Document Detail

Single-lung ventilation with carbon dioxide hemipneumothorax: hemodynamic and respiratory effects in piglets.
MedLine Citation:
PMID:  22171739     Owner:  NLM     Status:  Publisher    
Objectives:  Video-assisted thoracoscopic surgery (VATS) has become a standard procedure in pediatric surgery. To facilitate surgical access, the dependent lung has to collapse using intrathoracic carbon dioxide insufflation and/or single-lung ventilation. These procedures can induce hemodynamic deteriorations in adults. The potential impacts of single-lung ventilation in combination with capnothorax on hemodynamics in infants have never been studied before. Aim:  We conducted a randomized experimental study focusing on hemodynamic and respiratory changes during single-lung ventilation with or without capnothorax in a pediatric animal model. Methods:  Twelve piglets were randomly assigned to receive single-lung ventilation with (SLV-CO(2) ) or without (SLV) capnothorax with an insufflation pressure of 5 mmHg for a period of two hours. Before, during, and after single-lung ventilation, hemodynamic and respiratory parameters were measured. Results:  Although mean arterial pressure remained stable during the course of the study and no critical incidents were monitored, cardiac index (CI) decreased significantly with SLV-CO(2) (baseline 3.6 ± 1.6 l·min(-1) ·m(-2) vs 2.9 ± 1.1 l·min(-1) ·m(-2) at 120 min, P < 0.05). Furthermore, global end-diastolic volume and intrathoracic blood volume (ITBV) decreased as well significantly with SLV-CO(2) , causing a significant between-group difference in ITBV (P < 0.05). Conclusions:  Despite a decrease in CI and preload parameters, the combination of single-lung ventilation and low-pressure capnothorax was well tolerated in piglets and could justify further clinical studies to be performed in infants and children focusing on hemodynamic and respiratory changes during VATS.
Lars Witt; Wilhelm Alexander Osthaus; Timon Schröder; Natascha Teich; Carmen Dingemann; Joachim Kübler; Dietmar Böthig; Robert Sümpelmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-15
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  -     ISSN:  1460-9592     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
 Clinic of Anaesthesiology, Hannover Medical School, Hannover, Germany  Department for Paediatric Surgery, Hannover Medical School, Hannover, Germany  Department for Paediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany.
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