Abstract
Objective To evaluate the effect of dynamic lung compliance(Cydn)-guided positive end-expiratory pressure(PEEP)titration on lung injury in the patients undergoing robot-assisted radical prostatectomy. Methods Forty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 65-80 yr, with body mass index of 19-28 kg/m2, scheduled for elective robot-assisted radical prostatectomy under general anesthesia, were divided into 2 groups(n=20 each)using a random number table method: control group(group C)and PEEP group(group P). Mechanical ventilation was performed according to preset parameters after tracheal intubation in group C, and PEEP was set by a double titration method after tracheal intubation and after pneumoperitoneum in group P. At 4 min after intubation(T1), 4 min, 1 h and 2 h after establishing pneumoperitoneum-Trendelenburg position(T2-4), and 1 and 30 min after extubation(T5, 6)in group C or at 4 min after completing the first PEEP titration(T1), 4 min, 1 h and 2 h after completing the second PEEP titration(T2-4)and T5, 6 in group P, blood samples were collected from the radial artery for determination of club cell protein 16, surfactant protein-D, tumor necrosis factor-alpha and interleukin-6 concentrations in serum(by enzyme-linked immunosorbent assay). Results Compared with group C, the serum concentrations of club cell protein 16 at T2-6 and surfactant protein-D, tumor necrosis factor-alpha and interleukin-6 at T3-6 were significantly decreased in group P(P<0.05). Conclusion Cydn-guided PEEP titration can reduce the lung injury in patients undergoing robot-assisted radical prostatectomy. Key words: Lung compliance; Positive-pressure respiration; Prostatic neoplasms; Respiratory function tests
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