The Effects of Inhaled Nitric Oxide and Its Combination with Intravenous Almitrine on PaO2 During One-Lung Ventilation in Patients Undergoing Thoracoscopic Procedures

Moutafis, M.; Liu, Ngai; Dalibon, Nicolas; Kuhlman, G; Ducros, Laurent; Castelain, M.H.; Fischler, Marc

doi:10.1097/00000539-199711000-00032

Cited by 36 publications

(11 citation statements)

References 18 publications

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“…The calculation of sample size of the study, with two-tailed α error of 5 % and β error of 20 %, was done based on PaO 2 measured during OLV under propofol anaesthesia in a published study [123.7 (54.7) mmHg] (3). Based on this measurement, thirty patients per group were required to detect a difference of 39.7 mmHg in the lowest PaO2 between two groups.…”

Section: Methodsmentioning

confidence: 99%

A Comparison of Effects of Propofol and Isoflurane on Arterial Oxygenation Pressure, Mean Arterial Pressure and Heart Rate Variations Following One-Lung Ventilation in Thoracic Surgeries

Attar¹,

Tabari²,

Rahnamazadeh³

et al. 2014

Iran Red Crescent Med J

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Background:Hypoxia occurs during one-lung ventilation (OLV) due to the arteriovenous shunt of unsaturated pulmonary venous blood. Hypoxic pulmonary vasoconstriction (HPV) acts as a defense mechanism against shunting. In thoracic surgery, anesthetics with minimal inhibitory effect on HPV and minimal hemodynamic changes are preferred.Objectives:The present study aimed to evaluate the effects of propofol and isoflurane on patients’ arterial oxygen pressure following one-lung ventilation during thoracic surgeries.Materials and Methods:In this randomized clinical trial study which was conducted in Iran, sixty patients with ASA (The American Society of Anesthesiologists) class I & II who were candidates for right elective thoracotomy were divided in two groups. Induction of anesthesia in the two groups was conducted using the same method, and left double-lumen endotracheal tube was inserted. In the first group propofol was used for the maintenance of anesthesia, and isoflurane for the second group. During two-lung ventilation and at minutes 5 and 10 after OLV, ABG (arterial blood gas) (for detecting the mean pressure of arterial oxygen), mean arterial pressure and heart rate were recorded.Results:Sixty patients (mean age = 4124.18 ± 18.63 years) were divided into two groups. The age and gender of the subjects were not statistically different between the two groups. In the propofol group, the arterial oxygen pressure during two-lung ventilation and at 5th and 10th minutes after OLV was 263.14 ± 136.19, 217.40 ± 133.99 and 182.34 ± 122.39; in the isoflurane group, it was reported as 206.29 ± 135.59, 164.78 ± 118.90 and 155.35 ± 109.21 mmHg, respectively. In the propofol group, mean arterial pressure during two-lung ventilation, and 5th and 10th minutes after OLV, was 84.01 ± 20.67, 88.15 ± 20.23 and 86.10 ± 19.13, respectively; regarding the isoflurane group, it was reported as 79.66 ± 17.04, 84.78 ± 20.19 and 86.50 ± 17.07 mmHg, respectively. In the propofol group, heart rate during two-lung ventilation, and 5th and 10th minutes after OLV was 92.77 ± 17.20, 94.0 ± 18.34 and 94.33 ± 21.03, respectively; In the isoflurane group, it was reported as 92.87 ± 16.96, 91.8 ± 18.75 and 91.05 ± 17.20 min, respectively. These values were statistically similar in the two study groups.Conclusions:The effects of propofol on hemodynamics and arterial oxygen pressure during one- or two-lung ventilation were not different from those of isoflurane.

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Section: Methodsmentioning

confidence: 99%

A Comparison of Effects of Propofol and Isoflurane on Arterial Oxygenation Pressure, Mean Arterial Pressure and Heart Rate Variations Following One-Lung Ventilation in Thoracic Surgeries

Attar¹,

Tabari²,

Rahnamazadeh³

et al. 2014

Iran Red Crescent Med J

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“…After the onset of baseline left OLV in PEEP 0 cm H 2 O, the left lung was ventilated with PEEP levels of 0, 5…”

Section: Experimental Designmentioning

confidence: 99%

“…Accepted for publication: April 12, 2005 Peroperative hypoxaemia frequently occurs during one-lung ventilation (OLV), [1][2][3][4] even in patients with healthy lungs. [5][6][7] Mechanisms involved in OLV-related hypoxaemia (OLV-RH) include the persistence of perfusion in the non-dependent non-ventilated lung 8 and ventilation to perfusion mismatch in the ventilated lung. 9 Indeed, the dependent lung is prone to collapse during expiration, with consequent worsening in ventilation to perfusion mismatching.…”

mentioning

confidence: 99%

Effects of PEEP on oxygenation and respiratory mechanics during one-lung ventilation

Michelet

Roch

Brousse

et al. 2005

British Journal of Anaesthesia

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“…75 As NO distributes directly into the alveoli, it is a selective microvasodilator only of those capillaries adjacent to ventilated alveoli, and therefore improve V/Q matching. 78,79 These results may be important for patients with a marginal respiratory reserve who are unable to maintain oxygenation on OLV. There was no beneficial effect of NO in the absence of hypoxemia, pulmonary vasoconstriction, and elevated pulmonary pressure during OLV.…”

Section: Modulating the Pulmonary Circulationmentioning

confidence: 98%

New Developments in Thoracic Anesthesia

Cohen¹

2010

ASA Refresher Courses in Anesthesiology

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The Effects of Inhaled Nitric Oxide and Its Combination with Intravenous Almitrine on PaO2 During One-Lung Ventilation in Patients Undergoing Thoracoscopic Procedures

Cited by 36 publications

References 18 publications

A Comparison of Effects of Propofol and Isoflurane on Arterial Oxygenation Pressure, Mean Arterial Pressure and Heart Rate Variations Following One-Lung Ventilation in Thoracic Surgeries

A Comparison of Effects of Propofol and Isoflurane on Arterial Oxygenation Pressure, Mean Arterial Pressure and Heart Rate Variations Following One-Lung Ventilation in Thoracic Surgeries

Effects of PEEP on oxygenation and respiratory mechanics during one-lung ventilation

New Developments in Thoracic Anesthesia

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