Pulmonary ventilation reserve function is used to predict intraoperative ventilation function and postoperative outcome in patients with spinal orthopedic surgery

Abstract

Objective To investigate the effect of pulmonary ventilation reserve function on perioperative pulmonary function and postoperative outcome in patients undergoing spinal orthopedic surgery. Methods Ninety patients undergoing spinal orthopedic surgery in our hospital from June 2019 to December 2020 were divided into two groups according to the percentage of preoperative pulmonary reserve function index MVV in the predicted value. Arterial oxygen partial pressure, carbon dioxide partial pressure, oxygenation index (OI), airway plateau pressure (Pplat), and airway resistance (AR) of patients in each group were observed before the start of surgery (T0), at 1 h (T1) and 2 h (T2) after the start of surgery, and at the end of surgery (T3). After the end of surgery, the probability of patient transfer to ICU, time to resume spontaneous breathing, and time to extubation were recorded, and PaO2 and inflammatory factors interleukin-6, procalcitonin, and C-reactive protein of patients were followed up for 1 week. Results In both groups, PaO2 and OI decreased obviously while Pplat and AR increased significantly at T1, T2, and T3, but in Group A, Pplat and AR were markedly lower than those in Group B while PaO2 and OI were notably higher than those in Group B ( p < 0.05). Both time to resume spontaneous breathing and time to extubation in Group B were longer than those in Group A ( p < 0.05). The probability of entering ICU in Group B is higher than that in Group A. Both PaO2 and OI at day 3 after surgery in Group B were lower than those in Group A. While, there is no difference at T2. Conclusion For patients, both intraoperative pulmonary function and time to postoperative resuscitation can be predicted by measuring the preoperative MVV, and long-term prognosis will not be affected by the pulmonary function impairment.