Effect of individualized PEEP titration by ultrasonography on perioperative pulmonary protection and postoperative cognitive function in patients with chronic obstructive pulmonary disease

• Published in: BMC pulmonary medicine 2023-06, Vol.23 (1), p.232-232, Article 232
• Main Authors: Luo, Lai-Feng, Lin, Yu-Mei, Liu, Ying, Gao, Xiao-Hua, Li, Chui-Yu, Zhang, Xiao-Qi, Wu, Jian-Hua, Chen, Zhi-Yuan
• Format: Article
• Language: English
• Subjects: Anesthesia; Blood pressure; Care and treatment; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease (COPD); Cognitive ability; Cognitive function; Gastrointestinal surgery; Hypoxia; Individualized PEEP; Interleukin 6; Interleukin-6 (IL-6); Intubation; Laparoscopic surgery; Laparoscopy; Lung diseases; Lung diseases, Obstructive; Mechanical ventilation; Medical research; Methods; Montreal Cognitive Assessment (MoCA); Mortality; Obstructive lung disease; Patients; Pulmonary ultrasound (LUS); Pulmonology; Research methodology; Respiratory function; Surgery; Titration; Ultrasonic imaging; Ultrasound imaging; Ventilators
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-023-02471-y

To evaluate the effect of the individualized positive end-expiratory pressure (PEEP) lung protection ventilation strategy by combining driving pressure (ΔP) and pulmonary ultrasound (LUS)-based titration on lung function and postoperative cognitive function in patients with chronic obstructive pulmonary disease (COPD) during laparoscopic surgery. A total of 108 patients with COPD undergoing laparoscopic gastrointestinal surgery under general anesthesia were included in this study. They were randomly divided into three groups (n = 36): traditional volume ventilation group (Group C), fixed PEEP 5 cmH O group (Group P), and ΔP combined with LUS-based PEEP titration in the resuscitation room group (Group T). All three groups were given volume ventilation mode, I:E = 1:2; In group C, VT was 10 mL/kg and PEEP was 0 cmH O; In groups P and T, VT was 6 mL/kg and PEEP was 5 cmH O; After mechanical ventilation for 15 min in Group T, ΔP in combination with LUS was used to titrate PEEP. The oxygenation index (PaO2/FiO2), airway platform pressure (Pplat), dynamic lung compliance (Cdyn), Montreal Cognitive Assessment (MoCA), and venous interleukin-6(IL-6) were recorded at the corresponding time points, and the final PEEP value in Group T was recorded. The final PEEP value of Group T was (6.4 ± 1.2) cmH O; Compared with groups C and P: PaO /FiO and Cdyn in Group T were significantly increased (P