摘要
Abstract
Objective To investigate the optimal individual tidal volume and positive end-expiratory pressure (PEEP) based on the dynamic pressure-volume curve for patients with one-lung ventilation.Methods Forty-two ASA Ⅰ ～ Ⅱ patients scheduled for an elective lobectomy were randomly enrolled in this study.The conventional two lung ventilation was kept for 30 rin (To) and followed by one-lung ventilation(OLV) operation.PEEP was applied to the lung ventilation by PLIP + 0.196 kPa of P-V curve, three different tidal volume modes were conducted successively, T1 (100％ VUIP), T2 (80％ VUIP) and T3 (60％ VUIP), each mode was kept for 30 min.Value of tidal volume, MAP, HR, CVP, peak airway pressure (Ppeak), airway resistance (Raw) and lung-thorax compliance (CT) were recorded, and the blood gas and pulmonary shunt fraction (Qs/Qt) were calculated.Results PEEP was (0.64 ± 0.13)kPa and tidal volume was (10.1 ± 1.2) mL/kg, (7.2 ± 1.1 )mL/kg, (5.6 ± 0.7) mL/kg at T1, T2 aud T3.Compared with T1, the Ppeak, Raw and Qs/Qt reduced, PaO2 and CT got corresponding improvement at T2, MAP, and PaCO2 increased at T3 significantly (P ＜ 0.05).Conclusion In terms of dynamic P-V curve, 80％ VUIP adding PLIP + 0.196 kPa PEEP can improve arterial oxygenation and pulnonary compliance, and decrease pulmonary shunt fraction during OLV, however, the effect of haemodynamics is not significant.关键词
肺通气/压力-容积曲线/呼气末正压/潮气量
