Document Detail

Haemodynamic changes during thoracoscopic surgery the effects of one-lung ventilation compared with carbon dioxide insufflation.
MedLine Citation:
PMID:  10594427     Owner:  NLM     Status:  MEDLINE    
We investigated the haemodynamic and respiratory effects of one-lung ventilation and carbon dioxide insufflation in 13 adult patients undergoing video-assisted thoracoscopy. Cardiorespiratory variables were determined during carbon dioxide insufflation at intrahemithoracic pressures of 5, 10 and 15 mmHg, and after 5 and 15 min of one-lung ventilation. Carbon dioxide insufflation was associated with a clear deterioration in circulatory function. The cardiac index decreased subsequent to increasing intrathoracic pressures. The mean cardiac index (SD) at pressures of 10 and 15 mmHg was 1.86 (0.39) and 1.52 (0.46), respectively, and may be compared with the reduced venous return consistent with tension pneumothorax. One-lung ventilation did not affect haemodynamic variables but reduced arterial oxygenation indices (PaO2/FIO2) from 424.29 (160.79) after induction of anaesthesia, to 207.72 (125.50) after 5 min and 172.04 (72.03) after 15 min of one-lung ventilation, respectively. The oxygenation index was not influenced by intrahemithoracic carbon dioxide insufflation. One-lung ventilation via a double-lumen endobronchial tube is safe and convenient for video-assisted thoracoscopic surgery. It has no further consequences on haemodynamic variables, whereas the compression of the lung by carbon dioxide insufflation may cause circulatory dysfunction.
H Brock; R Rieger; C Gabriel; W Pölz; W Moosbauer; S Necek
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  55     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-16     Completed Date:  2000-02-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  10-6     Citation Subset:  AIM; IM    
Department of Anaesthesiology and Intensive Care Medicine, Linz, Austria.
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MeSH Terms
Carbon Dioxide / administration & dosage
Hemodynamics / physiology*
Insufflation / methods*
Middle Aged
Oxygen / blood
Respiration, Artificial / methods*
Thoracic Surgery, Video-Assisted*
Treatment Outcome
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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