机构：[1]Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union MedicalCollege, National Cancer Center, Beijing 100021, China[2]Department of Emergency Medicine, Sir Run-Run Shaw Hospital, Zhejiang UniversitySchool of Medicine, Hangzhou 310016, China[3]Department of Thoracic Surgery, St. James’s University Hospital, Leeds, UK[4]Department ofThoracic Surgery, Shanghai Pulmonary Hospital, Shanghai 200433, China[5]Department of Thoracic Surgery, Fujian Medical University UnionHospital, Fujian 350001, China[6]Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China广东省人民医院[7]Shanghai ChestHospital, Shanghai 200030, China[8]Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College ofMedicine, Taipei 10002, Taiwan[9]Mayo Clinic, Phoenix, AZ, USA[10]Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou310009, China[11]Department of Anesthesiology and Critical Care Medicine, University of Florida, Gainesville, FL, USA[12]Department of ThoracicSurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China华中科技大学同济医学院附属同济医院[13]Department ofAnaesthesia and Postoperative Care, Hospital General Universitario Gregorio Marañon, Madrid, Spain[14]Department of Thoracic Surgery, TheFirst Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China[15]Guangzhou Institute of Respiratory Disease & ChinaState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510000, China[16]FirstAffiliated Hospital, Medical College of Zhejiang University, Hangzhou 310003, China[17]Department of Thoracic Surgery, Yunnan Cancer Hospital,Kunming 650100, China[18]Department of Esophageal Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China[19]Department of Thoracic Surgery, Shandong Qianfoshan Hospital, Jinan 250014, China[20]Department of Thoracic Surgery, Peking Union MedicalCollege Hospital, Beijing 100032, China[21]Department of Thoracic Surgery, Beijing Chaoyang Hospital, Beijing 100049, China北京朝阳医院[22]Department ofThoracic Surgery, Sichuan Cancer Hospital and Institute, Chengdu 610041, China四川省肿瘤医院[23]Department of Thoracic Surgery, Tangdu Hospital FourthMilitary Medical University, Xi’an 710038, China[24]Department of Thoracic Surgery, Henan Cancer Hospital, Zhengzhou 450008, China河南省肿瘤医院[25]Department of Thoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China[26]Divisionof Thoracic Surgery, Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan[27]Department of Thoracic Surgery, China and JapanFriendship Hospital, Beijing 100029, China[28]Department of Cardiovascular and Thoracic Surgery, West China Hospital, Sichuan University,Chengdu 610041, China四川大学华西医院[29]Department of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shengyang 110042, China[30]Departmentof Thoracic Surgery, The First Hospital Affiliated to Soochow University, Suzhou 215000, China[31]Department of Thoracic Surgery, ZhejiangCancer Hospital, Hangzhou 310000, China[32]Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin,N.T., Hong Kong, China[33]Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark[34]Department of Thoracic Surgery,Guangzhou General Hospital of Guangzhou Military Area Command, Guangzhou 510000, China[35]Department of Thoracic Surgery andOncology, National Cancer Institute, Pascale Foundation, Naples, Italy[36]Thoracic Surgery Unit, University of Torino, Torino, Italy[37]Departmentof Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China[38]Department of Thoracic Surgery, DapingHospital, Research Institute of Surgery Third Military Medical University, Chongqing 400042, China[39]Department of Thoracic Surgery, SecondAffiliated Hospital of Jilin University, Changchun 130041, China[40]Department of Thoracic Surgery, Southwest Hospital, Third Millitary Medical University, Chongqing 400038, China[41]Department of Thoracic Surgery, General Hospital of Shenyang Military Area, Shenyang 110015, China[42]Department of Cardiovascular and Thoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China[43]Department of Thoracic Surgery, Zhongda Hospital Southeast University, Nanjing 210009, China[44]Department of Thoracic Surgery, JiangsuCancer Hospital, Nanjing 210008, China[45]Department of Thoracic Surgery, Heilongjiang Cancer Hospital, Harbin 150049, China[46]Departmentof Thoracic Surgery, Peking University Third Hospital, Beijing 100083, China[47]Department of Cardiovascular Surgery, Second Xiangya Hospitalof Central South University, Changsha 410011, China[48]Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha410008, China[49]Cancer Center, San Yat-sen University, Guangzhou 510060, China[50]Department of Thoracic Surgery, The First AffiliatedHospital of Xinjiang Medical University, Urumqi 830011, China[51]Department of Thoracic Surgery, Tanjin Chest Hospital, Tianjin 300300, China[52]Department of Thoracic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200000, China[53]Departmentof Thoracic Surgery, Shanghai Changzheng Hospital, Shanghai 200000, China[54]Department of Thoracic Surgery, Xuanwu Hospital of Capital University of Medical Sciences, Beijing 100053, China首都医科大学宣武医院
Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e.g., volume controlled (VCV) versus pressure controlled (PCV)]; (III) use of therapeutic hypercapnia; (IV) use of alveolar recruitment (open-lung) strategy; (V) pre-and post-operative application of positive end expiratory pressure (PEEP); (VI) Inspired Oxygen concentration; (VII) Non-intubated thoracoscopic lobectomy; and (VIII) adjuvant pharmacologic options. The recommendations of class II are non-intubated thoracoscopic lobectomy may be an alternative to conventional one-lung ventilation in selected patients. The recommendations of class IIa are: (I) Therapeutic hypercapnia to maintain a partial pressure of carbon dioxide at 50-70 mmHg is reasonable for patients undergoing pulmonary lobectomy with one-lung ventilation; (II) PV with a tidal volume of 6 mL/kg and PEEP of 5 cmH(2)O are reasonable methods, based on current evidence; (III) alveolar recruitment [open lung ventilation (OLV)] may be beneficial in patients undergoing lobectomy with one-lung ventilation; (IV) PCV is recommended over VCV for patients undergoing lung resection; (V) pre-and post-operative CPAP can improve short-term oxygenation in patients undergoing lobectomy with one-lung ventilation; (VI) controlled mechanical ventilation with I:E ratio of 1:1 is reasonable in patients undergoing one-lung ventilation; (VII) use of lowest inspired oxygen concentration to maintain satisfactory arterial oxygen saturation is reasonable based on physiologic principles; (VIII) Adjuvant drugs such as nebulized budesonide, intravenous sivelestat and ulinastatin are reasonable and can be used to attenuate inflammatory response.
第一作者机构：[1]Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union MedicalCollege, National Cancer Center, Beijing 100021, China[*1]Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Cancer Center, Beijing 100021, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union MedicalCollege, National Cancer Center, Beijing 100021, China[*1]Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Cancer Center, Beijing 100021, China
推荐引用方式(GB/T 7714)：
Shugeng Gao,Zhongheng Zhang,Alessandro Brunelli,et al.The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy[J].JOURNAL OF THORACIC DISEASE.2017,9(9):3246-3254.doi:10.21037/jtd.2017.08.166.
APA：
Shugeng Gao,Zhongheng Zhang,Alessandro Brunelli,Chang Chen,Chun Chen...&Qinghua Zhou.(2017).The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy.JOURNAL OF THORACIC DISEASE,9,(9)
MLA：
Shugeng Gao,et al."The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy".JOURNAL OF THORACIC DISEASE 9..9(2017):3246-3254
