Cardiopulmonary effects of one-lung ventilation in supine patients |
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| Affiliation: | 1. Interstitial Lung Disease Unit, Royal Brompton and Harefield National Health Service (NHS) Foundation Trust, London, UK;2. Department of Lung Transplantation, Royal Brompton and Harefield National Health Service (NHS) Foundation Trust, London, UK;3. Department of Cardiothoracic Pharmacology, National Heart and Lung Institute, Imperial College London, London, UK;4. Department of Lung Transplantation, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK;5. Department of Interstitial Lung Disease, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK;6. Department of Medicine, University of Cambridge, Cambridge, UK;1. Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA;2. Department of Epidemiology, Mailman School of Public Health, New York, NY, USA;3. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA;4. Department of Psychiatry and Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA;5. Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USA;6. Department of Paediatrics, University of Melbourne, Melbourne, Australia;7. Murdoch Children’s Research Institute, Melbourne, Australia;8. Department of Anaesthesia and Pain Management, Royal Children’s Hospital, Melbourne, Australia;9. Departments of Anesthesiology and Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA;10. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA |
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| Abstract: | The cardiopulmonary effects of one-lung ventilation (OLV), with continuous positive airway pressure (CPAP, 5 cm H2O) to the nonventilated lung, were compared to the effects of two-lung ventilation (TLV) in 12 supine patients undergoing coronary artery bypass grafting (CABG). Monitoring was performed with electrocardiography (ECG), arterial, and pulmonary artery catheters. Measurements of cardiac index (CO, heart rate (HR), systemic (MAP) and pulmonary artery pressures (PAP), pulmonary artery occlusion pressure (PAOP), mixed venous oxygen saturation (SvO2), and arterial blood for pH, PaO2, PaCO2 and HCO3- were performed with stable maintenance of anesthesia during both one- and two-lung ventilation. Mean values for CI, HR, MAP, MPAP, PVR, and SvO2 demonstrated no significant changes between OLV and TLV; systemic vascular resistance (SVR) and pulmonary artery occlusion pressure (PAOP) were statistically (P < 0.05) different, but of minor clinical significance. The data suggest that OLV, accompanied by CPAP (5 cm H20) to the nonventilated lung, produces minimal changes in cardiopulmonary measurements in supine patients. |
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