 55 patients with COPD in ASA Ⅱ～Ⅲ,aged 49～75 years,body mass index of 18～26 kg/m2 undergoing laparoscopic surgery in First Affiliated Hospital of Hebei North University from Apirl 2020 to December 2020 were included,and randomly divided into the control group(VC group,n=27)and the test group(PV groups,n=28).The control group was given conventional ventilation strategy and the test group was given lung protective ventilation strategy.HR,MAP,SpO2,the Ppeak,the Pplat,the Cdyn,OI,and RI of the two groups were compared at 10 minutes after tracheal intubation(T0),1 hour after tracheal intubation(T1)and immediately after surgery(T2).The PACU time were recorded of the two groups.Results:1.There were no differences in general informations between the two groups,including the age,gender,BMI,FEV1/FVC,ASA score,types of operation(P>0.05).2.There were no differences in SpO2,MAP and HR between the two groups at T0,T1,T2(P>0.05).3.Comparison of the Cdyn,Ppeak,Pplat at time points between the two groups.①Cdyn:Intra-group comparison:compared with T0,the Cdyn of the two groups decreased at T1,T2(P<0.05);Inter-group comparison:compared with the VC group,the Cdyn of the PV group had no difference at T0(P>0.05)and increased at T1,T2(P<0.05).②Ppeak,Pplat:Intra-group comparison:compared with T0,the Ppeak and Pplat of the two groups increased at T1,T2(P<0.05);Inter-group comparison:compared with the VC group,the Ppeak and Pplat of the PV group had no difference at To(P>0.05)and decreased at T1,T2(P<0.05).4.Comparison of the RI,OI at time points between the two groups.①RI:Intra-group comparison:compared with T0,the RI of the two groups increased at T1,T2(P<0.05);Inter-group comparison:compared with the VC group,the RI of the PV group had no difference at T0(P>0.05)and decreased at T1,T2(P<0.05).②OI:Intra-group comparison:compared with T0,the OI of the two groups decreased at T1,T2(P<0.05);Inter-group comparison:compared with VC group,the OI of the PV group had no difference at T0(P>0.05)and increased at T1,T2(P<0.05).5.There were no differences in the course of COPD and operation time between the two groups.(P>0.05).The PACU time of the PV group shorter than the VC group(P<0.05).Conclusion:Lung protective ventilation strategy can improve the respiratory mechanics and oxygenation function with COPD in patients following laparoscopic surgery,and plays a role in protecting lung function and shortens the PACU time.