Controlled hypercapnia during one-lung ventilation in patients undergoing pulmonary resection.
BACKGROUND
In a pilot study, the haemodynamic and gas exchange effects of acute hypercapoia during one-lung ventilation in thoracotomy patients were investigated. The effects of normocapnic one-lung ventilation (OLV-N) on haemodynamics and pulmonary gas exchange were compared with those of hypercapnic one-lung ventilation (OLV-H) in 14 patients undergoing pulmonary lobectomy.


METHODS
Hypercapnia was induced by decreasing tidal volume until PaCO2 increased to 8-9 kPa. During OLV, minute ventilation was reduced from 8.8+/-1.7 to 4.2+/-0.7 l min(-1).


RESULTS
Cardiac index (from 3.3+/-0.6 to 3.9+/-0.6 l min(-1), P<0.01) and pulmonary vascular resistance index (from 245+/-96 to 347+/-125 dyn s cm(-5) m(-2), P<0.05) increased during OLV-H, whereas systemic vascular resistance index decreased from 1952+/-403 to 1636+/-361 dyn s cm(-5) m(-2) (P<0.01). Pulmonary oxygenation remained unchanged.


CONCLUSIONS
All patients had an uneventful course during OLV-H. The determinants of pulmonary oxygenation during hypercapnic one-lung ventilation remain to be further elucidated.
Sticher
J
J
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, Germany.
Müller
M
M
Scholz
S
S
Schindler
E
E
Hempelmann
G
G
D001784:Blood Gas Analysis; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000503:physiopathology*; D008168:Lung / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010865:Pilot Projects; D011652:Pulmonary Circulation / Q000502:physiology; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D014655:Vascular Resistance / Q000502:physiology