Application of lung protective ventilation strategy in anesthesia for large volume lung lavage

Objective To observe the effect of protective ventilation strategy in the treatment of large volume lung lavage.

Methods Totally 60 patients with occupational pneumoconiosis were randomly divided into two groups:constant volume ventilation group(control group) and protective ventilation group(test group). The patients were received sequential induction, endobronchial intubation and general anesthesia. General anesthesia was maintained by intravenous anesthesia. The patients were given one-lung ventilation. Patients in the control group were treated with tidal volume(VT) 8-10 mL/kg, aspiratory rate(R) 12-14/min, fraction of inspiration O₂ (FiO₂)1.0, airway pressure 2.5-4 kPa, partial pressure of carbon dioxide in artery(PaCO₂) 30-45 mmHg, while the patients in the test group treated with VT 6-8 mL/kg, R 14-16/min, FiO₂ 1.0, airway pressure 1.5-2.5 kPa, PaCO₂ 40-55 mmHg and positive end expiratory pressure (PEEP) 0.8-1.0 kPa. The mean arterial pressure, heart rate, pulse oxygen saturation and end tidal carbon dioxide partial pressure at each time point were compared between the two groups.

Results The average arterial pressure of patients in the test group was higher than that in the control group during and after operation time(P < 0.05). The heart rate in the test group was higher than that in the control group after operation time(P < 0.05). There was no significant difference of blood oxygen saturation and carbon dioxide partial pressure between the two groups(P>0.05).

Conclusion The application of lung protective ventilation strategy has no significant adverse effect on anesthesia and operation. It can be used as a safe and reliable choice.