Clinical observation of low tidal volume with low positive end-expiratory pressure in one-lung ventilation patients undergoing esophageal cancer resection

Objective:To investigate the effects of low tidal volume with low positive end-expiratory pressure in one-lung ventilation patients undergoing esophageal cancer resection.Methods: Thirty-two ASA classⅠorⅡpatients scheduled to undergo esophagectomy for esophageal cancer were randomly assigned into 2 groups(n=16 each).Low VT and low positive end-expiratory pressure(PEEP)mechanical ventilation were applied to the patients in group A(VT=6 ml·kg-1,f=16,PEEP=5 cm H2O),while traditional ventilation was used in group B(VT=10 ml·kg-1,f=12,PEEP=0).Arterial blood samples were taken and PaO2,PaCO2,PETCO2,PaO2/FiO2 and MAP were recorded at the time points of before operation(T1),60 min after one-lung ventilation(T2),15 min after double lung ventilation and 30 min after tracheal extubation(T4).Peak airway pressure(Ppeak),Pplat and Paw were recorded during operation.Results: At T2,Ppeak,Pplat and Paw in group A was lower than that in group B(P0.05)and PaO2,PaO2/FiO2 in group A was higher than that in group B(P0.05);at T2,3,4.There was no significant difference in PaCO2,PETCO2 and MAP at each time points between the two groups(P0.05).Conclusion: Low tidal volume with low positive end-expiratory pressure in one-lung ventilation used in esophageal cancer resection can improve hypoxemia during operation and accelerates the recovery of respiratory functions after operation with no depression on hemodynamics.It is a safe and effective method of ventilation for patients who will accept esophageal cancer surgery under general anesthesia.