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The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery.

Abstract The objective of the present study was to explore the effects of different one-lung ventilation (OLV) modes on lung function in elderly patients undergoing esophageal cancer surgery. A total of 180 consecutive elderly patients (ASA Grades I-II, with OLV indications) undergoing elective surgery were recruited in the study. Patients were randomly divided into 4 groups (n = 45). In Group A, patients received low tidal volume (VT < 8 mL/kg) + pressure controlled ventilation (PCV), low tidal volume (VT < 8 mL/kg) + volume-controlled ventilation (VCV) in Group B, high tidal volume (VT ≥ 8 mL/kg) + PCV in Group C and high tidal volume (VT ≥ 8 mL/kg) + VCV in Group D. Two-lung ventilation involved routine tidal volume (8-10 mL/kg) at a frequency of 12 to 18 times/min, and VCV mode. Clinical efficacy among 4 groups was compared. The partial pressure of end-tidal carbon dioxide (PetCO2) did not significantly differ among 4 groups (all P > .05), and the oxygenation index and SO2 in Group A were significantly higher than in the other groups (P < .05). The PetCO2, peak airway pressure (Ppeak), platform airway pressure (Pplat), and mean airway pressure (Pmean) in Group A were significantly lower than those in the other groups (all P < .05). However, airway resistance (Raw) among 4 groups did not significantly differ (all P > .05). The incidence of pulmonary infection, anastomotic fistula, ventilator-induced lung injury, lung dysfunction, difficulty weaning from mechanical ventilation, and multiple organ dysfunction in Groups A and B were lower than that in Groups C and D (all P < .05). The expression levels of IL-6, tumor necrosis factor-α, and C-reactive protein in lavage fluid in Group A were significantly lower than those in the other groups (all P < .05). OLV with low tidal volume (VT < 8 mL/kg) + PCV (5 cmH2O PEEP) improved lung function and mitigated inflammatory responses in elderly patients undergoing esophageal cancer surgery.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29505522
OWN - NLM
STAT- MEDLINE
DCOM- 20180309
LR  - 20180309
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 1
DP  - 2018 Jan
TI  - The effects of one-lung ventilation mode on lung function in elderly patients
      undergoing esophageal cancer surgery.
PG  - e9500
LID - 10.1097/MD.0000000000009500 [doi]
AB  - The objective of the present study was to explore the effects of different
      one-lung ventilation (OLV) modes on lung function in elderly patients undergoing 
      esophageal cancer surgery. A total of 180 consecutive elderly patients (ASA
      Grades I-II, with OLV indications) undergoing elective surgery were recruited in 
      the study. Patients were randomly divided into 4 groups (n = 45). In Group A,
      patients received low tidal volume (VT &lt; 8 mL/kg) + pressure controlled
      ventilation (PCV), low tidal volume (VT &lt; 8 mL/kg) + volume-controlled
      ventilation (VCV) in Group B, high tidal volume (VT &gt;/= 8 mL/kg) + PCV in Group C
      and high tidal volume (VT &gt;/= 8 mL/kg) + VCV in Group D. Two-lung ventilation
      involved routine tidal volume (8-10 mL/kg) at a frequency of 12 to 18 times/min, 
      and VCV mode. Clinical efficacy among 4 groups was compared. The partial pressure
      of end-tidal carbon dioxide (PetCO2) did not significantly differ among 4 groups 
      (all P &gt; .05), and the oxygenation index and SO2 in Group A were significantly
      higher than in the other groups (P &lt; .05). The PetCO2, peak airway pressure
      (Ppeak), platform airway pressure (Pplat), and mean airway pressure (Pmean) in
      Group A were significantly lower than those in the other groups (all P &lt; .05).
      However, airway resistance (Raw) among 4 groups did not significantly differ (all
      P &gt; .05). The incidence of pulmonary infection, anastomotic fistula,
      ventilator-induced lung injury, lung dysfunction, difficulty weaning from
      mechanical ventilation, and multiple organ dysfunction in Groups A and B were
      lower than that in Groups C and D (all P &lt; .05). The expression levels of IL-6,
      tumor necrosis factor-alpha, and C-reactive protein in lavage fluid in Group A
      were significantly lower than those in the other groups (all P &lt; .05). OLV with
      low tidal volume (VT &lt; 8 mL/kg) + PCV (5 cmH2O PEEP) improved lung function and
      mitigated inflammatory responses in elderly patients undergoing esophageal cancer
      surgery.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Zhang, Bao-Juan
AU  - Zhang BJ
AD  - Department of Anesthesia, Jining No. 1 People's Hospital, Jining City, Shandong
      Province, China.
FAU - Tian, Hai-Tao
AU  - Tian HT
FAU - Li, Hai-Ou
AU  - Li HO
FAU - Meng, Jian
AU  - Meng J
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Bronchoalveolar Lavage Fluid/chemistry
MH  - C-Reactive Protein/analysis
MH  - Esophageal Neoplasms/*surgery
MH  - Female
MH  - Humans
MH  - Interleukin-6/analysis
MH  - Male
MH  - Middle Aged
MH  - One-Lung Ventilation/*methods
MH  - Respiratory Function Tests
MH  - Tumor Necrosis Factor-alpha/analysis
EDAT- 2018/03/06 06:00
MHDA- 2018/03/10 06:00
CRDT- 2018/03/06 06:00
PHST- 2018/03/06 06:00 [entrez]
PHST- 2018/03/06 06:00 [pubmed]
PHST- 2018/03/10 06:00 [medline]
AID - 10.1097/MD.0000000000009500 [doi]
AID - 00005792-201801050-00019 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Jan;97(1):e9500. doi: 10.1097/MD.0000000000009500.