title: Low tidal volume with PEEP and recruitment expedite the recovery of pulmonary function.
abstract: The potentially harmful effects of short-term mechanical ventilation during surgery have been examined in recent years. An optimal strategy for mechanical ventilation of patients during non-laparoscopic abdominal surgery must be devised. A total of 63 patients undergoing elective open abdominal surgery with more than 2 h of ventilation time were selected for this randomized, open-label, clinical study. They were divided into three ventilation groups: high volume of 9 ml/kg IBW (ideal body weight) with ZEEP (zero end-expiratory pressure); low volume of 7 ml/kg IBW with 8 cm H2O PEEP (positive end expiratory pressure); and low volume of 7 ml/kg IBW with 8 cm H2O PEEP and recruitment. Intraoperative PaO2/FiO2 ratio and pulmonary compliance and postoperative pulmonary function were measured. There were no significant differences in intraoperative PaO2/FiO2 ratio among the three groups (P=0.31). The pulmonary compliance of three groups showed different changes over time (group effect over time P=0.0006). There were no significant differences in FEV1 or FVC among the three groups (P=0.32 and 0.09, respectively), but both of these measurements showed different changes over time (group effect over time P<0.001). On the first postoperative day, the low volume with high PEEP and recruitment group had significantly higher FEV1 than the other two groups (mean ± SD): 1.52 ± 0.37 versus 0.95 ± 0.38 (P<0.001) and 1.52 ± 0.37 versus 0.95 ± 0.34 (P<0.001), respectively. Low tidal volume with PEEP and recruitment showed advantages in maintaining the pulmonary compliance and expediting the recovery of the 1(st) postoperative day's pulmonary function in patients undergoing non-laparoscopic abdominal surgery.
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical UniversityHarbin, China; Laboratory of Medical Genetics, Harbin Medical UniversityHarbin, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Pi
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Yinghua
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Changsong
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Jinghui
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Ziwei
authors.initials: Z
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Nana
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Laboratory of Medical Genetics, Harbin Medical University Harbin, China.
authors.forename: Songbin
authors.initials: S
authors.lastname: Fu
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University Harbin, China.
authors.forename: Enyou
authors.initials: E
authors.lastname: Li
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000768:Anesthesia, General; D001784:Blood Gas Analysis; D002681:China; D017558:Elective Surgical Procedures; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007430:Intraoperative Care; D008168:Lung / Q000503:physiopathology*; D008170:Lung Compliance; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011175:Positive-Pressure Respiration / Q000009:adverse effects; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control*; D020127:Recovery of Function; D012307:Risk Factors; D013147:Spirometry; D013990:Tidal Volume; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
keywords: PaO2/FIO2 ratio; Ventilation strategy; pulmonary compliance; pulmonary function
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