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Steinack C, Balmer H, Ulrich S, Gaisl T, Franzen DP. One-Lung Ventilation during Rigid Bronchoscopy Using a Single-Lumen Endotracheal Tube: A Descriptive, Retrospective Single-Center Study. J Clin Med 2023; 12:jcm12062426. [PMID: 36983426 PMCID: PMC10057473 DOI: 10.3390/jcm12062426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Using one-lung ventilation (OLV) through a single-lumen endotracheal tube (SLT) in the untreated lung during rigid bronchoscopy (RB) and jet ventilation, high oxygenation can be guaranteed, whilst procedures requiring thermal energy in the other lung are still able to be used. This pilot study aimed to examine the bronchoscopy-associated risks and feasibility of OLV using an SLT during RB in patients with malignant airway stenosis. All consecutive adult patients with endobronchial malignant lesions receiving OLV during RB from 1 January 2017 to 12 May 2021 were included. We assessed perioperative complications in 25 RBs requiring OLV. Bleeding grades 1, 2, and 3 complicated the procedure in two (8%), five (20%), and five (20%) patients, respectively. The median saturation of peripheral oxygen remained at 94% (p = 0.09), whilst the median oxygen supply did not increase significantly from 0 L/min to 2 L/min (p = 0.10) within three days after the bronchoscopy. The 30-day survival rate of the patients was 79.1% (95% CI 58.4-91.1%), all of whom reported an improvement in subjective well-being after the bronchoscopy. OLV using an SLT during RB could be a new treatment approach for endobronchial ablative procedures without increasing bronchoscopy-associated risks, allowing concurrent high-energy treatments.
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Affiliation(s)
- Carolin Steinack
- Department of Pulmonology, Interventional Lung Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Helene Balmer
- Department of Pulmonology, Interventional Lung Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Silvia Ulrich
- Department of Pulmonology, Interventional Lung Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Thomas Gaisl
- Department of Pulmonology, Interventional Lung Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Daniel P Franzen
- Department of Pulmonology, Interventional Lung Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
- Department of Internal Medicine, Spital Uster, Brunnenstrasse 42, 8610 Uster, Switzerland
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2
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Systematic Review and Meta-Analysis of Efficiency and Safety of Double-Lumen Tube and Bronchial Blocker for One-Lung Ventilation. J Clin Med 2023; 12:jcm12051877. [PMID: 36902663 PMCID: PMC10003923 DOI: 10.3390/jcm12051877] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 01/29/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
One-lung ventilation is also used in some thoracic or cardiac surgery, vascular surgery and oesophageal procedures. We conducted a search of the literature for relevant studies in PubMed, Web of Science, Embase, Scopus and Cochrane Library. The final literature search was performed on 10 December 2022. Primary outcomes included the quality of lung collapse. Secondary outcome measures included: the success of the first intubation attempt, malposition rate, time for device placement, lung collapse and adverse events occurrence. Twenty-five studies with 1636 patients were included. Excellent lung collapse among DLT and BB groups was 72.4% vs. 73.4%, respectively (OR = 1.20; 95%CI: 0.84 to 1.72; p = 0.31). The malposition rate was 25.3% vs. 31.9%, respectively (OR = 0.66; 95%CI: 0.49 to 0.88; p = 0.004). The use of DLT compared to BB was associated with a higher risk of hypoxemia (13.5% vs. 6.0%, respectively; OR = 2.27; 95%CI: 1.14 to 4.49; p = 0.02), hoarseness (25.2% vs. 13.0%; OR = 2.30; 95%CI: 1.39 to 3.82; p = 0.001), sore throat (40.3% vs. 23.3%; OR = 2.30; 95%CI: 1.68 to 3.14; p < 0.001), and bronchus/carina injuries (23.2% vs. 8.4%; OR = 3.45; 95%CI: 1.43 to 8.31; p = 0.006). The studies conducted so far on comparing DLT and BB are ambiguous. In the DLT compared to the BB group, the malposition rate was statistically significantly lower, and time to tube placement and lung collapse was shorter. However, the use of DLT compared to BB can be associated with a higher risk of hypoxemia, hoarseness, sore throat and bronchus/carina injuries. Multicenter randomized trials on larger groups of patients are needed to draw definitive conclusions regarding the superiority of any of these devices.
