Effect of permissive hypercapnia of CO2 artificial pneumothorax induced by single cavity tracheal intubation on coagulation, fibrinolysis, and lung function in esophageal cancer surgery
CHENG Yuanjian YI Chao LI Rui
Department of Cardiothoracic Surgery, Panzhihua Central Hospital, Sichuan Province, Panzhihua 617067, China
Abstract Objective To study the effect of permissive hypercapnia of CO2 artificial pneumothorax induced by single cavity tracheal intubation on coagulation, fibrinolysis, and lung function in esophageal cancer surgery. Methods A total of 108 patients with esophageal cancer expected to undergo laparoscopic thoracic surgery in Panzhihua Central Hospital of Sichuan Province from January 2020 to January 2022 were included as research objects, and they were divided into observation group and control group according to random number table method, with 54 patients in each group. In the observation group, the single lumen tracheal catheter was inserted orally, while in the control group, the left double-lumen bronchial catheter was inserted orally. The coagulation fibrinolytic indexes (coagulation response time [R], blood clot formation rate [K], plasminogen activator inhibitor-1 [PAI-1], tissue plasminogen activator [t-PA]) of the two groups were analyzed before surgery (T0), 60 min at the start of lung ventilation (T1), 30 min at the end of lung ventilation (T2), and one day after surgery (T3). Peak airway pressure and dynamic lung compliance were recorded, and compared between the two groups at each time point. Results In the observation group, R and K values at T1 and T2 were higher than those at T0, K value at T2 was lower than that at T1, and R and K values at T3 were lower than those at T1 and T2, R and K values at T1 and T2 in the observation group were higher than those in the control group at the same time point (P＜0.05). The levels of PAI-1 at T3 and t-PA at T1 in observation group were lower than those in control group at the same time point (P＜0.05). The peak airway pressures of two groups at T1, T2, and T3 were higher than those at T0, T2 and T3 were lower than T1, and T3 was lower than T2 (P＜0.05). The dynamic lung compliance at T1, T2, and T3 was lower than that at T0, T2 and T3 were higher than T1, and T3 was higher than T2 (P＜0.05). The peak airway pressures at T1, T2, and T3 in the observation group were lower than those in the control group at the same time points, and the dynamic lung compliance was higher than the control group at the same time points (P＜0.05). Conclusion Permissive hypercapnia of CO2 artificial pneumothorax has a protective effect on lung function in esophageal cancer surgery, which can reduce the occurrence of lung infection, but has certain influence on the coagulation and fibrinolytic function of patients, attention should be paid to preventing intraoperative bleeding.
CHENG Yuanjian YI Chao LI Rui. Effect of permissive hypercapnia of CO2 artificial pneumothorax induced by single cavity tracheal intubation on coagulation, fibrinolysis, and lung function in esophageal cancer surgery[J]. 中国医药导报, 2023, 20(5): 94-97.
