Clinical analysis of pulmonary protective ventilation strategy in neonatal thoracoscopic surgery

OUYANG Weidong; HU Huakun; XU Kai; PENG Xihua; XIAO Yu

Abstract：Objective: To explore the effect of different tidal volume lung protective ventilation strategies on thoracoscopic surgery in neonates. Methods: A total of 60 neonates with emergency or elective thoracoscopic surgery from January 2016 to December 2017 were randomly divided into two groups. In the routine tidal volume group (group A), the tidal volume was 10 ～ 12 m L/kg, the end of breath positive pressure was 0. 79 k Pa mechanical ventilation, and the small tidal volume group (group B) :the tidal volume was 6 to 8 m L/kg, and the end of the respiratory positive pressure was 0. 49 k Pa mechanical ventilation. Theny the heart rate (HR), mean arterial pressure (MAP) and blood gas analysis were recorded at different time points during the operation, and CO2 pneumothorax pressure was recorded in both groups. Results: Compared with t1, the values of MAP and HR decreased significantly at t2 and t3 in the two groups, and the level of partial pressure of oxygen (PaO2) decreased, and the partial pressure of carbon dioxide (PaCO2) was higher, and the difference was statistically significant (P ＜ 0. 05). There was no significant difference between the t4 above and t1 (P＞ 0. 05). The levels of PaO2 and Pa CO2 at t2 and t3 in group B were significantly lower than those in A group at the same time, and the differences were statistically significant (P ＜ 0. 05). The pressure of pneumothorax in group B was significantly lower than that in group A (P ＜ 0. 05). Conclusion: Small tidal volume lung protective ventilation strategy can effectively reduce the artificial CO2 pneumothorax pressure in neonatal thoracoscopic surgery, which is worth to be spread.