Pressure control ventilation and positive end-expiratory pressure during one-lung ventilation in the application of.doc

 PAGE \* MERGEFORMAT 5 Pressure control ventilation and positive end-expiratory pressure during one-lung ventilation in the application of During one-lung anesthesia to ensure good arterial oxygenation is a key issue. At present, most thoracic surgery during one-lung ventilation (one-lung ventilation, OLV), remains the main use of volume-controlled ventilation modes (volume controlled ventilation, VCV). At this point, usually airway pressure will be significantly increased, while the excessive increase of airway pressure ventilation may lead to pulmonary alveolar lateral pressure within the blood vessels, so that vascular resistance increased, so that the transfer of part of the blood flow to the contralateral lung collapse, leading to increase in arteriovenous shunt. Therefore, in order to reduce airway pressure, anesthesiologist during one-lung ventilation with low tidal volume usually choose high-frequency ventilation modes, but with low tidal volume ventilation is easy for the side of the lungs Atelectasis, more is not conducive to oxygenation [1]. In fact in this case, the anesthesiologist can also choose to patients with severe respiratory failure during the treatment widely used in pressure control ventilation (pressure controlled ventilation, PCV) and the use of end-expiratory pressure (PEEP) to improve arterial oxygenation in order to reduce peak airway pressure. 1, pressure control ventilation and volume controlled ventilation is the comparison of VCV suction generated by the positive pressure breathing machine will be pre-set volume of gas with constant-speed air flow into the lungs, increased airway pressure; expiratory intrapulmonary gas by chest recoil, eliminated from the body, airway pressure returned to zero. VCV of airway pressure waveform shown in Figure 1 (1). PCV is characterized by a rapid increase in airway pressure to the pre-peak, followed by a decreasing flow waveforms in order to maintain the level of airway pressure on the default.