肥胖患者单肺通气期间的通气策略

背景 肥胖人群比例不断升高,肥胖影响正常生理功能,给麻醉带来不少问题,尤其在单肺通气(one-lung ventilation,OLV)过程中. 目的 减少肥胖患者OLV过程对预后转归的影响,降低肥胖患者围手术期呼吸系统并发症的发生率. 内容 探讨肥胖患者围手术期OLV期间的通气策略,包括通气模式的选择、保护性通气策略、高碳酸血症、肺泡复张策略和吸氧浓度的选择. 趋向 肥胖患者OLV期间采用小潮气量联合呼气末正压通气(positive end-expiratory pressure, PEEP)、间断肺泡复张和低到中度Fi02等通气策略有助于改善氧合、降低肺不张发生率,高碳酸血症在无肺部疾病患者中是否具有肺保护作用尚待研究.

The ventilation strategy of one-lung ventilation for obese patients

Background The proportion of obese people is rising.Obesity influences the normal physiological function,causing lots of problems in anesthesia,especially during one-lung ventilation (OLV).Objective To reduce the effect of one-lung ventilation on prognosis and decrease the incidence of perioperative respiratory complications in obese patients.Content To explore the ventilation strategies of OLV for obesity patients during perioperative period,including the choices of ventilation modes,protective ventilation strategy,hypercapnia,alveolar recruitment strategy and oxygen concentration selection.Trend Low tidal volume combined with positive end-expiratory pressure (PEEP),intermittent alveolar recruitment and low to moderate FiO2 help to improve oxygenation and reduce the incidence of atelectasis in obese patients during one-lung ventilation.Whether hypercapnia has a lung proctive effect on patients without lung disease or not,it remains to be investigated.