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Chang TR, Yuan MK, Pan SF, Chuang CC, So EC. Double-Lumen Endotracheal Tube-Predicting Insertion Depth and Tube Size Based on Patient's Chest X-ray Image Data and 4 Other Body Parameters. Diagnostics (Basel) 2022; 12:diagnostics12123162. [PMID: 36553170 PMCID: PMC9777797 DOI: 10.3390/diagnostics12123162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
In thoracic surgery, the double lumen endotracheal tube (DLT) is used for differential ventilation of the lung. DLT allows lung collapse on the surgical side that requires access to the thoracic and mediastinal areas. DLT placement for a given patient depends on two settings: a tube of the correct size (or ‘size’) and to the correct insertion depth (or ‘depth’). Incorrect DLT placements cause oxygen desaturation or carbon dioxide retention in the patient, with possible surgical failure. No guideline on these settings is currently available for anesthesiologists, except for the aid by bronchoscopy. In this study, we aimed to predict DLT ‘depths’ and ‘sizes’ applied earlier on a group of patients (n = 231) using a computer modeling approach. First, for these patients we retrospectively determined the correlation coefficient (r) of each of the 17 body parameters against ‘depth’ and ‘size’. Those parameters having r > 0.5 and that could be easily obtained or measured were selected. They were, for both DLT settings: (a) sex, (b) height, (c) tracheal diameter (measured from X-ray), and (d) weight. For ‘size’, a fifth parameter, (e) chest circumference was added. Based on these four or five parameters, we modeled the clinical DLT settings using a Support Vector Machine (SVM). After excluding statistical outliers (±2 SD), 83.5% of the subjects were left for ‘depth’ in the modeling, and similarly 85.3% for ‘size’. SVM predicted ‘depths’ matched with their clinical values at a r of 0.91, and for ‘sizes’, at an r of 0.82. The less satisfactory result on ‘size’ prediction was likely due to the small target choices (n = 4) and the uneven data distribution. Furthermore, SVM outperformed other common models, such as linear regression. In conclusion, this first model for predicting the two DLT key settings gave satisfactory results. Findings would help anesthesiologists in applying DLT procedures more confidently in an evidence-based way.
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Affiliation(s)
- Tsai-Rong Chang
- Department of Computer Science and Information Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Mei-Kang Yuan
- Department of Radiology, An-Nan Hospital, China Medical University, Tainan 70965, Taiwan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
| | - Shao-Fang Pan
- Department of Cell Biology and Anatomy College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chia-Chun Chuang
- Department of Anesthesiology, An-Nan Hospital, China Medical University, Tainan 70965, Taiwan
| | - Edmund Cheung So
- Department of Anesthesiology, An-Nan Hospital, China Medical University, Tainan 70965, Taiwan
- Correspondence:
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Elsabeeny WY, Ibrahim MA, Abed SM, Shehab NN. Role of Lung Ultrasound in Confirmation of Double Lumen Endotracheal Tube Placement for Thoracic Surgeries: A Prospective Diagnostic Accuracy Study. Anesth Pain Med 2022; 12:e132312. [PMID: 36937173 PMCID: PMC10016132 DOI: 10.5812/aapm-132312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/09/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022] Open
Abstract
Background In thoracic surgeries requiring thoracotomy incisions, correct positioning of the double-lumen endotracheal tube (DLT) is mandatory. After the pandemic of novel COVID-19, using simple, noninvasive technology such as lung ultrasound (LUS) can be important in avoiding the possibility of spreading infectious diseases or contagious infections that can follow using fiberoptic bronchoscopy (FOB). Objectives We aimed to assess the accuracy of auscultation and LUS in relation to FOB in the assessment of DLT placement and to identify the possibility of using LUS as an alternative to FOB during DLT insertion. Methods This diagnostic accuracy study was conducted according to STARD guidelines; enrolled 120 cases requiring DLT intubation. After DLT insertion, all patients were examined by stethoscope, then by LUS for determination of DLT position, and then confirmed by FOB in the same patient. Results Three patients dropped out due to failed intubation, and only 117 cases were analyzed. Time was significantly longer for LUS than for auscultation and FOB and was insignificantly different between auscultation and FOB. Auscultation had 76.14% sensitivity, 34.48% specificity, and 65.81% accuracy in the determination of correct DLT placement. LUS had 92.05% sensitivity, 79.31% specificity, and 88.89% accuracy in detecting correct DLT placement. There was substantial agreement between LUS and FOB (κ = 0.705) and poor agreement between auscultation and FOB (κ = 0.104). Conclusions LUS can be used as a simple, noninvasive tool for detecting DLT placement with a substantial agreement with FOB.
