| Gradient of bronchial end-tidal CO2 during two-lung ventilation in lateral decubitus position is predictive of oxygenation disorder during subsequent one-lung ventilation. | |
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MedLine Citation:
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PMID: 19444556 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Hypoxemia is one of the major problems during one-lung ventilation (OLV). During two-lung ventilation (TLV) using a double-lumen bronchial tube, bronchial endtidal carbon dioxide partial pressure (ETbr(CO2)) can be determined on both sides, independently. The ETbr(CO2) is mainly dependent on the pulmonary perfusion to each lung. If the degree of oxygenation disorder during OLV were to be predictable before starting OLV, this could provide time to prepare for any subsequent hypoxemia. The aim of this study was to investigate whether the difference of ETbr(CO2) (D-ETbr(CO2)) between the dependent and the nondependent lungs during TLV in the lateral decubitus position (LP) could be a predictive factor for the severity of oxygenation disorder under subsequent OLV. METHODS: Eighteen patients undergoing lung surgery were enrolled in this study. Anesthesia was induced with intravenous thiopental and fentanyl, supplemented by the inhalation of sevoflurane. A left-sided double-lumen bronchial tube was placed. The ETbr(CO2) was independently determined on each side during TLV in the supine position (SP) and at 10 min after changing the position from SP to LP. PaO2/inspiratory fraction of oxygen (FIO2) was taken at 15 min after switching from TLV to OLV in LP. RESULTS: The decrease of PaO2/FIO2 at 15 min during OLV in LP correlated with the reduction of the D-ETbr(CO2) predetermined during TLV in LP (r = 0.698; P < 0.01). CONCLUSION: The D-ETbr(CO2) predetermined during TLV in LP could be a predictive factor for the severity of oxygenation disorder after starting OLV in LP. |
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Authors:
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Yosuke Yamamoto; Seiji Watanabe; Tatsuhiko Kano |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-05-15 |
Journal Detail:
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Title: Journal of anesthesia Volume: 23 ISSN: 1438-8359 ISO Abbreviation: J Anesth Publication Date: 2009 |
Date Detail:
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Created Date: 2009-05-15 Completed Date: 2009-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8905667 Medline TA: J Anesth Country: Japan |
Other Details:
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Languages: eng Pagination: 192-7 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anesthesia, Intravenous Anesthetics, Intravenous Blood Gas Analysis Carbon Dioxide / metabolism* Female Fentanyl Humans Intubation, Intratracheal Lung Neoplasms / surgery Male Middle Aged Oxygen Consumption / physiology* Posture / physiology Respiration, Artificial / methods* Thiopental Tidal Volume |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Intravenous; 124-38-9/Carbon Dioxide; 437-38-7/Fentanyl; 76-75-5/Thiopental |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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