A noninvasive partial carbon dioxide rebreathing technique for measurement of pulmonary capillary blood flow is also a useful oxygenation monitor during one-lung ventilation.
OBJECTIVE
To test the hypothesis that effective pulmonary capillary blood flow can be a useful indicator for estimating appropriate oxygenation and ventilation during one-lung ventilation in lung surgery.


METHODS
Prospective data analysis.


METHODS
A 770-bed general teaching hospital.


METHODS
15 ASA physical status II and III patients undergoing elective lung surgery.


METHODS
Patients received general and thoracic epidural anesthesia and underwent lung operation with one-lung ventilation.


METHODS
We measured effective pulmonary capillary blood flow by a partial CO2 rebreathing method and oxygenation parameters during two-lung ventilation before surgery, during one-lung ventilation, and during two-lung ventilation after lung surgery.


RESULTS
The effective pulmonary capillary blood flow index significantly decreased by 31.6%, which was associated with a significant decrease in arterial oxygen tension (PaO2). The pulmonary shunt fraction increased to 46.3% during one-lung ventilation. During two-lung ventilation, after chest closure, effective pulmonary capillary blood flow index divided by heart rate (i.e., effective pulmonary blood stroke flow index) was still significantly lower than that seen during two-lung ventilation before thoracotomy. There were significant correlations between effective pulmonary capillary blood flow, pulmonary blood stroke flow index, and PaO2.


CONCLUSIONS
Effective pulmonary capillary blood flow index and effective pulmonary blood stroke flow index are useful indicators for determining appropriate oxygenation therapy during one-lung ventilation.
Fujii
Shunsuke
S
Department of Anesthesiology and Pain Clinic, Seirei-Mikatabara General Hospital, Hamamatsu, Japan.
Kikura
Mutsuhito
M
Takada
Tomosue
T
Katoh
Shigeru
S
Aoyama
Nao
N
Sato
Shigehito
S
D000368:Aged; D002196:Capillaries / Q000502:physiology; D002245:Carbon Dioxide / Q000378:metabolism*; D002302:Cardiac Output; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000627:therapeutic use*; D011652:Pulmonary Circulation; D012121:Respiration, Artificial
D002245:Carbon Dioxide; D010100:Oxygen