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

Du Gyun Yun, Jong In Han, Dong Yeon Kim, Jong Hak Kim, Youn Jin Kim, Rack Kyung Chung

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The present study will focus on the rationale for the use of small tidal volume with 6 cmH2O 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 cmH2O 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.

Original languageEnglish
Pages (from-to)329-333
Number of pages5
JournalKorean Journal of Anesthesiology
Volume67
Issue number5
DOIs
StatePublished - 1 Nov 2014

Keywords

  • One-lung ventilation
  • Oxygenation
  • Positive-pressure respiration
  • Thoracoscopy
  • Tidal volume

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