Key result
Lung-protective ventilation significantly improved pulmonary oxygenation function and reduced postoperative pulmonary complications compared to conventional ventilation.
Why the study?
To observe the effects of lung-protective ventilation on oxygenation index and postoperative pulmonary complications after laparoscopic radical gastrectomy in middle-aged and elderly patients.
Does lung-protective ventilation improve oxygenation and reduce postoperative pulmonary complications in middle-aged and elderly patients undergoing laparoscopic radical gastrectomy?
RCT (n=120)
Randomized
Does lung-protective ventilation improve oxygenation and reduce postoperative pulmonary complications in middle-aged and elderly patients undergoing laparoscopic radical gastrectomy?
Intraoperative lung-protective ventilation improves oxygenation and reduces pulmonary complications in middle-aged and elderly patients undergoing prolonged laparoscopic gastrectomy.
LPV improves oxygenation and reduces early PPCs in middle-aged/elderly gastrectomy patients; extends RCT evidence for protective ventilation in prolonged laparoscopy.
This study aimed to observe the effects of lung-protective ventilation (LPV) on oxygenation index (OI) and postoperative pulmonary complications (PPCs) after laparoscopic radical gastrectomy in middle-aged and elderly patients. A total of 120 patients who were scheduled to undergo laparoscopic radical gastrectomy with an expected time of >3 h were randomly divided into conventional ventilation (CV group) with tidal volume (TV) of 10 mL/kg without positive end-expiratory pressure (PEEP), and lung-protective ventilation (PV group) with 7 mL/kg TV and personal level of PEEP with regular recruitment maneuver every 30 min. Measurements of OI, modified clinical pulmonary infection score (mCPIS), and PPCs were assessed during the perioperative period. Fifty-seven patients in the CV group and 58 in the PV group participated in the data analysis. Patients in the PV group showed better pulmonary dynamic compliance, OI, and peripheral capillary oxygen saturation during and after surgery. The mCPIS was significantly lower in the PV group than in the CV group after surgery. The incidence rate of PPCs was lower in the PV group than in the CV group and the difference was significant in patients whose ventilation time was longer than 6 h in both groups. LPV during laparoscopic radical gastrectomy significantly improved pulmonary oxygenation function and reduced postoperative mCPIS and the incidence of PPCs during the early period after surgery of middle-aged and elderly patients, especially patients whose mechanical ventilation time was longer than 6 h.
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Liu et al. (2019) conducted an RCT in Laparoscopic radical gastrectomy (n=120). Lung-protective ventilation vs. Conventional ventilation with tidal volume of 10 mL/kg without PEEP was evaluated on Oxygenation index (OI) and postoperative pulmonary complications (PPCs). Lung-protective ventilation significantly improved pulmonary oxygenation function and reduced postoperative pulmonary complications compared to conventional ventilation.
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