Use Of PCV-VG Ventilation Mode In Patients Undergoing One-lung Ventilation Anesthesia

Objective:To compare the effect of two mechanical ventilation mode--pressure controlled ventilation-volume guaranteed(PCV-VG)mode and pressure control ventilation(PCV)mode in patients undergoing one-lung ventilation anesthesia.Taking respiratory dynamics,oxygenation,the level of inflammatory cytokines in blood as evaluation parameters.Methods: 60 thoracic surgery patients(aged from 45 to 76 years old,ASA Ⅰ-Ⅱ)without respiratory tract infection and quit smoking for more than 4 weeks were selected.They were randomly allocated into two groups.One lung ventilation(OLV)with the mode of PCV was used in group P(n=30),while the mode of PCV-VG was used in group G(n=30).The peak airway pressure(Ppeak),mean airway pressure(Pmean),airway resistance(Raw),and lung compliance(CL)were recorded at the beginning of OLV(T2),30 min(T3)and 60 min(T4)after OLV,30 min of restoring two-lung ventilation(TLV)(T5)respectively.In addition,arterial blood gas were analyzed to detect the PO2,PCO2 and Lac.The plasma concentration of IL-6、IL-10 and TNF-α were tested at each time point of T2 to T5,as well as 24 hours after surgery(T6).Results:Compared with T1,CL decreased at T2-T4 and PO2 decreased at T3-T4(P(27)0.05 or P(27)0.01)in group P and group G;Pmean and Raw increased at T2-T5,PCO2 increased at T5 in both groups(P(27)0.05 or P(27)0.01);Ppeak increased at T2-T5 and Lac increased at T5(P(27)0.05 or P(27)0.01)in group P,while there was no significantly difference in group G.Compared with T2,IL-6、TNF-α increased at T3-T6 and IL-10 increased at T3-T5 in both groups(P(27)0.01).Compared with group P,IL-10 increased at T3-T4 and IL-6decreased at T6 in group G(P(27)0.05 or P(27)0.01).Conclusion:PCV-VG mode may have minor influence on respiratory dynamics and reduce the release of inflammatory factors compared with PCV mode.PCV-VG mode may protect patients’ pulmonary function.