The effect of lung-protective ventilation on Pa-etCO 2 in elderly surgical patients

Objective: This study aimed to determine whether the lung-protective strategy of reducing driving pressure can optimize the Pa-etCO ₂ gradient in elderly patients and improve patient prognosis. Methods : Under anaesthesia, patients in the PV group were compared with those in the CV group via an individualized method of increasing positive end expiratory pressure (PEEP) to reduce driving pressure (PEEP starting from 9 cmH ₂ O, reducing tidal volume from 8 ml/kg–6 ml/kg estimated body weight (PWB) to lower the plateau pressure (Pplat)<20 cmH2O, and lowering the PEEP if the target plateau pressure was not achieved). Result: There was no significant difference in the changes in Pa-etCO ₂ between the PV group five minutes after anaesthesia (T ₀ ) and the suture group (T _end ) (p>0.05), whereas the Pa-etCO ₂ in the CV T _end group increased compared with that in the CV T ₀ group (p<0.01). The T _end to respiratory recovery time (p<0.05), extubation time (p<0.05), and conscious time (p<0.05) in the PV group were shorter than those in the CV group. Conclusion : Individual ventilation strategies that reduce driving pressure can optimize the Pa-etCO ₂ gradient in elderly prone spine surgery patients, shorten the recovery time, and improve patient prognosis.