Objective To investigate the risk of lung injury associated with perioperative protective mechanical ventilation in patients living in plateau area.

Methods We chose 120 patients from plateau area who would receive general anesthesia, and randomly divided into the protective ventilation group (PV group) and the control ventilation group (CV group). In CV group, we used a tidal volume of 10 mL/kg, no positive end-expiratory pressure (PEEP) or lung re-expansion, ventilation frequency of 12 times/min, and a ratio of 1:2. In PV group, we used a tidal volume of 6 mL/kg, a ventilation frequency of 12 times/min, and a ratio of 1:2, PEEP 6 cmH2O(1 cmH₂O=98.066 5 Pa), and did lung re-expansion every half hour. We recorded lung compliance, pulmonary oxygenation index (OI=PaO₂/FiO₂), alveolar-arterial partial pressure difference (A-aDO₂), oxygenation index (PaO₂/FiO₂), average arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO₂) of the patients at 5 minutes after anesthesia induction(T1), 1 hour after mechanical ventilation(T2), and before extubation (T3) respectively.

Results In PV group, Cdyn and OI at T2 and T3 were significantly increased (P < 0.05), and A-aDO₂ was significantly decreased (P < 0.05). The changes in MAP, HR and SpO₂ in the two groups were not statistically significant. There was no significant difference in PaO₂ and PaCO₂ between the two groups at each time point. The Qs/Qt value of T3 in PV group was significantly lower than that in CV group (P < 0.05).

Conclusions Protective ventilation can reduce the risk of lung injury associated with perioperative mechanical ventilation in patients living in plateau area.