Effects of two driving pressure-based methods to set positive end-expiratory pressure on pulmonary mechan-ics and oxygenation in patients undergoing laparoscopic and thoracoscopic esophagectomy
ZHU Haowen
XU Shijie
LIU Ran
HONG Xinhua
XUE Yiting
TIAN Wenze
SU Zhen
Abstract：Objective To investigate the effects of two driving pressure-based methods to set positive end-expiratory pressure on pulmonary mechanics and oxygenation in patients undergoing laparoscopic and thoracoscopic esophagectomy.Methods Sixty patients undergoing laparoscopic and thoracoscopic esophagectomy were divided into two groups(n=30 each):incremental group(group Ⅰ)and decremental group(group D).PEEP titration was performed in both groups during thoracoscopy and laparoscopy.Respiratory mechanics parameters,hemodynamic parameters,and blood gas analysis were collected for analysis before preoxygenation(T0),10 minutes after intuba-tion(T1),20 minutes after PEEP application for one-lung ventilation(T2),20 minutes after PEEP application for two-lung ventilation(T3),before extubation(T4),and 30 minutes after extubation(Ts).The postoperative pulmonary complications within 3 days and 7 days after operation,hospitalization duration,and costs were recorded.Results Compared with group Ⅰ,patients in group D showed higher oxygenation index and pulmonary compliance during surgery(P＜0.05).In both groups,driving pressure decreased and compliance increased after PEEP titration(P＜0.05).Conclusion Both driving pressure-guided incremental and decremental titration of individualized PEEP improved intraoperative respiratory mechanics in patients undergoing laparoscopic and thoracoscopic esopha-gectomy,and decremental titration was more effective in improving intraoperative respiratory mechanics and oxygenation in patients during operation.
Keywords：driving pressurepositive end-expiratory pressureesophageal cancerincremental ti-trationdecremental titration
Publication Date：2025-07-25
Online Publishing Date：2025-08-20(First online date of this platform, not the publication date of the document)
Pages：7( 2217-2223 )