EIT-guided Protective Pulmonary Ventilation In Patients Undergoing Laparoscopic Abdominal Surgery

Part oneEIT-guided PEEP for Protective Pulmonary Ventilation in patientsundergoing Laparoscopic Abdominal SurgeryObjectiveTo research on the optimal PEEP for protective pulmonary ventilation in patients undergoing laparoscopic abdominal surgery.Materials and MethodsThe clinical protocol incorporates the objects of study that can meet the standa rds into the same research group.After tracheal intubation and mechanical,the pati ents were applied with low tidal volume and recruitment maneuver,PEEP increased gradually(0mm Hg,6mm Hg,8mm Hg,10 mm Hg,12 mm Hg,14 mm Hg).The re spiratory system index and circulatory system index of the patients under different PEEP were measured.With the help of EIT monitoring,we got the optimal PEEP for protective pulmonary ventilation in patients undergoing laparoscopic abdominal s urgery.ResultsThe PEEP level of 8 cm H2 O was defined as the EIT-guided optimal PEEP.At the PEEP level of 8 cm H2 O,the dorsal regions of the patients under EIT monitoring(ROI3and ROI4)reached the maximum,and the ventral regions(ROI1 and ROI2)reached the minimum.Meantime,the PaO2/FiO2 of the patients reached the maximum and the Qs/Qt reached the minimum at the same PEEP level.Conclusion The EIT-guided optimal PEEP for protective pulmonary ventilation in patients undergoing laparoscopic abdominal surgery was 8 cm H2 O.Part twoThe Impact of Pulmonary Function on the EIT-guided Protective PulmonaryVentilation in Patients of Laparoscopic SurgeriesObjectiveTo research the impact of pulmonary function on the EIT-guided protective pulmonary ventilation in patients undergoing laparoscopic abdominal surgery.Material and MethodsPatients that can meet the standards were randomly were assigned to the pulmonary protective ventilation(Y)group and conventional ventilation(N)group.The protective pulmonary ventilation group adopt low tidal volume ventilation combined with recruitment maneuver and the optimal PEEP under EIT monitoring,while the conventional ventilation group adopt conventional tidal volume ventilation with no recruitment maneuver and ZEEP(the PEEP is 0 cm H2O).The region of interest of EIT monitoring,PaO2/FiO2 and circulation system index were measured.Results(1)There was obvious statistics difference(P<0.05)among the dorsal regions(ROI3and ROI4)of EIT between protective pulmonary ventilation(Y)group and conventional ventilation(N)group after after applications of pneumoperitoneum(T2)and after the exsufflation of pneumoperitoneum(T3).However,there was no obvious statistics difference(P > 0.05)among the ventral regions(ROI1 and ROI2)between protective pulmonary ventilation(Y)group and conventional ventilation(N)group after applications of pneumoperitoneum(T2)and after the exsufflation of pneumoperitoneum(T3).(2)PaO2/FiO2 and circulation system index were different between two groups during the surgery process(T2~T3)and after the anesthesia(T4)(P<0.05).ConclusionIn patients undergoing laparoscopic surgery,the EIT-guided protective pulmonary ventilation guided by increased pulmonary function and reduced the occurrence of pulmonary atelectasis,combined with improving the oxygenation during and after the operation.