Two-Lung and One-Lung Ventilation in Patients with Chronic Obstructive Pulmonary Disease: The Effects of Position and FIO2

Abstract

This study compares oxygenation during thoracic surgery during periods of two-lung and one-lung ventilation with patients in the supine and lateral positions when using three different fraction of inspired oxygen values. Arterial oxygen tension was decreased in all three groups during one-lung ventilation in comparison with the two-lung ventilation values, but the decrease was significantly less in the lateral, compared with the supine position.

Optimal PEEP during one‐lung ventilation with capnothorax: An experimental study

“…With an insufflation pressure of 16 cm H 2 O a PEEP between 12 and 18 cm H 2 O was not only optimal for the ventilatory parameters but also for the hemodynamics. 82 [14] 82 [11] 72 [15] 70 [18] 81 [7] 83 [9] 81 [12] 76 [11] 77 [7] 74 [12] 65 [14] 68 [21] 63 [15] 0.005 SvO 2 (%) 73 [8] 44 [9] 46 [14] 54 [17] 54 [7] 60 [9] 61 [13] 52 [9] 54 [6] 43 [9] 37 [17] 33 [15] 28 [16] <0.0001…”

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

“…Several factors are known to contribute to the magnitude of intrapulmonary shunt during OLV, including hypoxic pulmonary vasoconstriction (HPV) [18], CO, and positioning of patients [19]. CO, when augmented to double or triple baseline, can increase shunt by increasing pulmonary artery pressure that results in opposing the weak forces affecting HPV [20,21] and by increasing mixed venous oxygen tension, which is shown to inhibit HPV [22].…”

Step-by-step clinical management of one-lung ventilation: Continuing Professional Development

“…35 A F I O 2 of 0.5-0.8 should be adequate at the initiation of OLV in the majority of cases, after which, it should be titrated to the minimum required to achieve oxygen saturation (SpO 2 ) of 92-96%. Recommendations…”