Effects of Different Ventilation Modes on PaO<sub>2</sub> and Lactic Acid in Arterial Blood of Upper and Lower Limbs in Rectal Cancer Patients under Trendelenburg Posture

Min ZHAO; Hui YANG; Wei-hao MA; Shan-shan LI

doi:10.12259/j.issn.2095-610X.S20210412

Volume 42 Issue 4

Apr. 2021

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Min ZHAO, Hui YANG, Wei-hao MA, Shan-shan LI. Effects of Different Ventilation Modes on PaO2 and Lactic Acid in Arterial Blood of Upper and Lower Limbs in Rectal Cancer Patients under Trendelenburg Posture[J]. Journal of Kunming Medical University, 2021, 42(4): 61-66. doi: 10.12259/j.issn.2095-610X.S20210412

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Min ZHAO, Hui YANG, Wei-hao MA, Shan-shan LI. Effects of Different Ventilation Modes on PaO₂ and Lactic Acid in Arterial Blood of Upper and Lower Limbs in Rectal Cancer Patients under Trendelenburg Posture[J]. Journal of Kunming Medical University, 2021, 42(4): 61-66. doi: 10.12259/j.issn.2095-610X.S20210412

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Effects of Different Ventilation Modes on PaO₂ and Lactic Acid in Arterial Blood of Upper and Lower Limbs in Rectal Cancer Patients under Trendelenburg Posture

doi: 10.12259/j.issn.2095-610X.S20210412

Dept. of Anesthesiology，The 3rd Affiliated Hospital of Kunming Medical University， Kunming Yunnan 650118，China

Received Date: 2020-12-23
Publish Date: 2021-04-01

Abstract

Abstract

Objective To investigate the changes of upper and lower limb artery PaO₂ and blood lactic acid in rectal cancer patients with different ventilation modes in Trendelenburg position during perioperative period, so as to provide basis and reference for the reasonable implementation of perioperative body function protection strategy. Methods Forty patients underwent elective laparoscopic radical resection of rectal cancer were randomly divided into two groups: volume control ventilation group （VCV group, 20 cases） and pressure control ventilation group （PCV group, 20 cases）. In each group, the changes of PaO₂ and blood lactic acid in the ipsilateral upper and lower limbs of patients with rectal cancer at different time points were observed and compared under Trendelenburg position. Results The PaO₂ of the upper limbs was higher than that of the lower limbs in the two groups. In the VCV group, there was statistically significant difference in PaO₂ in the arteries of upper and lower limbs at T1 and T4 （P < 0.05）. In PCV group, there was statistically significant difference in PaO₂ of upper and lower limb arteries at T0 and T4 （P < 0.05）. PaO₂ in the upper and lower extremity arterial blood of PCV group was higher than that of VCV group, and the difference of PaO₂ in the upper extremity artery at T2 and T3 between the two groups was statistically significant （P < 0.05）.The difference of lower limb artery PaO₂ between the two groups at T1-4 was statistically significant （P < 0.05）. Compared with T0 time point, PaO₂ in the upper extremity of VCV group was significantly decreased at T2-4 time point, and that in the lower extremity of VCV group was significantly decreased at T1-4 time point, the difference was statistically significant （P < 0.05）. In the PCV group, the upper and lower limbs arterial PaO₂ decreased at T5, and the difference was statistically significant （P < 0.05）. The levels of arterial lactic acid in upper limbs were lower than those in lower limbs in 2 groups, and there was statistical significance in the values of arterial lactic acid in upper and lower limbs in VCV group at T2 and T4 （P < 0.05）. There was statistically significant difference in arterial lactic acid value of upper and lower limbs in PCV group at T3 （P < 0.05）. The arterial lactic acid in the upper and lower limbs of the PCV group was lower than that of the VCV group, and the arterial lactic acid in the lower limbs of the PCV group was significantly lower than that of the VCV group at T0, T2 and T3, with statistical significance （P < 0.05）. Conclusion PCV ventilation mode in perioperative period has more advantages in improving arterial blood PaO₂, reducing blood lactic acid, improving tissue perfusion. The advantages of PCV were more prominent in the lower limbs which can reduce the adverse effect of Trendelenburg posture on patients.
- Trendelenburg position,
- Ventilation mode,
- Arterial partial pressure of oxygen,
- Lactic acid

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References(16)

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