小潮气量快频率压力控制通气模式在婴儿胸腔镜手术中的应用

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Abstract Objective To investigate the application of high frequency with low tidal volume by pressure controlled ventilation mode in thoracoscopic surgery for infants, and to provide a feasible ventilation method for infants who cannot achieve one lung ventilation in thoracoscopic surgery. Methods Nineteen infants who received thoracoscopic surgery in Beijing Children′s Hospital, Capital Medical University from December 2016 to August 2019 were selected as study objects. Single lumen main endotracheal intubation was performed after induction of anesthesia. The respiratory rate (RR) was 24-34 times/min, the inspiration/exhalation ratio (I∶E) was 1∶1.5, and the tidal volume was maintained at 9-10 mL/kg. After the establishment of artificial pneumothorax, used high frequency with low tidal volume by pressure controlled ventilation mode, RR was 30-40 times/min, I∶E was 1∶1, and the tidal volume was maintained at 6-7 mL/kg. Heart rate (HR), percutaneous pulse oxygen saturation (SpO2), mean arterial pressure (MAP), RR, the airway peak pressure (PPEAK), and end-expiratory partial carbon dioxide (PETCO2) were observed and recorded at before used high frequency with low tidal volume by pressure controlled ventilation mode (Ta), 10 min after used high frequency with low tidal volume by pressure controlled ventilation mode (T10), 30 min after used high frequency with low tidal volume by pressure controlled ventilation mode (T30) and bilateral ventilation was restored 10 min (Tz). Anaesthesia related complications were recorded. Results HR, RR, PPEAK and PETCO2 levels at T10, T30 were higher than those at Ta, SpO2 and MAP levels were lower than those at Ta (all P < 0.05). HR and PETCO2 levels at T30 were lower than those at T10, while SpO2, MAP and RR levels were higher than those at T10 (all P < 0.05). HR, RR, PPEAK and PETCO2 levels at Tz were lower than those at T10 and T30, SpO2 and MAP levels were higher than those at T10 and T30 (all P < 0.05). PPEAK and PETCO2 levels at Tz were higher than those at Ta (all P < 0.05). There were no complications related to anesthesia such as hoarseness and atelectasis occurred after extubation. Conclusion For infants who cannot achieve one lung ventilation in thoracoscopic surgery, the application of high frequency with low tidal volume by pressure controlled ventilation mode is a feasible method.

Key words： Tidal volume High frequency Pressure control Infant Thoracoscope

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	ZOU Nan ZHANG Jianmin XIN Zhong▲

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ZOU Nan ZHANG Jianmin XIN Zhong▲. Application of high frequency with low tidal volume by pressure controlled ventilation mode in infant thoracoscopic surgery[J]. 中国医药导报, 2020, 17(25): 115-118.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I25/115

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