Abstract

One-lung ventilation (OLV) is the isolation and selective ventilation of one lung field. OLV allows the collapse of lung lobes on the side of the thoracic surgical approach to facilitate observation of intrathoracic structures and to achieve lung immobility. OLV be achieved by endotracheal intubation with double lumen tubes or bronchial blockers. In this study, cardiopulmonary consequences of two-lung ventilation (TLV), OLV and Re-TLV (TLV after OLV) were evaluated in 5 dogs. The dogs were anesthetized with mask induction and maintained with isoflurane in oxygen. Tidal volume and respiratory rates were set to maintain end-tidal $CO_2$ at $40{\pm}2mmHg$ during instrumentation. Following instrumentation, the dogs were placed in right lateral recumbency and induced spontaneously respiration state. Effect of TLV on hemodynamic and pulmonary variables were recorded. Then, the left bronchus was obstructed by endotracheal intubation with double lumen endotracheal tube to achieve OLV state and recording was continued. After OLV, double lumen endotracheal tube was extubated, and standard endotracheal tubes was intubated again. In this study, spontaneous OLV caused significant decrease in $PaO_2$, arterial oxygen saturation, mixed-venous oxygen saturation, and increase in $PaCO_2$. Especially, a significant elevation in $PaCO_2$ and respiratory acidosis were remarkable findings. So spontaneous ventilation in OLV affected gas exchange and hemodynamic function.

주제어

#spontaneous one-lung ventilation   #double lumen endotracheal tube   #cardiorespiratory effect   #dog  

저자의 다른 논문

참고문헌 (33)

