The effect of left heart bypass on pulmonary blood flow and arterial oxygenation during one-lung ventilation in patients undergoing descending thoracic aortic surgery.
OBJECTIVE
To study the effect of left heart bypass (LHB) on regional pulmonary blood flow and arterial oxygenation during one-lung ventilation (OLV).


METHODS
Prospective, observational study


METHODS
Operating room


METHODS
14 ASA physical status II and III patients scheduled to undergo descending thoracic or thoracoabdominal aortic surgery using LHB.


METHODS
Parameters studied during OLV with 100% oxygen before and during LHB mean arterial pressure, heart rate, pulmonary artery pressure, pulmonary capillary wedge pressure, central venous pressure, cardiac index, cardiac output, arterial oxygen tension (PaO(2)), mixed venous oxygen pressure, alveolar arterial oxygen difference (P((A-a)O2)), and right upper pulmonary venous flow (RUPVF). Right upper pulmonary venous flow was measured using transesophageal echocardiography.


RESULTS
With the transition to OLV, there was a significant decrease in PaO(2) and a significant increase in P((A-a)O2). However once LHB was initiated, these values improved significantly (P = 0.0007 and 0.0004, respectively) with the simultaneous increase in RUPVF (P = 0.0018).


CONCLUSIONS
LHB improved pulmonary blood flow to the dependent lung and arterial oxygenation during OLV in descending thoracic aortic surgery.
Yuki
Koichi
K
Department of Anesthesiology, Itabashi Chuo Medical Center, Itabashi-ku, Tokyo, Japan. yuki.koichi@gmail.com
Sakuramoto
Chieko
C
Matsumoto
Chieko
C
Hoshino
Mariko
M
Niimi
Yoshinari
Y
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001783:Blood Flow Velocity; D004562:Electrocardiography; D005260:Female; D018611:Heart Bypass, Left / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000502:physiology*; D012039:Regional Blood Flow; D012121:Respiration, Artificial / Q000379:methods*; D012129:Respiratory Function Tests; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D010100:Oxygen