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Báo cáo y học: "Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation: a randomized controlled trial. | Montes et al. Journal of Cardiothoracic Surgery 2010 5 99 http www.cardiothoracicsurgery.Org content 5 1 99 JOTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Comparison of two protective lung ventilatory regimes on oxygenation during one-lung ventilation a randomized controlled trial 1 1 1 2i z 2 i - 2 Felix R Montes Daniel F Pardo Hernán Charris Luis J Tellez Juan C Garzon Camilo Osorio Abstract Background The efficacy of protective ventilation in acute lung injury has validated its use in the operating room for patients undergoing thoracic surgery with one-lung ventilation OLV . The purpose of this study was to investigate the effects of two different modes of ventilation using low tidal volumes pressure controlled ventilation PCV vs. volume controlled ventilation VCV on oxygenation and airway pressures during OLV. Methods We studied 41 patients scheduled for thoracoscopy surgery. After initial two-lung ventilation with VCV patients were randomly assigned to one of two groups. In one group OLV was started with VCV tidal volume 6 mL kg PEEP 5 and after 30 minutes ventilation was switched to PCV inspiratory pressure to provide a tidal volume of 6 mL kg PEEP 5 for the same time period. In the second group ventilation modes were performed in reverse order. Airway pressures and blood gases were obtained at the end of each ventilatory mode. Results PaO2 PaCO2 and alveolar-arterial oxygen difference did not differ between PCV and VCV. Peak airway pressure was significantly lower in PCV compared with VCV 19.9 3.8 cmH2O vs 23.1 4.3 cmH2O p 0.001 without any significant differences in mean and plateau pressures. Conclusions In patients with good preoperative pulmonary function undergoing thoracoscopy surgery the use of a protective lung ventilation strategy with VCV or PCV does not affect the oxygenation. PCV was associated with lower peak airway pressures. Introduction Anesthesia for thoracic surgery routinely involves one lung ventilation OLV to provide