Effects of lower tidal volumes on oxygenation during one-lung ventilation Düşük soluk hacimlerinin tek akciǧer ventilasyonunda oksijenasyon üzerine etkileri
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.17, sa.1, ss.5-11, 2011 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 17 Sayı: 1
- Basım Tarihi: 2011
- Doi Numarası: 10.5222/gkdad.2011.005
- Dergi Adı: Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.5-11
- Anahtar Kelimeler: One-lung ventilation, Oxygenation, Shunt, Tidal volume
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
Aim: In one-lung ventilation (OLV), use of same tidal volumes (TV) as in two-lung ventilation (TLV) is recommended. However, lower TVs are recently found to be associated withrelatively reduced inflammatory response. The aim of this study is to compare the effects of conventional ventilation using higher tidal volumes with those of the reduced TV application during OLV on the oxygenation. Methods: Thirty-one patients scheduled for elective lung resection were randomly assigned to two ventilation strategies in two different sequences using pressure-controlled ventilation (PCV) during OLV. During TLV, ventilation pressures were adjusted to obtain a TV required for the maintenance of normocapnia. During OLV, TVs were adjusted either by increasing the ventilation pressure to obtain the same TV as in TLV (normocapnic stage: StN) or artificial respiration was maintained by remaining in the same ventilation pressure as in TLV and allowing a hypercarbic state (hyypercapnic stage: StH). In each patient, both methods of the study were applied in two stages. At the end of every stage, PaO 2, PaCO 2, TV, and Qs/Qt were recorded. Results: There was a significant difference in TV (569±180 mL vs 399±136 mL; p<0.001) and in PCO, (39.1±6.2 mmHg vs 46±7.6 mmHg; p<0.001) between StN and StH, respectively. In other words in our study TV values were significantly lower in StN, while PaCO 2 measurements were found to be significantly higher in StH. There was a slight but insignificant decrease in PaO 2 and a slight but insignificant increase in Qs/Qt during StH compared to StN (StN vs StH: 192±56 mmHg vs 176±50 mmHg; and 28.7±8.8% vs 31.4±8.4%). Conclusion: Since lower TVs do not result in any important clinical change in oxygenation during OLV, ventilation with lower TV can be used without any hesitation.