1. Bee D, Wach RA. Hypoxic pulmonary vasoconstriction in chronically hypoxic rats. Respir Physiol 1984, 56, 91-103 
2. Benumof JL, Wahrenbrock EA. Dependency of hypoxic pulmonary vasoconstriction on temperature. J Appl Physiol 1977, 42, 56-58 
3. Cohen E. Physiology of the lateral position and onelung ventilation. Chest Surg Clin N Am 1997, 7, 753-771 
4. Cullen DJ, Eger EI. Cardiovascular effects of carbon dioxide in man. Anesthesiology 1974, 41, 345-349 
5. Heneghan CP, Scallan MJ, Branthwaite MA. Endtidal carbon dioxide during thoracotomy. Its relation to blood level in adults and children. Anesthesiology 1981, 36, 1017-1021 
6. Sykes MK, Gibbs JM, Loh L, Marin JB, Obdrzalek J, Arnot RN. Preservation of the pulmonary vasoconstrictor response to alveolar hypoxia during the administration of halothane to dogs. Br J Anaesth 1978, 12, 1185-1196 
7. Tachibana M, Abe S, Tabara H, Yoshimura H, Matsuura H, Nagasue N, Nakamura T. One-lung or two-lung ventilation during transthoracic oesophagectomy?. Can J Anaesth 1994, 41, 710-715 
8. Dries DJ. Permissive hypercapnia. J Trauma 1995, 39, 984-989 
9. Powell LL. Causes of respiratory failure. Vet Clin North Am Small Anim Pract 2002, 32, 1049-1058 
10. Lumb AB. Change in the carbon dioxide tension. In: Lumb AB, Nunn JF (eds.). Nunn's Applied Respiratory Physiology. pp. 460-471, 5th ed. Butterworth, London, 1987 
11. Salman MD. Effect of one-lung ventilation on oxygen delivery in anesthetized dogs with an open thoracic cavity. Am J Vet Res 2003, 64, 443-448 
12. Groh J, Kuhnle GE, Ney L, Sckell A, Goetz AE. Effect of isoflurane on regional pulmonary blood flow during or lung ventilation. Br. J Anaesth 1995, 74, 209-216 
13. Lejeune P, Brimioulle S, Leeman M, Hallemans R, Melot C, Naeije R. Enhancement of hypoxic pulmonary vasoconstriction by metabolic acidosis in dogs. Anesthesiology 1990, 73, 256-264 
14. Marshall C, Marshall B. Site and sensitivity for stimulation of hypoxic pulmonary vasoconstriction. J Appl Physiol 1983, 55, 711-716 
15. Baraka A, Aouad M, Taha S, El-Khatib M, Kawkabani N, Soueidi A. Apnea-induced hemoglobin desaturation during one-lung vs two-lung ventilation. Can J Anaesth 2000, 47, 58-61 
16. Marshall C, Lindgren L, Marshall BE. Metabolic and respiratory hydrogen ion effects on hypoxic pulmonary vasoconstriction. J Appl Physiol 1984, 57, 545-550 
17. Morgan GE, Mikhail MS, Murray MJ. Anesthesia for thoracic surgery In: Morgan GE, Mikhail MS, Murray MJ, Larson CP (eds.). Clinical Anesthesiology. pp. 525-534, 3rd ed. Lange Medical Blooks, New York, 1996 
18. Day TK. Blood gas analysis. Vet Clin North Am Small Anim Pract 2002, 32, 1031-1048 
19. James BE, Edmond C, Steven MN. Anesthesia for thoracic surgery In: Barash PG, Cullen BF, Stoelting RK (eds.). Clinical Anesthesia. pp. 817-833. 4th ed. Lippincott Williams & Wilkins, Philadelphia, 2001 
20. Barer GR, Howard P, McCurrie JR, Shaw JW. Change in the pulmonary circulation after bronchial occlusion in anesthetized dogs and cats. Cir Res 1969, 25, 747-764 
21. Barton L. Respiratory muscle fatigue, Vet Clin North Am Small Anim Pract 2002, 32, 1059-1079 
22. Hyman AL, Kadowitz PJ. Effects of alveolar and perfusion hypoxia and hypercapnia on pulmonary vascular resistance in the lamb. Am J Physiol 1975, 228, 397-403 
23. Gentilello LM, anardi D, Mock C, Arreola-Risa C, Maier RV. Permissive hypercapnia in trauma patients. J Trauma 1995, 39, 846-853 
24. Johnson DH, Chang PC, Hurst TS, Reynolds FB, Lang SA, Mayers I. Changes in PETCO2 and pulmonary blood flow after bronchial occlusion in dogs. Can J Anaesth 1992, 39, 184-191 
25. Cutaia M, Rounds S. Hypoxic pulmonary vasoconstriction. Physiologic significance, mechanism, and clinical relevance. Chest 1990, 97, 706-718 
26. Marshall C, Lindgren L, Marshall BE. Effects of halothane, enflurane, and isoflurane on hypoxic pulmonary vasoconstriction in rat lungs in vitro. Anesthesiology 1984, 60, 304-308 
27. Kiely DG, Cargill RI, Lipworth BJ. Effects of hypercapnia on hemodynamic, inotropic, lusitropic, and electrophysiological indices in human. Chest 1996, 109, 1215-1221 
28. Lejeune P, Vachiery JL, De Smet JM, Leeman M, Brimioulle S, Delcroix M, Melot C, Naeije R. PEEP inhibts hypoxic pulmonary vasoconstriction in dogs. J Appl Physiol 1991, 70, 1867-1873 
29. Malmkvist G. Maintenance of oxygenation during onelung ventilation. Effect of intermittent reinflation of the collapsed lung with oxygen. Anesth Analg 1989, 68, 763-766 
30. Marshall B, Hanson CW, Frasch F, Marshall C. Role of hypoxic pulmonary vasoconstriction in pulmonary gas exchange and blood flow distribution. 2. Pathophysiology. Intensive Care Med 1994, 20, 379-389 
31. Campos JH, Reasoner DK, Moyers JR. Comparison of a modified double-lumen endotracheal tube with a single-lumen tube with enclosed bronchial blocker. Anesth Analg 1996, 83, 1268-1272 
32. Cantwell SL, Duke T, Walsh PJ, Pemedios AM, Walker D, Ferguson JG. One-lung versus two-lung ventilation in the closed-chest anesthetized dog: A comparison of cardiopulmonary parameters. Vet Surgery 2000, 29, 365-373 
33. Garcia F, Prandi D, Pena T, Franch J, Trasserra O. Examination of the thoracic cavity and lung lobectomy by means of throcoscopy in dogs. Can Vet J 1998, 39, 285-291 

이 논문을 인용한 문헌 (0)

1. 이 논문을 인용한 문헌 없음