Effect Of Protective Lung Ventilation Strategy Applied On Lung Compliance And Oxygenation In Patients Undergoing Laparoscopic Radical Resection Of Rectal Cancer

ObjectiveTo explore the effects of protective lung ventilation strategy applied on lung compliance and oxygenation in patients undergoing laparoscopic radical resection of rectal cancer.MethodsA total of 60 patients underwent laparoscopic radical resection of rectal cancer were randomly divided into three groups:group A?low V_T+high RR+small PEEP+lung recruitment maneuver?group B?low V_T+high RR+small PEEP?and group C?routine VT+routine RR?.All the three groups received intermittent positive ventilation.Group A was given low tidal volume+low PEEP+lung recruitment maneuver?tidal volume of6 ml/kg,respiratory rate was 16 times/min,PEEP was 5 cm H₂O,which was applied every 30 min?;group B was given low tidal volume+low PEEP?tidal volume was 6 ml/kg,respiratory rate was 16 times/min,PEEP was 5 cm H2O?;group C:tidal volume was10 ml/kg,respiratory rate was 10 times/min.the peak airway pressure?Ppeak?,the mean airway pressure?Pmean?,CL were recorded at before pneumoperitoneum?T0?,after pneumoperitoneum 10min?T1?,30min?T2?,60 min?T3?during operation,release of pneumoperitoneum?T4?.The arterial blood gas analysis was performed at T0,T2,T3 and T4.Then the oxygenation index?OI?was calculated.ResultsThe Ppeak and Pmean were significantly higher among the three groups after pneumoperitoneum?T1,T2,T3,T4?compared with T0?P<0.05?,Ppeak of group C was significantly higher compared with that of group A and group B?P<0.05?;CL of group C was lower significantly than that of group A and group B at T1^T3?P<0.05?.while the difference between group A and group B were not significant.Therefore,the traditional low-frequency ventilation model with high tidal volume will produce higher airway resistance than the protective pulmonary ventilation model.The increase of airway resistance is undoubtedly one of the important factors of mechanical lung injury.The OI of the three groups decreased significantly after exthbation?P<0.05?and the difference among the three groups was not significant.PaCO₂ in the three groups were maintained within the normal range and the difference was not statistically significant.Hypoxemia did not appear during pneumoperitoneum.Mechanical ventilation is essential in patients undergoing general anesthesia,Less respiratory are associated with lung injury,acute lung injury,health.The rate of postoperative pulmonary complications is of concern to anesthesiologists problems,protective ventilation strategy should be paid more and more attention.From when previous studies have shown that different surgical positions are protected during surgery.Mechanical ventilation is still controversial,and there's still a lot of protection.The gas problem needs to be addressed by a clinician with in-depth research,but the more clinical practice proves the strategy of perioperative protective ventilation.Applications are a trend,and what we should do now is better protect protective ventilation strategy in clinical application.ConclusionCompared with conventional ventilation,the protective lung ventilation strategy?low V_T+high RR+small PEEP+lung recruitment maneuver?can significantly reduce the mean airway pressure and peak airway pressure of mechanical ventilation in the patients undergoing laparoscopic radical resection of rectal cancer.It can also improve patient's dynamic lung compliance,good for lung protection.It is not difficult to find out by monitoring the function of lung oxygenation.,both the protective pulmonary ventilation strategy and the traditional ventilation model can maintain a good level of oxygen compatibility.