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Affiliation(s)
- Walaa Y Elsabeeny
- Department of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
- Corresponding Author: Department of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - Mostafa A Ibrahim
- Department of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Sayed M Abed
- Department of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Nahla N Shehab
- Department of Anesthesia, Intensive Care and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
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Singley PM, Peterson TJ, Rallya WE, Iaconetti DJ, Khandhar SJ, Hodgson JA. Maintaining One-Lung Ventilation With an Endobronchial Blocker Through a Damaged Left-Sided Double-Lumen Tube: A Case Report. A A Pract 2022; 16:e01586. [PMID: 35605173 DOI: 10.1213/xaa.0000000000001586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
One-lung ventilation (OLV) can be accomplished utilizing a double-lumen tube (DLT) and an endobronchial blocker (EBB) or intentionally placing a standard endotracheal tube (ETT) into a mainstem bronchus. However, secondary options must be available should the primary method fail. We present a case where an EBB and a fiberoptic bronchoscope (FOB) were successfully passed through a left-sided DLT to reestablish right-lung isolation after the DLT bronchial cuff was surgically damaged. We advocate competency in placing both DLTs and EBBs, as well as having EBBs readily accessible as a secondary isolation method during OLV.
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Affiliation(s)
- Patrick M Singley
- From the Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Thomas J Peterson
- From the Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - William E Rallya
- From the Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | | | | | - John A Hodgson
- From the Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland
- Departments of Anesthesiology
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Shen L, Chen JQ, Yang XL, Hu JC, Gao W, Chai XQ, Wang D. Flurbiprofen used in one-lung ventilation improves intraoperative regional cerebral oxygen saturation and reduces the incidence of postoperative delirium. Front Psychiatry 2022; 13:889637. [PMID: 36117654 PMCID: PMC9470861 DOI: 10.3389/fpsyt.2022.889637] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We previously demonstrated that flurbiprofen increased arterial oxygen partial pressure and reduced intrapulmonary shunts. The present study aims to investigate whether flurbiprofen improves intraoperative regional cerebral oxygen saturation (rScO2) and reduces the incidence of postoperative delirium (POD) in elderly patients undergoing one-lung ventilation (OLV). METHODS One hundred and twenty patients undergoing thoracoscopic lobectomy were randomly assigned to the flurbiprofen-treated group (n = 60) and the control-treated group (n = 60). Flurbiprofen was intravenously administered 20 minutes before skin incision. The rScO2 and partial pressure of arterial oxygen (PaO2) were recorded during the surgery, and POD was measured by the Confusion Assessment Method (CAM) within 5 days after surgery. The study was registered in the Chinese Clinical Trial Registry with the number ChiCTR1800020032. RESULTS Compared with the control group, treatment with flurbiprofen significantly improved the mean value of intraoperative rScO2 as well as the PaO2 value (P < 0.05, both) and significantly reduced the baseline values of the rScO2 area under threshold (AUT) (P < 0.01) at 15, 30, and 60 min after OLV in the flurbiprofen-treated group. After surgery, the POD incidence in the flurbiprofen-treated group was significantly decreased compared with that in the control group (P < 0.05). CONCLUSION Treatment with flurbiprofen may improve rScO2 and reduce the incidence of POD in elderly patients undergoing thoracoscopic one-lung ventilation surgery for lung cancer. CLINICAL TRIAL REGISTRATION http://www.chictr.org/cn/, identifier ChiCTR1800020032.
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Affiliation(s)
- Liang Shen
- Department of Anesthesiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China.,Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Jia-Qi Chen
- Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Xin-Lu Yang
- Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Ji-Cheng Hu
- Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Wei Gao
- Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Xiao-Qing Chai
- Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
| | - Di Wang
- Pain Clinic, Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China
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Long Y, Zeng Q, He X, Ye H, Su Y, Zheng R, Yu J, Xu E, Li K. One-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome. Int J Hyperthermia 2020; 37:49-54. [PMID: 31918592 DOI: 10.1080/02656736.2019.1708483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose: To investigate the feasibility, efficacy and safety of one-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome.Materials and methods: From 5 January 2017 to 16 April 2019, 64 patients who underwent ultrasound-guided thermal ablation with a total of 75 liver malignant tumors located in the hepatic dome were enrolled in the present study. One-lung ventilation was employed to improve the acoustic window and protect the lung and diaphragm. If the one-lung ventilation was unsuccessful, artificial pleural effusion was added. The technical efficacy was confirmed by contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) 1 month later. After that, CT/MRI was performed every 3-6 months.Results: Among the enrolled patients, the technical success rate of one lung ventilation was 92.2% (59/64). The visibility scores of tumors were improved significantly after one-lung ventilation compared to those before one-lung ventilation (p < .001). Finally, 78.6% (55/70) of the tumors achieved clinical success of one-lung ventilation to become clearly visible and underwent thermal ablation. Fourteen of the remaining 15 tumors achieved a satisfactory acoustic window after combination of artificial pleural effusion. One lesion remained inconspicuous and partly affected by pulmonary gas. The follow-up period was 8 months (3-30 months). The technical efficacy rate was confirmed to be 100% (75/75). During the follow-up period, local tumor progression occurred in 2 patients (2/75, 2.7%). Major complications occurred in two patients (2/64, 3.1%) receiving one-lung ventilation.Conclusions: One-lung ventilation is a promising noninvasive method for the thermal ablation of hepatic dome tumors due to its efficacy and safety.
