Co-administration of ephedrine prevents reductions in cardiac output and systemic oxygen delivery secondary to lung compression maneuvers during one-lung ventilation, without reducing arterial oxygenation

Abstract

Although arterial oxygenation was not significantly improved by the nondependent lung compression, the addition of intravenous ephedrine to nondependent lung compression prevented the decrease in systemic oxygen delivery without deterioration of arterial oxygenation during OLV in patients undergoing esophagectomy.

Hypoxaemia associated with one-lung anaesthesia: new discoveries in ventilation and perfusion

“…Prevention of reduction of cardiac output and hence oxygen delivery may be attenuated by administration of inotropic agents such as ephedrine. 25 In addition, haemoglobin (Hb) may influence hypoxaemia by affecting capillary oxygen content as shown in the following equation, in which SaO 2 is arterial oxygen saturation, and P A O 2 is alveolar oxygen partial pressure:…”

Arterial Oxygenation and Management of Hypoxemia During VATS

“…Clamping of the operative pulmonary artery has been described during VATS surgery [47,48]. If hilar exposure is not available, physical distortion of the lung anatomy can reduce pulmonary blood flow, but may be associated with decreases in the cardiac index because of increased right ventricular afterload [49]. Caution must therefore be exercised depending on the baseline right ventricular function and the hemodynamic response to PA manipulation.…”