Comparison Of Different Ventilation Modes In Infants And Young Children Undergoing Laparoscopic Surgery:A Randomized Controlled Study

Objective:To observe the effect of different ventilation strategies on pulmonary function indicators and lung ultrasound score in infants and young children undergoing laparoscopic surgery,and to explore the value of lung ultrasound score in evaluating perioperative oxygenation status.Methods:A total of 60 children undergoing laparoscopic surgery between February2019 and October 2022 were enrolled in this study and randomly assigned to two groups:V and P,with 30 patients in each group.After induction of general anesthesia,all patients received endotracheal intubation and mechanical ventilation throughout the surgical procedure.The V-group was ventilated with conventional volume-controlled ventilation,while the P-group received low tidal volume with Positive end expiratory pressure（PEEP）ventilation.Pulmonary function indicators,lung ultrasound scores（LUS）,and hemodynamic parameters were assessed at six time points:before induction of anesthesia（T1）,5 minutes after tracheal intubation（T2）,30 minutes after pneumoperitoneum（T3）,2 hours after pneumoperitoneum（T4）,after tracheal extubation（T5）,and 2 hours after pneumoperitoneum cessation（T6）.The duration of pneumoperitoneum and surgical time were recorded for both groups.Results:After pneumoperitoneum,the lung ultrasound score and Peak airway pressure(P_peak)were observed to increase,while Dynamic lung compliance(C_dyn)decreased at each time point in both groups,with statistical significance（P<0.05）.Furthermore,the lung ultrasound score and P_peak were significantly lower in the P-group compared to the group,whereas C_dyn was significantly higher in the P-group than the V-group at each time point after pneumoperitoneum（P<0.05）.The Oxygenation index（OI）values in T3 and T4 were significantly lower than those in T2（P<0.01）.The OI values in T3,T4 and T5 in P-Group were higher than those in V-Group（P<0.05）.In addition,a negative correlation was observed between the lung ultrasound score and OI value.There were no significant differences in the general condition,duration of pneumoperitoneum,or surgery time between the two groups（P<0.05）.Conclusion:The low tidal volume with PEEP ventilation strategy can alleviate the impact of mechanical ventilation on pulmonary function in children undergoing laparoscopic surgery,and the lung ultrasound score has a certain correlation with oxygenation index.