Premium
Controlled hypercapnia during one‐lung ventilation in patients undergoing pulmonary resection
Author(s) -
Sticher J.,
Müller M.,
Scholz S.,
Schindler E.,
Hempelmann G.
Publication year - 2001
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2001.045007842.x
Subject(s) - medicine , hypercapnia , ventilation (architecture) , anesthesia , oxygenation , vascular resistance , cardiac index , thoracotomy , lung , hemodynamics , cardiac output , tidal volume , hypoxic pulmonary vasoconstriction , cardiology , respiratory system , mechanical engineering , acidosis , engineering
Background: In a pilot study, the haemodynamic and gas exchange effects of acute hypercapoia during one‐lung ventilation in thoracotomy patients were investigated. The effects of normocapnic one‐lung ventilation (OLV‐N) on haemodynamics and pulmonary gas exchange were compared with those of hypercapnic one‐lung ventilation (OLV‐H) in 14 patients undergoing pulmonary lobectomy. Methods: Hypercapnia was induced by decreasing tidal volume until PaCO 2 increased to 8–9 kPa. During OLV, minute ventilation was reduced from 8.8±1.7 to 4.2±0.7 l min −1 . Results: Cardiac index (from 3.3±0.6 to 3.9±0.6 l min −1 , P <0.01) and pulmonary vascular resistance index (from 245±96 to 347±125 dyn s cm −5 m −2 , P <0.05) increased during OLV‐H, whereas systemic vascular resistance index decreased from 1952±403 to 1636±361 dyn s cm −5 m −2 ( P <0.01). Pulmonary oxygenation remained unchanged. Conclusions: All patients had an uneventful course during OLV‐H. The determinants of pulmonary oxygenation during hypercapnic one‐lung ventilation remain to be further elucidated.