One-Lung Ventilation in Anesthesia

Rocca, Giorgio Della; Vetrugno, Luigi

doi:10.1007/978-3-319-31398-6_13

Cited by 2 publications

(3 citation statements)

References 46 publications

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“…All surgeries performed under general anesthesia require artificial ventilation using a mechanical ventilator [ 4 , 5 , 6 , 7 ]. Normal ventilation in an awake person is achieved by creating negative pressure that pulls a volume of air into the lungs.…”

Section: Introductionmentioning

confidence: 99%

“…Known as one-lung ventilation (OLV), this increases the potential for damage to the single ventilated lung [ 9 , 10 , 11 ]. Secondly, most patients who have lung surgery have abnormal lungs, making them more vulnerable to lung damage with mechanical ventilation, increasing the risk for developing respiratory complications [ 4 , 5 , 6 , 7 , 11 ]. Forcing air into the lungs has significant potential to cause injury if the frequency, pressure, and volume are not carefully controlled.…”

Section: Introductionmentioning

confidence: 99%

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Temporal and Spatial Patterns of Inflammation and Tissue Injury in Patients with Postoperative Respiratory Failure after Lung Resection Surgery: A Nested Case–Control Study

Kormish,

Ghuman,

Liu

et al. 2023

IJMS

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Thoracic surgeries involving resection of lung tissue pose a risk of severe postoperative pulmonary complications, including acute respiratory distress syndrome (ARDS) and respiratory failure. Lung resections require one-lung ventilation (OLV) and, thus, are at higher risk of ventilator-induced lung injury (VILI) attributable to barotrauma and volutrauma in the one ventilated lung, as well as hypoxemia and reperfusion injury on the operated lung. Further, we also aimed to assess the differences in localized and systemic markers of tissue injury/inflammation in those who developed respiratory failure after lung surgery versus matched controls who did not develop respiratory failure. We aimed to assess the different inflammatory/injury marker patterns induced in the operated and ventilated lung and how this compared to the systemic circulating inflammatory/injury marker pattern. A case–control study nested within a prospective cohort study was performed. Patients with postoperative respiratory failure after lung surgery (n = 5) were matched with control patients (n = 6) who did not develop postoperative respiratory failure. Biospecimens (arterial plasma, bronchoalveolar lavage separately from ventilated and operated lungs) were obtained from patients undergoing lung surgery at two timepoints: (1) just prior to initiation of OLV and (2) after lung resection was completed and OLV stopped. Multiplex electrochemiluminescent immunoassays were performed for these biospecimen. We quantified 50 protein biomarkers of inflammation and tissue injury and identified significant differences between those who did and did not develop postoperative respiratory failure. The three biospecimen types also display unique biomarker patterns.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Temporal and Spatial Patterns of Inflammation and Tissue Injury in Patients with Postoperative Respiratory Failure after Lung Resection Surgery: A Nested Case–Control Study

Kormish,

Ghuman,

Liu

et al. 2023

IJMS

View full text Add to dashboard Cite

show abstract

“…[6] Hypoxic pulmonary vasoconstriction (HPV) is the primary compensatory mechanism of the body against the pulmonary shunt, which is to divert the pulmonary perfusion blood from the non-ventilated area to the ventilated area, thus reducing pulmonary shunt and improving hypoxemia. [7–9] Anesthetics is one of the critical factors affecting HPV, and anesthesiologists must develop an anesthetic plan with minimal HPV inhibition for patients requiring 1-lung ventilation. [10,11] Dexmedetomidine is a highly selective α 2 adrenergic receptor agonist, which can directly stimulate peripheral α 2 receptors to induce vasoconstriction and increase blood pressure, and also act on central α 2 receptors to suppress sympathetic excitation, [12] which could dilate blood vessels and lower blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane maintained during one-lung ventilation: A case–control study

Wang

Gong²,

Yu³

et al. 2022

Medicine

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Background: The effects of dexmedetomidine on the circulatory system are complex. It is difficult to predict its effects on intrapulmonary shunts and hypoxic pulmonary vasoconstriction in patients with one-lung ventilation. This study aimed to investigate the effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane during one-lung ventilation. Methods: Forty patients requiring thoracoscopic lobectomy were randomly divided into the dexmedetomidine group (Group D, n = 20) and the normal saline group (Group N, n = 20). The arterial partial pressure of oxygen (PaO2), pulmonary shunt fraction (Qs/Qt), mean end-tidal sevoflurane concentration, mean arterial pressure, and heart rate were compared between the 2 groups at 3 time points: (i) after 5 minutes of two-lung ventilation (T0), (ii) after 30 minutes of one-lung ventilation (OLV) (T1), and (iii) after 45 minutes of OLV (T2). The dosage of sevoflurane from the beginning of OLV to T2 was calculated. Results: There were no significant differences in age, body mass index, and FEV1/FVC between Groups D and N (P > .05). At T0, T1, and T2, the PaO2 levels of Group D and Group N were similar (P > .05), and the PaO2 levels of Group D and Group N decreased after OLV. The Qs/Qt level of Groups D and N were similar at T0 (P > .05), and the level of Groups D and N at T1 and T2 was higher than that at T0. The Qs/Qt of Group D was statistically significantly lower than that of Group N at T1 and T2 (P < .05). Conclusion: Compared with the control group, we found that dexmedetomidine can reduce the intrapulmonary shunt fraction and improve the body’s status during OLV.

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One-Lung Ventilation in Anesthesia

Cited by 2 publications

References 46 publications

Temporal and Spatial Patterns of Inflammation and Tissue Injury in Patients with Postoperative Respiratory Failure after Lung Resection Surgery: A Nested Case–Control Study

Temporal and Spatial Patterns of Inflammation and Tissue Injury in Patients with Postoperative Respiratory Failure after Lung Resection Surgery: A Nested Case–Control Study

Effect of dexmedetomidine on intrapulmonary shunt in patients with sevoflurane maintained during one-lung ventilation: A case–control study

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