Impact of Pressure-Controlled Volume-Guaranteed Ventilation on Pulmonary Function in Coal Workers with Pneumoconiosis Undergoing Laparoscopic Cholecystectomy

压力控制容量保证通气对接受腹腔镜胆囊切除术的尘肺煤工肺功能的影响

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Abstract

OBJECTIVE: This study aimed to investigate the effects of the pressure-controlled volume-guaranteed ventilation (PCV-VG) mode on pulmonary function in patients with pneumoconiosis undergoing laparoscopic cholecystectomy. METHODS: Forty patients with pneumoconiosis scheduled for elective laparoscopic cholecystectomy under general anesthesia were randomly divided into two groups using a random number table method: the PCV-VG mode group and the volume-controlled ventilation (VCV) mode group. The primary outcome was lung ultrasound score (LUS) after entering the operating room (T0), at the end of surgery (T3), 30 minutes after tracheal extubation (T4), and 2 hours postoperatively (T5). Peak airway pressure (Ppeak) and plateau pressure (Pplat) were recorded 2 minutes before (T1) and 20 minutes after the initiation of artificial pneumoperitoneum (T2). Arterial blood gas analyses were performed at T0, T2, and T4 to calculate the oxygenation index (OI). RESULTS: Compared to the VCV group (n = 20), the PCV-VG group (n = 20) exhibited significantly improvement of median LUS at T3, T4, and T5 (all P < .05). Significantly lower Ppeak and Pplat were found in PCV-VG group at T1 (16.2 ± 1.81 and 14.6 ± 1.85) and T2 (24.3 ± 2.75 and 19.7 ± 3.08) (P < .05). Additionally, median OI significantly improved at T2 and T4 in PCV-VG group (P < .05). No early postoperative pulmonary complications were found in both groups. CONCLUSION: For patients with pneumoconiosis undergoing laparoscopic cholecystectomy, the PCV-VG mode can reduce intraoperative airway pressures and early postoperative LUS values, decrease ventilation loss, and improve perioperative oxygenation.

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