Observing The Feasibility Of Using The Lung-centric Formula To Select Tidal Volume During Gastric Cancer Surgery

Objective: To discuss whether the proposed “lung-centric formula” can provide another method for the selection of tidal volume during laparoscopic radical gastrectomy.Methods: A total of 150 patients undergoing elective laparoscopic radical gastrectomy for gastric cancer at the First Hospital of Jilin University from September 2017 to April 2018 were selected as the study subjects.All patients were divided into three groups according to the forced vital capacity that calculated depending on lung function tests before surgery,a total of 42 cases were less than 2600 ml,named group A(randomly divided into two groups a1,a2);38 cases were greater than 2600 ml and less than 3800 ml,named group B(randomly divided into two groups b1,b2);A total of 40 cases were greater than 3800 ml,named group C(randomly divided into two groups c1,c2).The a1,b1 and c1 groups were subjected to mechanical ventilation using the tidal volume calculated using the formula “Vt=FVC/8”,and a2,b2 and c2 were subjected to mechanical ventilation using the tidal volume calculated using the standard lung protective formula Vt=7cc/kg.Comparing the effects of two tidal volumes on respiratory mechanics in surgical patients,peak airway pressure,airway platform pressure,end-tidal carbon dioxide pressure,and dynamic lung compliance were recorded at 1 h(T1),2 h(T2),and 3 h(T3)after mechanical ventilation.Results: At T1,T2,and T3,peak airway pressure,airway plateau pressure,and partial pressure of end-expiratory carbon dioxide increased significantly in group a1 compared to group a2(P<0.05).There was no statistically significant difference in dynamic compliance;differences in airway peak pressure,airway platform pressure,end-tidal carbon dioxide pressure,and dynamic lung compliance were not statistically significant between b1 and b2;c1 vs c2,the partial pressure of end-expiratory carbon dioxide decreased,and there was no statistically significant difference in peak airway pressure,airway platform pressure,and dynamic lung compliance.Conclusion: Using the lung-centric formula to select the tidal volume during laparoscopic radical gastrectomy,it is more suitable for this patient population,and can provide another method for the selection of tidal volume during laparoscopic radical gastrectomy.