title: Smoking as a risk factor for intraoperative hypoxemia during one lung ventilation.
abstract: BACKGROUND
  Smoking is associated with many intra and postoperative events, especially respiratory complications. Hypoxemia and airway damage are found to aggravate any pre-existing respiratory pathology among smokers. One lung ventilation (OLV) carries a 4-10 % risk of development of hypoxia.
  
  
  OBJECTIVE
  The purpose of this study was to predict the incidence of hypoxemia for smokers during OLV for patients undergoing video-assisted thoracoscopic surgery (VATS).
  
  
  METHODS
  Sixty patients undergoing VATS using OLV by double lumen tube were included in this pilot cross-sectional study. These patients were divided into 2 groups, group S which included 30 heavy smoker patients (smoking more than 20 cigarettes per day for more than 20 years) and group NS which included 30 non-smoker patients. Intra and postoperative arterial oxygen tension (PaO(2)), arterial carbon dioxide tension (PaCO(2)), and intraoperative peak airway pressure were compared between the 2 groups.
  
  
  RESULTS
  PaO(2) was significantly higher in the non-smoker group than in the smoker group, both at the start and end of OLV. It was 173 ± 68 mmHg for NS compared with 74 ± 10.8 mmHg for S at the start of OLV; at the end of OLV it was 410 ± 78 mmHg for the former and 360 ± 72 mmHg for the latter (P < 0.05).
  
  
  CONCLUSIONS
  From this study it can be concluded that for heavy smoker patients there was a significant reduction in arterial oxygen tension (PaO(2)) in comparison with non-smokers. However, hypoxemia reported for both groups was comparable.
authors: Department of Anesthesia, Faculty of Medicine, Cairo University, Giza, Egypt. mohamedkhalil404@hotmail.com
authors: Mohamed A
authors: MA
authors: Khalil
mesh_terms: D001158:Arteries / Q000378:metabolism; D002245:Carbon Dioxide / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D007431:Intraoperative Complications / Q000209:etiology; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation / Q000009:adverse effects* / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen
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