Clinical Observation Of Venturi Tube Low Pressure Blowing Oxygen Device For One Lung Ventilation

Objective:One lung ventilation(OLV) technology can provide the best operative field for open thoracic operation, avoid lung expansion in the operating side, prevent secretions or blood from the operation side lung to the health side lung. prevent airway obstruction, and cross infection, etc. However, this kind of non-physical ventilation mode causes V/Q imbalance, increasing intra-pulmonary Qs/Qt, thus decreasing PaO2, and reducing SpO2. Continuous clinical research target on respiratory parameters and ventilation mode, in order to prevent or deal with hypoxemia incidence. CPAP is the first choice of improving oxygenation during OLV. The objective of this research is to use Venturi tube device to simulate CPAP for atelectatic lungs with low pressure blowing oxygen, to observe the influence on PaO2-providing methods and basis for preventing or dealing with hypoxemia during OLVMethods:Fourty ASA Ⅰ-Ⅱ patients undergoing lung operation under OLV were randomly divided into2groups (n=20each). Control group(group A):Place the tube into non-ventilation lung, without blowing. Observation group (group B):Place the Venturi into the non-ventilated lung, blowing oxygen with low pressure15min after OLV. During operation ventilation mode is set to IPPV,VCV. Tidal volume is set to8-10ml/kg during two lung ventilation, with FiO21.0, I:E=1:2, RR=10-12per minute, maintaining PETCO2within30-40mmHg (1mmHg=0.133kPa). During OLV period, the tidal volume is set to6-8ml/kg, with FiO21.0, and RR=14-16per minute, maintaining PETCO2within30-40mmHg (1mmHg=0.133kPa). Blood samples were taken at before operation (T1, baseline), TLV supine position(T2),TLV lateral position(T3),15min OLV (T4),30min OLV (T5),45min OLV (T6), and TLV supine position after operation(T7).Results:Compared with A group, at T3and T7, PaO2from group B were slightly higher, but have no statistical significance (P>0.05);PaO2from group B at T5, T6were significantly higher than those from group A (P<0.05)Conclusion:Using the Venturi tube blowing oxygen for non-ventilated lung with low pressure, can improve PaO2during OLV, does not affect the surgical condition, which can be used for preventing or treating intraoperative hypoxemia during OLV.