The effects of one-lung ventilation mode on lung function in elderly patients undergoing esophageal cancer surgery

The objective of the present study was to explore the effects of different one-lung ventilation (OLV) modes on lung function in elderly patients undergoing esophageal cancer surgery. A total of 180 consecutive elderly patients (ASA Grades I-II, with OLV indications) undergoing elective surgery were recruited in the study. Patients were randomly divided into 4 groups (n=45). In Group A, patients received low tidal volume (VT < 8mL/kg)+pressure controlled ventilation (PCV), low tidal volume (VT < 8mL/kg)+volume-controlled ventilation (VCV) in Group B, high tidal volume (VT >= 8mL/kg)+PCV in Group C and high tidal volume (VT >= 8mL/kg)+VCV in Group D. Two-lung ventilation involved routine tidal volume (8-10mL/kg) at a frequency of 12 to 18times/min, and VCV mode. Clinical efficacy among 4 groups was compared. The partial pressure of end-tidal carbon dioxide (PetCO(2)) did not significantly differ among 4 groups (all P>.05), and the oxygenation index and SO2 in Group A were significantly higher than in the other groups (P<.05). The PetCO(2), peak airway pressure (P-peak), platform airway pressure (P-plat), and mean airway pressure (P-mean) in Group A were significantly lower than those in the other groups (all P<.05). However, airway resistance (R-aw) among 4 groups did not significantly differ (all P>.05). The incidence of pulmonary infection, anastomotic fistula, ventilator-induced lung injury, lung dysfunction, difficulty weaning from mechanical ventilation, and multiple organ dysfunction in Groups A and B were lower than that in Groups C and D (all P<.05). The expression levels of IL-6, tumor necrosis factor-, and C-reactive protein in lavage fluid in Group A were significantly lower than those in the other groups (all P<.05). OLV with low tidal volume (VT < 8mL/kg)+PCV (5cmH(2)O PEEP) improved lung function and mitigated inflammatory responses in elderly patients undergoing esophageal cancer surgery.