Atemwegsmanagement bei der Ein-Lungen-Ventilation

Motsch, J.; Wiedemann, Klaus; Roggenbach, J.

doi:10.1007/3-540-29619-0_6

Cited by 1 publication

(2 citation statements)

References 29 publications

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“…In conclusion, pressure-controlled ventilation improves alveolar gas exchange and augments the recruitment of slower alveolar regions during MIDCAB procedures with OLV and should be a general strategy for OLV management [2,14,15].…”

Section: Original Cardiovascularmentioning

confidence: 99%

“…One-lung anaesthesia is an established form of ventilation during certain types of thoracic surgery, for example isolation of a lung with broncho-pleural fistula or pulmonary abscess [1,2], and single or bilateral sequential lung transplantation [2,3]. However, one-lung ventilation (OLV) with the entire tidal volume delivered only to one lung causing higher airway pressures may produce a marked alteration of ventilation, gas exchange and circulation, caused by compression of intra-alveolar vessels, increasing intrapulmonary shunt fraction (Q S /Q T ) and counteracting the physiological blood flow diversion to the nondependent lung by hypoxic pulmonary vasoconstriction [2].…”

Section: Introductionmentioning

confidence: 99%

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Pressure-Controlled versus Volume-Controlled One-Lung Ventilation for MIDCAB

Heimberg

Winterhalter

Strüber

et al. 2006

Thorac cardiovasc Surg

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One-lung ventilation is limited by hypoventilation and hypoxemia because of increasing airway pressure and intrapulmonary shunt. Previous clinical studies compared pressure-controlled versus volume-controlled ventilation during one-lung ventilation in patients with pre-existing pulmonary disease. We studied 50 patients undergoing thoracotomy and one-lung ventilation because of cardiovascular disease. After two-lung ventilation with volume-controlled ventilation, patients were divided randomly into two groups. In one group, ventilation was switched to pressure-controlled ventilation after starting one-lung ventilation. In the other group, volume-controlled ventilation was continued. Parameters of ventilation, pulmonary function and systemic and pulmonary hemodynamics were recorded. We observed, that peak airway pressure, dead space ventilation and arterial carbon dioxide partial pressure were significantly higher during volume-controlled ventilation. After one-lung ventilation patients with pressure controlled ventilation had lower alveolar-arterial oxygen tension difference and a higher arterial oxygen partial pressure with significant differences for those patients in the intensive care unit. We conclude that pressure-controlled ventilation may be useful to improve gas exchange and alveolar recruitment during one lung ventilation.

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Section: Original Cardiovascularmentioning

confidence: 99%