title: Minimal flow and half-closed system ventilation in lung surgery.
abstract: BACKGROUND
  This study aimed at determining the applicability of minimal flow anaesthesia in lung surgery.
  
  
  METHODS
  The standards anaesthesiological technique was modified to perform minimal flow half-closed system ventilation. For procedures on left lung orobronchial intubation was performed by a White no. 41 and no. 39 orotracheal tube, respectively in male and in female patients, in order to achieve a perfect tight of bronchial cuff and prevent gas loss from the circuit, because of the greater calibre of the right stem bronchus. The metal double lumen connector was replaced by a plastic tube that is clamped to exclude the lung from ventilation, whenever necessary. Fibrin glue was systematically applied on the bronchial stump or resected lung tissue before restoring ventilation.
  
  
  RESULTS
  No significant changes were recorded in heart rate, arterial systolic and diastolic pressure, end-expiratoy CO2 concentration, oxygen saturation, airways maximum and minimum pressure.
  
  
  CONCLUSIONS
  Minimal flow half-closed system ventilation can be easily performed also in pulmonary surgery provided that gas loss from the circuit is 50 ml/min by means of specific technical adjustments.
authors: Anaesthesiology and Intensive Care Department, Faculty of Medicine and Surgery, University Federico II, Naples.
authors: V
authors: V
authors: Brancadoro
authors: S
authors: S
authors: Elia
authors: D
authors: D
authors: Leone
authors: G
authors: G
authors: Canfora
authors: C
authors: C
authors: Mattiello
authors: M
authors: M
authors: Fattore
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012189:Retrospective Studies