Abstract: Objective To investigate effect of lung protective ventilation on respiration and circulation in elderly patients
receiving spinal operation performed in the prone position. Methods Sixty patients undergoing elective spinal surgery were
randomized control group [with VT of 10 mL/kg (PBW) and RR of 10-12 /min] and test group [with VT of 6 mL/kg +RMs+PEEP:
5 cmH2O (PBW) and RR of 12-18 /min]. Recruitment maneuver was performed once every 30 min. HR, MAP, Ppeak, PPlat, PaO2/
FiO2, SpO2, PaCO2, WBC, NEUT%, CRP, VAS, pulmonary complications risk score, and clinical pulmonary infection score were
recorded before the operation, upon entry in the operation room, at 5 min before and 30 min, 1 h, and 3 h after changing into
the prone position, and at 1 day and 3 days after the operation. Results Pulmonary complications risk score, HR, MAP, WBC,
NEUT%, and PaCO2 were all comparable between the two groups (P>0.05). Ppeak and Pplat of the test group were lower than those
of the control group after entering the operation room and at 5 min before and 30 min, 1 h, and 3 h after changing into the
prone position (P<0.05). Compared with those in the control group, the oxygenation index at 1 day after the operation was
significantly higher and CRP and postoperative clinical pulmonary infection score at 1 day and 3 days after the operation were
significantly lower in the test group (P<0.05). Conclusion Lung protective ventilation can reduce the risk of barotrauma,
reduce lung inflammation, and improve postoperative oxygenation in elderly patients undergoing spinal surgery in the prone
position without affecting intraoperative hemodynamics or causing CO2 retention .