Is small tidal volume with low positive end expiratory pressure during one-lung ventilation an effective ventilation method for endoscopic thoracic surgery?

被引:2
作者
Yun, Du Gyun [1 ]
Han, Jong In [1 ]
Kim, Dong Yeon [1 ]
Kim, Jong Hak [1 ]
Kim, Youn Jin [1 ]
Chung, Rack Kyung [1 ]
机构
[1] Ewha Womans Univ, Sch Med, Dept Anesthesiol & Pain Med, 1071,Anayungcheon Ro, Seoul 158710, South Korea
关键词
One-lung ventilation; Oxygenation; Positive-pressure respiration; Thoracoscopy; Tidal volume;
D O I
10.4097/kjae.2014.67.5.329
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: The present study will focus on the rationale for the use of small tidal volume with 6 cmH(2)O positive end expiratory pressure (PEEP) with the changes of arterial oxygen tension, plateau airway pressure, and static lung compliance during one lung ventilation for endoscopic thoracic surgery. Methods: Forty-three patients were intubated with a double-lumen endobronchial tube. After positioning the patients in the lateral decubitus, one-lung ventilation was started with 100% oxygen, tidal volume 10 ml/kg without PEEP; arterial oxygen tension, plateau airway pressure, and static compliance were checked as baseline values (T0). Fifteen minutes later, same parameters were measured (T15). The tidal volume had changed to 6 ml/kg with 6 cmH2O PEEP. Fifteen minutes later, the same parameters were measured (T30). Results: Oxygen tension had decreased at T15 (282.1 +/- 83.4 mmHg) compared to T0 (477.2 +/- 82.4 mmHg) (P < 0.0001), but was maintained at T30 (270.4 +/- 81.9 mmHg). There was no difference in peak inspiratory pressure at T15 or T30 compared to T0, plateau airway pressure was increased at T15 and T30 (P < 0.05) and static lung compliance was decreased at T15 and T30 (P < 0.0001). Conclusions: In carrying out one-lung ventilation for thoracic surgery using an endoscope, the addition of a PEEP of 6 cmH(2)O in the dependent lung, while reducing the tidal volume of 6 ml/kg, both oxygen tension and lung compliance are maintained without increasing the plateau airway pressure. Protective lung ventilation is useful for one lung ventilation.
引用
收藏
页码:329 / 333
页数:5
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