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Affiliation(s)
- Yinglin Long
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qingjing Zeng
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuqi He
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Huolin Ye
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yating Su
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Erjiao Xu
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kai Li
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Ashikhmina E. Commentary: To PEEP, or not to PEEP, that is no longer a question. J Thorac Cardiovasc Surg 2020; 160:1124-1125. [PMID: 32279961 DOI: 10.1016/j.jtcvs.2020.02.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Elena Ashikhmina
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minn.
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Clendenen N, Ahlgren B. Lung Isolation Techniques in Patients With Early-Stage or Long-Term Tracheostomy: A Clear Path Down a Tough Road. J Cardiothorac Vasc Anesth 2018; 33:440-441. [PMID: 30269887 DOI: 10.1053/j.jvca.2018.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Nathan Clendenen
- Department of Anesthesiology, University of Colorado Denver School of Medicine, Aurora, CO
| | - Bryan Ahlgren
- Department of Anesthesiology, University of Colorado Denver School of Medicine, Aurora, CO
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10
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Kammerer T. [Airway separation and one-lung ventilation : A special challenge for anesthetists]. Anaesthesist 2018; 67:553-554. [PMID: 30027477 DOI: 10.1007/s00101-018-0471-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- T Kammerer
- Klinik für Anaesthesiologie, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
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Sheybani S, Attar AS, Golshan S, Sheibani S, Rajabian M. Effect of propofol and isoflurane on gas exchange parameters following one-lung ventilation in thoracic surgery: a double-blinded randomized controlled clinical trial. Electron Physician 2018; 10:6346-6353. [PMID: 29629058 PMCID: PMC5878029 DOI: 10.19082/6346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/25/2018] [Indexed: 12/21/2022] Open
Abstract
Background The use of anesthetic drugs with minimal inhibitory effects on the hypoxic pulmonary vasoconstriction (HPV) could have a decisive role in preventing the hypoxemia during one-lung ventilation (OLV). Objective The aim of this study was to compare the effects of propofol and isoflurane on the changes in gas exchange parameters following OLV in thoracic surgery. Methods This double-blinded randomized controlled clinical trial was conducted on patients who were candidates for elective right thoracotomy referred to the central operating room of Ghaem Hospital in Mashhad, Iran, during February 2016–2017. Patients with age range of 18 to 75 years, class I and II American Society of Anesthesiologists (ASA) and thoracotomy with OLV for pulmonary resection or cyst drainage were included. The patients were randomly allocated (1:1 ratio) into two groups of propofol (P, 50–100μg/kg/min) and isoflurane (I, 1 minimum alveolar concentration (MAC) 1.1%). Partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), end-tidal carbon dioxide (ETCO2) and arterial oxygen saturation (SPO2) were recorded before and 15 minutes after OLV and compared between the two groups. The comparison of the mean gas exchange parameters before and 15 minutes after OLV was performed using Mann-Whitney test in SPSS version 19 software. P<0.05 was considered statistically significant. Results In this study, 122 patients with mean age of 59.4±14.1 years (two groups of 61) were studied. Both groups were matched for age or gender. The two groups had no significant difference in the gas exchange parameters before the OLV. Only PaCO2 (p=0.001) and ETCO2 (p=0.001) were significantly higher in the propofol group after 15 minutes OLV than in the isoflurane group. However, PaO2 (p=0.67), O2Sat (p=0.333) and PaCO2-ETCO2 gradient (p=0.809) showed no significant difference between the two groups at this minute. Conclusion Based on the results of this study, the propofol or isoflurane selection seems to have no significant effect on the arterial oxygenation. On the other hand, isoflurane and propofol could be an appropriate anesthetic for thoracic surgery by normalizing the carbon dioxide gradient range during the OLV. Clinical Trial Registration The study was also registered at the Iranian Registry of Clinical Trials (IRCT2015123013159N8). Funding The study was financially supported by the Deputy of Research of Mashhad University of Medical Sciences (grant number: 940119).
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Affiliation(s)
- Shima Sheybani
- M.D., Cardiac Anesthesiologist, Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sharifian Attar
- M.D., Anesthesiologist, Associate Professor, Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sogol Golshan
- M.D., Resident of Anesthesiology, Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Majid Rajabian
- Bachelor of science, Anesthetist Nurse, Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran
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