Practical Geriatrics

Practical Geriatrics ›› 2026, Vol. 40 ›› Issue (1): 48-52.doi: 10.3969/j.issn.1003-9198.2026.01.010

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Effects of mild hyperventilation on short-term diaphragmatic function in elderly patients undergoing laparoscopic radical resection of colorectal cancer

HE Lindan, FENG Jialu, CHEN Yuxuan, ZHANG Dengxin   

  1. Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou 221000, China (HE Lindan, FENG Jialu,ZHANG Dengxin);
    Wuxi Medical College, Jiangnan University,Wuxi 214000,China (CHEN Yuxuan)
  • Received:2025-05-09 Published:2026-01-16
  • Contact: ZHANG Dengxin, Email:9812015228@jiangnan.edu.cn

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Abstract: Objective To investigate the effects of mild hyperventilation on short-term postoperative diaphragmatic function in elderly patients undergoing laparoscopic radical resection for colorectal cancer, and to analyze the effects on postoperative cognitive function. Methods Eighty-eight elderly patients scheduled for elective laparoscopic colorectal surgery under general anesthesia were enrolled. They were randomly divided into the controlled hyperventilation group (Group H) and the conventional ventilation group (Group C) according to random number table, with 44 cases in each group. After induction of anesthesia and endotracheal intubation, both groups received mechanical ventilation in volume-controlled ventilation (VCV) mode. The respiratory rate (RR) was adjusted to maintain an end-tidal carbon dioxide partial pressure (PetCO2) of 35-45 mmHg in Group C and 30-34 mmHg in Group H. Arterial blood gas analysis was performed at the following time points: before anesthesia (T0), immediately after CO2 pneumoperitoneum establishment (T1), 1 h after pneumoperitoneum (T2), 2 h after pneumoperitoneum (T3), and immediately after extubation (T4). The score of the Mini-Mental State Examination (MMSE) was recorded 12 h before operation and 6, 24, and 48 h after operation. M-mode ultrasonography was used to measure diaphragmatic excursion (DE) and the diaphragmatic rapid shallow breathing index (D-RSBI) at T0 and T4. Results Compared to Group H, Group C showed a more significant decrease in postoperative diaphragmatic excursion and a more significant increase in the level of D-RSBI (P<0.05). At T2, T3 and T4, Group H had significantly higher pH values (P<0.05) and lower PaCO2 levels (P<0.05) compared to Group C. The incidence rate of postoperative diaphragmatic dysfunction showed significant difference between the two groups (P< 0.05). There were no statistically significant differences in the other indexes between the two groups. Conclusions Maintaining mild hyperventilation with a target PetCO2 of 30-34 mmHg can improve short-term postoperative diaphragmatic function in elderly patients undergoing laparoscopic radical resection for colorectal cancer, without exerting adverse effects on postoperative cognitive function.

Key words: diaphragmatic ultrasound, diaphragmatic function, controlled hyperventilation, lung protection

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