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首页> 外文期刊>Journal of clinical monitoring and computing >Positive end-expiratory pressure increases arterial oxygenation in elderly patients undergoing urological surgery using laryngeal mask airway in lithotomy position
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Positive end-expiratory pressure increases arterial oxygenation in elderly patients undergoing urological surgery using laryngeal mask airway in lithotomy position

机译：Positive end-expiratory pressure increases arterial oxygenation in elderly patients undergoing urological surgery using laryngeal mask airway in lithotomy position

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Elderly patients undergoing urological surgery in the lithotomy position may be vulnerable to perioperative hypoxemia. Positive end-expiratory pressure (PEEP) can improve arterial oxygenation. Although laryngeal mask airway (LMA) is widely utilized in urological surgery, it is not known how PEEP affects arterial oxygenation in these patients. We, therefore, evaluated the effect of PEEP on arterial oxygen partial pressure (PaO2) in elderly patients using LMA during urological surgery in the lithotomy position. Patients randomly received zero end-expiratory pressure (group Z, n = 34) or PEEP of 7 cmH(2)O (group P, n = 33). Ventilatory, respiratory, and haemodynamic variables were measured at 5 min (T0), 30 min (T1), and 60 min (T2) after LMA Supreme (TM) (sLMA) insertion. The primary outcome was the difference of PaO2 at T2 between the two groups. Atelectasis score, the incidence of a significant leak, and complications associated with sLMA insertion were also evaluated. PaO2 at T2 was significantly higher in group P than in group Z (20.0 +/- 4.9 vs. 14.7 +/- 3.7 kPa, P < 0.001). Atelectasis score at T2 was lower in group P than in group Z (5.3 +/- 1.7 vs. 8.4 +/- 2.3, P < 0.001). However, the incidence of a significant leak and complications associated with LMA insertion did not significantly differ between the two groups. PEEP can improve arterial oxygenation and reduce atelectasis in elderly patients using sLMA during urological surgery in the lithotomy position, suggesting that PEEP may be useful for elderly patients with an increased risk of perioperative hypoxemia when using sLMA.
机译：在截石位接受泌尿外科手术的老年患者可能容易发生围手术期低氧血症。呼气末正压 （PEEP） 可以改善动脉氧合。尽管喉罩气道 （LMA） 在泌尿外科手术中被广泛使用，但尚不清楚 PEEP 如何影响这些患者的动脉氧合。因此，我们评估了 PEEP 对在截石术期间泌尿外科手术中使用 LMA 的老年患者动脉氧分压 （PaO2） 的影响。患者随机接受呼气末压为零（Z组，n = 34）或PEEP为7 cmH（2）O（P组，n = 33）。在 LMA Supreme （TM） （sLMA） 插入后 5 分钟 （T0）、30 分钟 （T1） 和 60 分钟 （T2） 测量通气、呼吸和血流动力学变量。主要结局是两组患者T2时PaO2的差异。还评估了肺不张评分、严重渗漏的发生率以及与 sLMA 插入相关的并发症。P组T2的PaO2显著高于Z组（20.0 +/- 4.9 vs. 14.7 +/- 3.7 kPa，P < 0.001）。P组T2肺不张评分低于Z组（5.3 +/- 1.7 vs. 8.4 +/- 2.3，P < 0.001）。然而，与LMA插入相关的显着渗漏和并发症的发生率在两组之间没有显着差异。PEEP 可以改善在泌尿外科手术期间以截石位使用 sLMA 的老年患者的动脉氧合并减少肺不张，这表明 PEEP 可能对使用 sLMA 时围手术期低氧血症风险增加的老年患者有用。

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