Lung flooding — a new method for complete lung sonography

Lesser, T. H. J.; Klinzing, Stefan; Schubert, Harald; Klein, U.; Bartel, M

doi:10.1007/s004330050092

Cited by 20 publications

(16 citation statements)

References 10 publications

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“…To obtain optimum sonographic conditions, it is necessary to eliminate all gas residues from the lung after total atelectasis. This can be achieved by passively flooding the non-ventilated lung with a commercial whole electrolyte solution [ 10].…”

Section: Discussionmentioning

confidence: 99%

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May pentoxifylline improve lung function after one-lung flooding?

et al. 2001

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One-lung flooding makes the intraoperative sonography of round pulmonary lesions possible. During the flooded phase, the flooded lung suffers a significant reduction in perfusion. After ischemia and reperfusion, neutrophil granulocytes lead to further tissue injuries. A study was made on four animals to determine whether administration of pentoxifylline--a potent inhibitor of granulocyte adhesion to the endothelium--improves lung function after one-lung flooding. Two animals were subjected to thoracotomy with extended hemodynamic monitoring. Thoracoscopy was performed on two other animals, which were extubated after the flooding liquid was drained and survived for 24 degrees h. A bolus of 1 mg/kg of pentoxifylline was administered at the time of thoracotomy/thoracoscopy. followed by continuous infusion of pentoxifylline at a rate of 1.5 mg/kg per hour until 30 degrees min after reventilation (thoracotomy), or until extubation, respectively. The control group consisted of animals employed in previous experiments. Except for pentoxifylline administration, they were subjected to identical experimental conditions. The control group for the thoracotomy experiment comprised 14 animals, that for the thoracoscopy experiment three animals. The experiments proved that 30 degrees min after the draining of the flooding liquid and reventilation, all four pentoxifylline-treated animals had a higher partial arterial oxygen pressure and a lower pulmonary shunt volume compared with the control animals. In the two animals that survived, a positive effect on lung function was no longer detectable 24 degrees h after extubation. The administration did not lead to a drop in the pulmonary arterial pressure and did not cause any hemodynamic changes other than a moderate tachycardia.

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Section: Discussionmentioning

confidence: 99%

“…We have therefore developed the technique of unilateral flooding, which makes the lung accessible to complete sonographic examination [ 10]. After intubation with a double-lumen tube and disconnection of one semitube, one lung can be completely flooded with a whole electrolyte solution.…”

Section: Introductionmentioning

confidence: 99%

May pentoxifylline improve lung function after one-lung flooding?

et al. 2001

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“…The collapsed left lung was flooded with isotonic whole electrolyte solution as described earlier [4].…”

Section: Anaesthesia and Artificial Respirationmentioning

confidence: 99%

“…Flooding with a suitable liquid makes the lung accessible for complete ultrasonic examination [4]. For intraoperative application, this method is useful only if it allows small pulmonary lesions to be identified also in the deeper regions of the lung parenchyma.…”

Section: Introductionmentioning

confidence: 99%

Simulation of lung lesions for validating the sonography of the flooded lung

Lesser

Klinzing

Schubert

et al. 1999

Research in Experimental Medicine

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The quality of sonography of a unilaterally flooded lung needs to be validated on lesions of different echogenicity, size and subpleural position. Lesions were simulated in 12 young pigs with three different methods. After transbronchial (method 1) or transpleural puncture (method 2), diverse substances were injected into the lung. After 4 weeks, the thorax was opened and the lung flooded for the sonographic location of the lesions. In method 3, pulmonary lesions were simulated in an acute experiment after thoracotomy by transpleural injection or by filling of a Fogarty catheter balloon and were located sonographically. Transbronchial injection of alcohol invariably led to subsegment atelectasis. Only 25% of thoracoscopically controlled transpleural injections produced focal lesions in experiments in which the animals survived. Representative lesions were found only after alcohol injections. Transpleural injection of blood or a blood/Echovist suspension (method 3) simulated isoechogenic or echo-rich lesions with indistinct boundaries. By filling a Fogarty catheter balloon with saline solution or Echovist suspension, we succeeded in simulating echo-free or echo-rich lesions with smooth contours, located in different subpleural depths. After unilateral lung flooding, sonography successfully detected the locations of all these lesions and revealed their correlation with functional structures. Sonography of the flooded lung might be helpful in the intraoperative location of lesions, especially in the context of video-assisted thoracoscopic surgery.

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“…Therefore, we developed the technique of fluid flooding, which allows the sonographic examination of the complete lung [8]. A sonographic examination of lung succeeded by filling the unventilated half-lung with isotonic fluid after intubation with a double-lumen tube.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamics and gas exchange during experimental one-lung fluid flooding in pigs

Klinzing

Lesser

Schubert

et al. 1999

Research in Experimental Medicine

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One-sided fluid flooding of the lung after intubation with a double-lumen tube facilitates pulmonary sonography during surgery. Arterial blood pressure, cardiac index, and heart rate remained unchanged during one-lung fluid flooding in healthy animals. The arterial PO(2) was greater by about 100 mmHg after flooding one lung with 15 ml/kg fluid and ventilation with a FiO(2) of 1.0 compared with total atelectasis. This seems to be identical to a continuos positive airway pressure level of 5 cm H(2)O with pure oxygen on the nonventilated lung. The one-sided fluid flooding induced a statistically significant increase in pulmonary artery pressures and pulmonary capillary wedge pressure. In comparison with total atelectasis, fluid flooding in tendency reduced the pulmonary right-left shunt and increased the arterial PO(2).

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Lung flooding — a new method for complete lung sonography

Cited by 20 publications

References 10 publications

May pentoxifylline improve lung function after one-lung flooding?

May pentoxifylline improve lung function after one-lung flooding?

Simulation of lung lesions for validating the sonography of the flooded lung

Hemodynamics and gas exchange during experimental one-lung fluid flooding in pigs

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