Background
The bronchial suction has been applied in speeding lung collapse. Low suction pressure may not speed lung collapse, but high pressure causes occult lung injury. The
Conclusions
Applying - 10 cmH2O suction pressure for 1 min when pleural incision is a relatively safe method to promote lung collapse without the occurrence of occult lung injury.
Methods
Eighty-four subjects undergoing uniport video-assisted thoracoscopic surgery (VATS) were randomly assigned for non-suction (Group 0), -10 cmH2O suction pressure (Group - 10), and - 30 cmH2O suction pressure (Group - 30). The primary outcome were the lung collapse scores (LCS) at 0 min (T0) after the visualization of the lung using a 10-point visual analogue scale and area under the curve (AUC) of LCS over time. The secondary outcomes included disconnection from the ventilator, the assessment of occult lung injury using NOS-3 expression, histologic scores of lung injury, and lung W/D weight ratio, intraoperative hypoxemia, the incidence of perioperative pulmonary complications.
Results
Both the LCS at T0 and AUC analysis showed that compared with Group 0, Group - 10 and Group - 30 significantly achieved good lung collapse (P < 0.05), but no difference between Group - 10 and Group - 30. Four patients in Group 0 were treated with disconnection maneuver. The assessment of occult lung injury showed no differences. Conclusions: Applying - 10 cmH2O suction pressure for 1 min when pleural incision is a relatively safe method to promote lung collapse without the occurrence of occult lung injury.
Trial registration
Chinese Clinical Trial Registry number, ChiCTR2200062991. Registered on 26/08/2022.