[Impact of combined anesthesia using isoflurane on the development of adaptation mechanisms on changing ventilation conditions in thoracic surgery].
The paper deals with the effect of isoflurane (IF) as a component of combined anesthesia during thoracic interventions in the lateral position on the development of adaptation mechanisms to a change in artificial ventilation (AV) modes--from ventilation of both lungs to that of one lung (unilateral ventilation, ULV), long exposure to ULV and to a change from ULV to ventilation of both lungs. Eighteen patients at a high operation-anesthetic risk were examined. Measurements were made in 6 steps, including conditions in AV, exposure to ULV for 15-30, 55-60, and 80-120 minutes, AV after 20-min exposure to ULV, and at the end of surgery in the supine position. While analyzing the results, the authors made an important observation that IF has a property of preventing capillary formation in the ventilated portions, without impairing the mechanism of pulmonary hypoxic vasoconstriction in the area of atelectized alveoles. This contributed to the optimization of a ventilation-perfusion relationship and creates conditions for adequate oxygenation. The use of IF as a component of combined anesthesia during thoracic operations associated with a need for artificial unilateral ventilation in patients at a high operation-anesthetic risk created conditions for optimizing gas exchange and blood circulation at all stages of an operation and anesthesia.
Vyzhigina
M A
MA
Riabova
O S
OS
Kulagina
T Iu
TIu
Zhukova
S G
SG
Parshin
V D
VD
Sandrikov
V A
VA
Buniatian
A A
AA
D000222:Adaptation, Physiological / Q000187:drug effects*; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods; D016683:Supine Position; D019616:Thoracic Surgical Procedures
D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D007530:Isoflurane