|
Objective: To observe the effect of low tidal volume and one-lung ventilation composite end-expiratory pressure in patients with thoracotomy . Methods : ASA I - II level line Thoracic thoracotomy ( lobectomy , pulmonary wedge resection or radical resection of esophageal cancer ) patients , 30 cases after epidural anesthesia plus insert a double-lumen endobronchial tube , the left lateral decubitus position , first lung ventilation until the thoracotomy underwent one-lung ventilation . All cases on the basis of one-lung ventilation mode is divided into two groups ( n = 15 ) : I conventional one-lung ventilation ( VT = 10ml/kg , f = 10 beats / min ) ; low tidal volume group II one-lung ventilation composite breath PEEP ventilation (vt = 6ml/kg, peep = 5cmH2O). Each group were recorded at the same time point ( one-lung ventilation before the start of the end of the one-lung ventilation , after 24 hours) respiratory mechanics parameters (SPO2, Ppeak, Pmean PETCO2 ) , hemodynamic parameters ( SBP , DBP , HR ) and arterial blood was collected for blood gas analysis . Results: low tidal volume one-lung ventilation composite expiratory PEEP ventilation modes compared with the traditional one-lung ventilation mode , peak airway pressure ( Ppeak ) decreased significantly ( P lt ; 0.01 ) , PaCO2 was significantly higher ( P lt ; 0.01 ) The PaO2 elevated ( P lt ; 0.05 ) , MAP , HR was no significant difference . Conclusion : The low tidal volume and one-lung ventilation composite PEEP can improve oxygenation of one-lung ventilation , reduce airway pressure .
|