YUE-MING XU, CHUN-YU PENG, ZHI-GANG HE, SHUN-HONG WANG, HAI TIAN
Department of anesthesiology of 324 hospital of peoples liberation army, Chongqing 400020, China
Introduction: Severe abdominal infections often induce sepsis, and the lung is one of the organs that are frequently affected by sepsis. Many patients with sepsis caused by abdominal infections, but no clinical study on whether these patients should receive ventilation strategies has been reported. This study aims to investigate the effects of different mechanical ventilations on patients with sepsis in the abdominal cavity.
Materials and methods: A retrospective analysis was conducted on data obtained from 296 patients with sepsis in the abdominal cavity, who were admitted in our hospital, in order to evaluate the effects of mechanical ventilations with different tidal volumes. Carbon dioxide partial pressure, oxygenation index and mean airway plateau pressure at different time points after mechanical ventilation, the tracheal extubation rate within two hours after surgery, the incidence of atelectasis within 24 hours after surgery, and mortality within 28 days after surgery were compared between the two groups.
Results: Differences in the basic situations of patients upon entering the operating room between the two groups were not statistically significant. At 10, 30 and 60 minutes after mechanical ventilation, and at the end of the operation, differences in arte- rial blood pH value, oxygenation index, extubation rate within two hours after surgery, and the incidence of atelectasis within 24 after surgery between the two groups were not statistically significant (P>0.05). Ventilation was obviously excessive and airway plateau pressure was higher in group I, while patients had mild CO2 retention in group II; and the difference was statistically significant (P<0.05). Furthermore, differences in the incidence of acute respiratory distress syndrome and 28-day mortality between the two groups were statistically significant (P=0.04).
Conclusion: Lung protective ventilation can reduce the incidence of acute respiratory distress syndrome and 28-day mortality.
Intraoperative lung protection ventilation, sepsis, intra-abdominal infection, Acute Respiratory Distress Syndrome, pulmonary complication