%0 Journal Article
%T Pressure-Controlled Inverse Ratio Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function
%A Xiuqin Wang
%A Peimin Wang
%A Kaiguo Wang
%A Tao Jiang
%A Zan Xu
%J Journal of Biomedical Science and Engineering
%P 17-24
%@ 1937-688X
%D 2016
%I Scientific Research Publishing
%R 10.4236/jbise.2016.91003
%X Background: Studies have shown that pressure-controlled ventilation improves alveolar gas distribution. And inverse ratio ventilation has advantages of improving oxygenation in acute respiratory distress syndrome (ARDS) patients. However, the effects that pressure-controlled inverse ration ventilation in patients undergoes endotracheal intubation general anesthesia have not been assessed. Objective: To investigate whether pressure-controlled inverse ratio ventilation (PIV) would improve ventilatory and oxygenation parameters as well as lung function compared to conventional ventilation in patients undergoing open abdominal surgery. Interventions: In the conventional ventilation (CV) group, the ventilation strategy involved zero end-expiratory pressure and volume-controlled ventilation. In the pressure-controlled inverse ratio ventilation (PIV) group, the strategy involved P high starting at 7 cm H<sub>2</sub>O, P low starting at 4 cm H<sub>2</sub>O, T high at 4 s, T low at 2 s, and an inspiratory-to-expiratory time ratio of 2:1. The ĶĪP value was adjusted according to VT. Pressure levels were increased by 2 cm H<sub>2</sub>O until a maximal V<sub>T</sub> was observed. Inspired oxygen fraction (FIO<sub>2</sub>) was 1.0 and tidal volume (V<sub>T</sub>) was 6 mL/kg in both groups. Main Outcome Measures: The primary outcome is pulmonary function tests. Hemodynamic, ventilatory and oxygenation parameters were measured; visual analog scale (VAS) scores, and nausea and vomiting scores were also measured. Results: The PIV group tolerated pressure-controlled inverse ratio ventilation without significant hemodynamic instability. Mean airway pressure and static compliance were significantly higher in the PIV group than those in CV group (<i>P</i> &lt; 0.05). Patients in the PIV group showed better pulmonary function test results on postoperative day 1 (<i>P</i> &lt; 0.05). VAS and nausea and vomiting scores did not differ significantly between the two groups. Conclusion: Pressure-controlled inverse ratio ventilation during open abdominal surgery lasting &gt;2 h was well tolerated and improved respiratory compliance and lung function on the first postoperative day.
%K Inverse Ratio Ventilation
%K Conventional Ventilation
%K General Anesthesia
%K Lung Function
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=62913