The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 14: 2217 - 2223

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.14.014

Clinical Research

Effects of two driving pressure-based methods to set positive end-expiratory pressure on pulmonary mechanics and oxygenation in patients undergoing laparoscopic and thoracoscopic esophagectomy

  • Haowen ZHU ,
  • Shijie XU ,
  • Ran LIU ,
  • Xinhua HONG ,
  • Yiting XUE ,
  • Wenze TIAN ,
  • Zhen. SU
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  • Department of Anesthesiology，the Affiliated Huaian NO. , People′s Hospital of Nanjing Medical University, Huai′an 223300，Jiangsu，China

Received date: 2025-02-27

  Online published: 2025-07-29

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Abstract

Objective To investigate the effects of two driving pressure-based methods to set positive end-expiratory pressure on pulmonary mechanics and oxygenation in patients undergoing laparoscopic and thoracoscopic esophagectomy. Methods Sixty patients undergoing laparoscopic and thoracoscopic esophagectomy were divided into two groups （n = 30 each）： incremental group （group I） and decremental group （group D）. PEEP titration was performed in both groups during thoracoscopy and laparoscopy. Respiratory mechanics parameters， hemodynamic parameters， and blood gas analysis were collected for analysis before preoxygenation （T0）， 10 minutes after intubation （T1）， 20 minutes after PEEP application for one-lung ventilation （T2）， 20 minutes after PEEP application for two-lung ventilation （T3）， before extubation （T4）， and 30 minutes after extubation （T5）. The postoperative pulmonary complications within 3 days and 7 days after operation， hospitalization duration， and costs were recorded. Results Compared with group I， patients in group D showed higher oxygenation index and pulmonary compliance during surgery （P < 0.05）. In both groups， driving pressure decreased and compliance increased after PEEP titration （P < 0.05）. Conclusion Both driving pressure-guided incremental and decremental titration of individualized PEEP improved intraoperative respiratory mechanics in patients undergoing laparoscopic and thoracoscopic esophagectomy， and decremental titration was more effective in improving intraoperative respiratory mechanics and oxygenation in patients during operation.

Key words： driving pressure; positive end-expiratory pressure; esophageal cancer; incremental titration; decremental titration

Cite this article

Haowen ZHU , Shijie XU , Ran LIU , Xinhua HONG , Yiting XUE , Wenze TIAN , Zhen. SU . Effects of two driving pressure-based methods to set positive end-expiratory pressure on pulmonary mechanics and oxygenation in patients undergoing laparoscopic and thoracoscopic esophagectomy[J]. The Journal of Practical Medicine, 2025 , 41(14) : 2217 -2223 . DOI: 10.3969/j.issn.1006-5725.2025.14.014

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