Pulmonary protective ventilation strategy accelerates recovery of patients with QT prolonged syndrome undergoing thoracic sympathectomy

Abstract

AbstractBackgroundEndoscopic thoracic sympathectomy (ETS) is a new surgical method for the treatment of QT prolonged syndrome (LQTs). ETS requires double lung ventilation and one-lung ventilation (OLV) switching, which results in long operation time and great trauma. Conventional ventilation is easy to cause alveolar volume injury and biological injury, and increase the incidence of perioperative pulmonary complications, which is contrary to the basic requirements of ERAS. To compare the effects of conventional ventilation and pulmonary protective strategy ventilation on ETS about surgical rehabilitation during and after operation.MethodsThe study is randomized and blinded. Eighty LQTs patients with ETS were randomly divided into conventional ventilation group (CV Group) and pulmonary protective ventilation strategy group (PV Group), 40 cases in each group. They were compared at 4 time points-before anesthesia induction (T0), OLV 15min (T1), OLV 45min (T2) and 24 hours after operation (T3).Respiratory mechanics parameters, inflammatory factors, arterial blood gas and related calculation indexes, pulmonary complications 24 hours after operation, PACU observation time and hospitalization days were observed.ResultsPV group achieved more stable respiratory mechanics parameters, lower expression of inflammatory factors, better oxygenation, lower postoperative 24-hour pulmonary complications, shorter PACU observation time and hospital stay.ConclusionThe application of lung protective ventilation strategy in ETS is more suitable to ERAS requirements, and its clinical application is safe and effective, which worth promotion.