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首页> 外文期刊>Surgical Endoscopy >Positive end-expiratory pressure in pressure-controlled ventilation improves ventilatory and oxygenation parameters during laparoscopic cholecystectomy.
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Positive end-expiratory pressure in pressure-controlled ventilation improves ventilatory and oxygenation parameters during laparoscopic cholecystectomy.

机译：压力控制通气中的呼气末正压可改善腹腔镜胆囊切除术中的通气和充氧参数。

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BACKGROUND: During laparoscopy, pneumoperitoneum may result in intraoperative atelectasis, which impairs normal gas exchange. This study investigated whether positive end-expiratory pressure (PEEP) of 5 cmH(2)O in pressure-controlled ventilation (PCV) mode can improve ventilatory and oxygenation parameters during pneumoperitoneum. METHODS: Thirty patients, aged 18-65 years, undergoing laparoscopic cholecystectomy were randomly allocated to the ZEEP (PEEP = 0 cmH(2)O) or PEEP (PEEP = 5 cmH(2)O) group. PCV was started after induction of anesthesia. Apart from PEEP level, all other ventilator settings were identical for both groups. Peak airway pressure was set at induction and reset after pneumoperitoneum to deliver tidal volume of 8 ml/kg in both groups. Hemodynamic, ventilatory, and oxygenation parameters were measured after induction of anesthesia (T1) and 30 min after pneumoperitoneum (T2). RESULTS: Oxygenation index (PaO(2)/FiO(2)) was significantly higher in the PEEP group than in the ZEEP group at T2 (P = 0.031). In both groups, dynamic compliance significantly decreased over 40 min from T1 to T2. There were no significant differences in hemodynamics between the two groups during the study period. CONCLUSION: Application of PEEP of 5 cmH(2)O should be considered in PCV during laparoscopic surgeries to decrease intraoperative atelectasis caused by pneumoperitoneum to improve gas exchange and oxygenation.
机译：背景：腹腔镜检查期间，气腹可能会导致术中肺不张，从而损害正常的气体交换。这项研究调查了压力控制通气（PCV）模式下5 cmH（2）O的呼气末正压（PEEP）是否可以改善气腹过程中的通气和氧合作用参数。方法：将30例年龄在18-65岁的接受腹腔镜胆囊切除术的患者随机分配到ZEEP（PEEP = 0 cmH（2）O）或PEEP（PEEP = 5 cmH（2）O）组。诱导麻醉后开始PCV。除PEEP级别外，两组的所有其他呼吸机设置均相同。气腹峰值压力设定在吸气，气腹后复位，两组的潮气量均为8 ml / kg。诱导麻醉后（T1）和气腹后30分钟（T2）测量血流动力学，通气和氧合参数。结果：T2时，PEEP组的氧合指数（PaO（2）/ FiO（2））明显高于ZEEP组（P = 0.031）。在两组中，从T1到T2的40分钟内，动态顺应性均显着下降。在研究期间，两组之间的血液动力学没有显着差异。结论：腹腔镜手术中应考虑在PCV中应用5 cmH（2）O的PEEP，以减少由气腹引起的术中肺不张，从而改善气体交换和氧合作用。

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