Department of Anesthesia and Intensive Care Medicine, University of Marburg, Marburg, Germany.
Anaesthesia. 2010 Feb;65(2):124-9. doi: 10.1111/j.1365-2044.2009.06187.x. Epub 2009 Dec 3.
Obesity impairs peri-operative lung function. To evaluate the impact of pressure support ventilation vs pressure controlled ventilation in moderately obese adults upon early postoperative lung function, we randomly assigned 68 moderately obese patients (body mass index 25-35 kg x m(-2)) undergoing minor surgery to receive intra-operative ventilation either with pressure support or pressure controlled ventilation. We performed intra-operative blood gas analysis and measured pulse oximetry saturation, spirometry values at pre-operative assessment (baseline) and at 10 min, 30 min, 2 h and 24 h after extubation. The intra-operative oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) in the pressure support ventilation group was significantly improved over time (p < 0.0001). Postoperatively, the pressure support ventilation group also had better lung function and oxygenation values than did the pressure controlled ventilation group (p < 0.005). We conclude that pressure support ventilation better maintains lung function than pressure controlled ventilation in moderately overweight patients scheduled for minor surgery.
肥胖会损害围手术期肺功能。为了评估压力支持通气与压力控制通气对中度肥胖成年人术后早期肺功能的影响,我们将 68 例接受小手术的中度肥胖患者(体重指数 25-35 kg/m²)随机分为压力支持通气组或压力控制通气组。术中进行血气分析,并在术前评估(基线)、拔管后 10 分钟、30 分钟、2 小时和 24 小时测量脉搏血氧饱和度和肺功能值。压力支持通气组的术中氧合指数(动脉血氧分压/吸入氧分数)随时间显著改善(p<0.0001)。术后,压力支持通气组的肺功能和氧合值也优于压力控制通气组(p<0.005)。我们得出结论,在接受小手术的中度超重患者中,压力支持通气比压力控制通气更能维持肺功能。