Effects of individualized PEEP on pulmonary function, cerebral blood flow and postoperative cognitive function in patients undergoing laparoscopic radical resection of rectal cancer.
Xiaoyan Zhang, Jingjing Zhang, Caixia Zhao, Yichao Cai, Qing Yang, Caixia Yue, Kan Li
{"title":"Effects of individualized PEEP on pulmonary function, cerebral blood flow and postoperative cognitive function in patients undergoing laparoscopic radical resection of rectal cancer.","authors":"Xiaoyan Zhang, Jingjing Zhang, Caixia Zhao, Yichao Cai, Qing Yang, Caixia Yue, Kan Li","doi":"10.1186/s12885-025-14321-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of individualized PEEP on pulmonary function, cerebral blood flow, and postoperative cognitive function in patients undergoing laparoscopic radical resection of rectal cancer.</p><p><strong>Methods: </strong>100 patients who underwent laparoscopic radical rectal cancer surgery at our hospital between August 2021 and May 2023 were randomized into two groups: the DP group (optimal PEEP group oriented to driving pressure) and the Cdyn group (optimal PEEP group oriented to pulmonary compliance). Anesthesia was induced in both groups with 0.3 mg/kg of remizolam + 0.15 mg/kg of CIS atracurium + 0.5 ug/kg of sufentanil. Lung ultrasound score (LUS), peak and plateau airway pressures (PEAK, PLAT), oxygenation index (OI), driving pressure (DP), and pulmonary dynamic compliance (Cdyn) were measured at different time points. Cerebral blood flow and cognitive function were also assessed. T<sub>0</sub>: before induction of anesthesia; T<sub>1</sub>: before postoperative extubation of the tracheal tube; T<sub>2</sub>: 1 h after extubation; T<sub>3</sub>: on the third postoperative day; T<sub>4</sub>: 5 min after determining the optimal PEEP; T<sub>5</sub>: 1 h after the establishment of pneumoperitoneum; T<sub>6</sub>: 2 h after the establishment of the pneumoperitoneum; T<sub>7</sub>: 20 min at the end of pneumoperitoneum.</p><p><strong>Results: </strong>There were no significant differences in general information between the two groups, P > 0.05. Compared with the DP group, the Cdyn group had lower LUS at T<sub>3</sub>, higher PEAK at T<sub>5</sub>, T<sub>6</sub>, and T<sub>7</sub>, lower PLAT and OI at T<sub>6</sub> and T<sub>7</sub>, lower DP at T<sub>4</sub>, T<sub>6</sub>, and T<sub>7</sub>, and lower Cdyn at T<sub>6</sub> and T<sub>7</sub>, P < 0.05. The Cdyn group had lower cerebral blood flow at T<sub>4</sub> and T<sub>6</sub>, P < 0.05. The Cdyn group had higher cognitive function at stage T<sub>3</sub> as assessed by MMSE, P < 0.05.</p><p><strong>Conclusion: </strong>PEEP guided by lung compliance improves pulmonary function, cerebral blood flow, and cognitive function, offering clinical benefits.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"927"},"PeriodicalIF":3.4000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100997/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12885-025-14321-7","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the effects of individualized PEEP on pulmonary function, cerebral blood flow, and postoperative cognitive function in patients undergoing laparoscopic radical resection of rectal cancer.
Methods: 100 patients who underwent laparoscopic radical rectal cancer surgery at our hospital between August 2021 and May 2023 were randomized into two groups: the DP group (optimal PEEP group oriented to driving pressure) and the Cdyn group (optimal PEEP group oriented to pulmonary compliance). Anesthesia was induced in both groups with 0.3 mg/kg of remizolam + 0.15 mg/kg of CIS atracurium + 0.5 ug/kg of sufentanil. Lung ultrasound score (LUS), peak and plateau airway pressures (PEAK, PLAT), oxygenation index (OI), driving pressure (DP), and pulmonary dynamic compliance (Cdyn) were measured at different time points. Cerebral blood flow and cognitive function were also assessed. T0: before induction of anesthesia; T1: before postoperative extubation of the tracheal tube; T2: 1 h after extubation; T3: on the third postoperative day; T4: 5 min after determining the optimal PEEP; T5: 1 h after the establishment of pneumoperitoneum; T6: 2 h after the establishment of the pneumoperitoneum; T7: 20 min at the end of pneumoperitoneum.
Results: There were no significant differences in general information between the two groups, P > 0.05. Compared with the DP group, the Cdyn group had lower LUS at T3, higher PEAK at T5, T6, and T7, lower PLAT and OI at T6 and T7, lower DP at T4, T6, and T7, and lower Cdyn at T6 and T7, P < 0.05. The Cdyn group had lower cerebral blood flow at T4 and T6, P < 0.05. The Cdyn group had higher cognitive function at stage T3 as assessed by MMSE, P < 0.05.
Conclusion: PEEP guided by lung compliance improves pulmonary function, cerebral blood flow, and cognitive function, offering clinical benefits.
期刊介绍：
BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
