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- Title
Intraoperative lung-protective ventilation adjusting tidal volume to a plateau pressure restriction in elderly patients: A randomized controlled clinical trial.
- Authors
Zhou, Xinyi; Dong, Chunshan; Zhang, Jun; Sun, Peng; Lu, Qiang; Ma, Xiang
- Abstract
BACKGROUND: Lung-protective ventilation (LPV) strategies have been considered as best practice in the care of critically patients. OBJECTIVE: This study aimed to investigate the effects individualized perioperative LPV with a positive end-expiratory pressure (PEEP) and low tidal volumes (V T) based on a target airway plateau pressure (Pplat) in patients during and after an operation compared with conventional ventilation in elderly patients during abdominal surgery. METHODS: Sixty-one elderly patients with American Society of Anesthesiologists (ASA) I to III undergoing open abdominal surgery received either conventional ventilation (8 ml/kg - 1 V T ; CV group) or LPV (V T was adjusted to a target Pplat [ ⩽ 20 cm H 2 O]) in the volume-controlled mode with PEEP (9 cm H 2 O; LPV group) ventilation. RESULTS: Patients in the LPV group showed significantly lower pH values (7.30 ± 0.07 vs. 7.38 ± 0.05, P < 0.001) and respiratory indexes than that of CV group (0.806 ± 0.339 vs. 0.919 ± 0.300, P = 0.043) at the end of surgery. Compared with the CV group, the dynamic lung compliance (33.39 ± 3.163 vs. 30.15 ± 2.572, P < 0.001) was significantly higher, and the body temperature remained significantly more favorable in the LPV group (35.9 ± 0.3 vs. 35.1 ± 0.4, P < 0.001). Patients in the LPV group had significantly faster postoperative recovery than that of the CV group (P < 0.001). CONCLUSIONS: The study showed that LPV could be beneficial for ventilation, core body temperature, and postoperative recovery in elderly patients with healthy lungs.
- Subjects
AMERICAN Society of Anesthesiologists; OLDER patients; LUNGS; CLINICAL trials; RANDOMIZED controlled trials; POSITIVE end-expiratory pressure; VENTILATION
- Publication
Technology & Health Care, 2023, Vol 31, Issue 2, p539
- ISSN
0928-7329
- Publication type
Article
- DOI
10.3233/THC-220144