Dissertation > Excellent graduate degree dissertation topics show

The Effect of Lung Recruitment Maneuvers on Arterial Oxygenation and Dynamic Compliance during One Lung Ventilation

Author: ZhangXinMin
Tutor: MaHaiChun
School: Jilin University
Course: Clinical
Keywords: Lung Recruitment maneuvers One Lung ventilation hypoxemia Pulmonarydynamic compliance Positive End-Expiratory Pressure
CLC: R655.3
Type: Master's thesis
Year: 2013
Downloads: 34
Quote: 0
Read: Download Dissertation


Objective:To study the effect of lung recruitment maneuvers on arterial oxygenation anddynamic compliance during one lung ventilation. Try to definitude the duration ofonce LRM and proper frequency to do LRM.Methods:Forty patients with ASA status I-II undergoing elective open thoracotomy wererandomly allocated to two groups, aged18to70years, including male18andfemale22. Intravenous pathway was established after patient taken into operatingroom. Blood pressure, ECG, pulse oximetry were monitored. A catheter wasinserted in the radial artery of nondominant hand for invasive arterial pressuremonitoring under local anesthesia. After induction of anesthesia, a double-lumentube(DLT) of the appropriate size was intubated. After intubation, two lungs wereventilated until the patient was switched to lateral position. Control group:ventilation with6-8ml/Kg tidal volume and5cmH2O PEEP for OLV. LRM group:same ventilator pattern with controlled group, do LRM once after20minutes ofOLV. Before performing the strategy, the ventilator was switched to pressurecontrol ventilation, adjusting the level of pressure to obtain the same tidal volumethat the patient was receiving during volume control ventilation. This wasmaintained for3minutes. Then Pip and PEEP were increased stepwise from25/5to30/10, and finally35/15cmH2O. Every level of pressure was maintained during1minute. The difference of Pip-PEEP was limited to20cmH2O to avoid high tidalvolume during LRM, and then the parameter was set to the original level20/5cmH2O for1minute. After that the ventilator was set back to volume control.Before closure of thorax, the LRM group was applied for LRM, and the controlledgroup was re-expanded by a routine sustained inflation. Vital signs and artery blood samples were recorded at baseline(T0),20minutes after OLV(T1),15minutes(T2)、30minutes(T3)、45minutes(T4) after LRM respectively, and thebeginning of DLV. Pulmonary dynamic compliance was calculated.Results:Compared with control group, the PaO2of LRM is higher at T2,T3,T5,respectively(204±20),(175±14),(473±15)mmHg in LRM group, and(149±11),(154±12),(442±19)mmHg in the controlled group. The dynamiccompliance of LRM at T2and T5[(24.8±2.7)and(30±4)ml cm H2O-1] is betterthan controlled group[(20±3)and(25.9±2.5)ml cm H-2O1].Conclusions:LRM can improve arterial oxygenation and dynamic compliance during onelung ventilation, the duration of one LRM is about30-45min. LRM is better thanthe routine sustained inflation.

Related Dissertations

  1. The Analysis of Nocturnal Blood Oxygen Fluctuation in Patients with Chronic Obstructive Pulmonary Disease,R563.9
  2. The Research of Evaluation Index of Obstructive Sleep Apnea Hypopnea Syndrom Hypoxemia,R766
  3. The Clinical Research of Syndrome Law of Hypoxemia Secondary to Virus B Hepatitis and Its Pathogenesis,R259
  4. Hypoxemia Secondary to Hepatitis B-related Syndromes an Clinical Research Indicators,R259
  5. Research on Evaluation of Neonatal Hypoxia Left Ventricular Remodeling and Dysfunction by Doppler Echocardiography,R722.1
  6. Efficiency Studies on Using STOP Questionnaire to Screen the Occurrence Risk of Hypoxemia in Outpatients under Colonoscopy,R574.62
  7. Clinical Analysis of Cardiac Arrhythmia in Patients with Obstructive Sleep Apnea-hypopnea Syndrome,R766
  8. Oxygen Offering Way in Painless Gastroscopy,R614
  9. Influence of One-lung Ventilation on Respiratory Function during Perioperative Period of Esophagus Cancer,R614
  10. The Security and Feasibility Study on the Clinical Application of Anodynia Bronchofiberscopy,R768.1
  11. Thoracic surgery anesthesia clinical data review and meta-analysis,R614
  12. Intra-abdominal pressure gradient changes on multiple organ affected and Jiawei Dachengqitang intervention,R285
  13. The Influences of Hypoxemia on BNP of Patients with Normal Heart Function,R541.6
  14. Evaluation the effect of short-term Medroxyprogesterone Acetate in male stable COPD patients with chronic respiratory disfunction,R563.8
  15. Estrogen and its receptor on hypoxic pulmonary vascular remodeling in,R543.2
  16. Hypertension and obstructive sleep apnea syndrome relationship,R766
  17. Sleep Characteristics and Blood Level of ET-1 and NO in Patients with OSAHS and Their Links with BP,R766
  18. Sleep apnea syndrome cognitive dysfunction clinical research,R749.2
  19. The Clinical Epidemiological Study of Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Hypertension,R544.1
  20. Effects of Inhalation of Aerosol Iloprost during Partial Liquid Ventilation on the Oleic Acid-induced Acute Lung Injury in Rabbits.,R563.8
  21. The Experimental Study of Lishirezheng Associated with Hypoxemia,R228

CLC: > Medicine, health > Surgery > Of surgery > Science in the chest outside the > Bronchus and lung
© 2012 www.DissertationTopic.Net  Mobile