New Technology and Clinical Medicine
Oxygen supply and consumption in patients undergoing thoracic surgery under spontaneous breathing during anesthetic period
Zhizhao Deng, Bin Zeng, Meihua Dai, Weihang Li, Xinmiao Ye, Xiuping Li, Lei Chen
Published 2019-06-15
Cite as Chin J Biomed Eng, 2019, 25(3): 367-371. DOI: 10.3760/cma.j.issn.1674-1927.2019.03.020
Abstract
ObjectiveTo compare the relevant indexes of oxygen supply and oxygen consumption in tracheal intubation group and spontaneous respiration group, and to determine whether patients with spontaneous respiration during operation could maintain the balance of oxygen supply and consumption.
MethodsForty-one patients who fulfilled the inclusion criteria were included in the study between January 2017 and March 2018. All patients were divided into the tracheal intubation group (group A, n=20) and spontaneous respiration group (group B, n=21) . After anesthesia induction, orotracheal intubation with a double-lumen tube was performed for ventilation in group A. Spontaneous breathing was retained in group B by laryngeal mask airway placement after anesthesia induction, and the anesthesia machine was used for oxygen inhalation (inhaled oxygen concentration: 29%) . The hemoglobin (Hb) , arterial oxygen saturation (SaO2) , mixed venous oxygen saturation (ScvO2) , venous lactic acid (Lac) , arteriovenous oxygen content (Ca-vO2) , oxygenation index (OI) , oxygen supply index (DO2I) , oxygen consumption index (VO2I) and oxygen extraction rate (O2ER) at 1 min before thoracotomy (T0) ; at 5 min (T1) , 15 min (T2) , 30 min (T3) , 60 min (T4) after thoracotomy; during sternal closure (T5) ; and at 15 min after sternal closure (T6) were compared between the two groups.
ResultsIn Group B, the concentration of Hb was >90 g/L and SaO2 was above 90% at each time point. ScvO2 at T1-T3 and T5 in group B significantly increased compared with those in group A (P<0.05) ; Ca-vO2 at T1-T3 and T5, VO2I at T2-T4 in group B significantly decreased compared with that in group A (P<0.05) . O2ER, Lac B at T1-T5 in group B significantly decreased compared with that in group A (P<0.05) . There were no statistically significant differences in DO2I and OI at each time point between group B and group A (P>0.05) . There were no statistically significant differences in Lac, DO2I, VO2I and O2ER at T1-T6 and T0 in group B (P>0.05) . DO2I had positive correlation with VO2I (r=0.72, P<0.01) .
ConclusionUnder the premise of sufficient oxygen supply in the two groups, the oxygen consumption in group A is lower than that in group B. thoracic surgery under spontaneous breathing during anesthetic period. The balance of oxygen supply and consumption in group A undergoing thoracic surgery during anesthetic period may be maintained.
Key words:
Spontaneous breathing; Thoracic surgery; Anesthesia; Oxygen supply; Oxygen consumption
Contributor Information
Zhizhao Deng
Second Clinical College, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
Bin Zeng
Second Clinical College, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
Meihua Dai
Second Clinical College, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
Weihang Li
Second Clinical College, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
Xinmiao Ye
Second Clinical College, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
Xiuping Li
Department of Anesthesiology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
Lei Chen
Department of Anesthesiology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
