Abstract
Background and objective: The aim of this study was to test the efficacy of positive end-expiratory pressure (PEEP) to the dependent lung during one-lung ventilation, taking into consideration underlying lung function in order to select responders to PEEP. Methods: Forty-six patients undergoing open-chest thoracic surgical procedures were studied in an operating room of a university hospital. Patients were randomized to receive zero end-expiratory pressure (ZEEP) or 10 cmH2O of PEEP to the dependent lung during one-lung ventilation in lateral decubitus. The patients were stratified according to preoperative forced expiratory volume in 1 s (FEV1) as an indicator of lung function (below or above 72%). Oxygenation was measured in the supine position, in the lateral decubitus with an open chest, and after 20 min of ZEEP or PEEP. The respiratory system pressure-volume curve of the dependent hemithorax was measured in supine and open-chest lateral decubitus positions with a super-syringe. Results: Application of 10 cmH2O of PEEP resulted in a significant increase in PaO2 (P <0.05). This did not occur in ZEEP group, considered as a time matched control. PEEP improved oxygenation only in patients with high FEV1 (from 11.6 ± 4.8 to 15.3 ± 7.1 kPa, P <0.05). There was no significant change in the low FEV1 group. Dependent hemithorax compliance decreased in lateral decubitus, more in patients with high FEV1 (P <0.05). PEEP improved compliance to a greater extent in patients with high FEV1 (from 33.6 ± 3.6 to 48.4 ± 3.9 mL cmH2O-1, P <0.05). Conclusions: During one-lung ventilation in lateral decubitus, PEEP applied to the dependent lung significantly improves oxygenation and respiratory mechanics in patients with rather normal lungs as assessed by high FEV1.
| Original language | English |
|---|---|
| Pages (from-to) | 938-943 |
| Number of pages | 6 |
| Journal | European Journal of Anaesthesiology |
| Volume | 21 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2004 |
Fingerprint
Keywords
- Respiration, artificial, intermittent positive pressure ventilation, positive pressure respiration, one-lung ventilation
- Respiratory function tests, lung compliance, pulmonary gas exchange
- Respiratory mechanics
- Thoracic surgery
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Positive end-expiratory pressure applied to the dependent lung during one-lung ventilation improves oxygenation and respiratory mechanics in patients with high FEV1 . / Valenza, F.; Ronzoni, G.; Perrone, L.; Valsecchi, M.; Sibilla, S.; Nosotti, M.; Santambrogio, L.; Cesana, B. M.; Gattinoni, Luciano.
In: European Journal of Anaesthesiology, Vol. 21, No. 12, 12.2004, p. 938-943.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Positive end-expiratory pressure applied to the dependent lung during one-lung ventilation improves oxygenation and respiratory mechanics in patients with high FEV1
AU - Valenza, F.
AU - Ronzoni, G.
AU - Perrone, L.
AU - Valsecchi, M.
AU - Sibilla, S.
AU - Nosotti, M.
AU - Santambrogio, L.
AU - Cesana, B. M.
AU - Gattinoni, Luciano
PY - 2004/12
Y1 - 2004/12
N2 - Background and objective: The aim of this study was to test the efficacy of positive end-expiratory pressure (PEEP) to the dependent lung during one-lung ventilation, taking into consideration underlying lung function in order to select responders to PEEP. Methods: Forty-six patients undergoing open-chest thoracic surgical procedures were studied in an operating room of a university hospital. Patients were randomized to receive zero end-expiratory pressure (ZEEP) or 10 cmH2O of PEEP to the dependent lung during one-lung ventilation in lateral decubitus. The patients were stratified according to preoperative forced expiratory volume in 1 s (FEV1) as an indicator of lung function (below or above 72%). Oxygenation was measured in the supine position, in the lateral decubitus with an open chest, and after 20 min of ZEEP or PEEP. The respiratory system pressure-volume curve of the dependent hemithorax was measured in supine and open-chest lateral decubitus positions with a super-syringe. Results: Application of 10 cmH2O of PEEP resulted in a significant increase in PaO2 (P <0.05). This did not occur in ZEEP group, considered as a time matched control. PEEP improved oxygenation only in patients with high FEV1 (from 11.6 ± 4.8 to 15.3 ± 7.1 kPa, P <0.05). There was no significant change in the low FEV1 group. Dependent hemithorax compliance decreased in lateral decubitus, more in patients with high FEV1 (P <0.05). PEEP improved compliance to a greater extent in patients with high FEV1 (from 33.6 ± 3.6 to 48.4 ± 3.9 mL cmH2O-1, P <0.05). Conclusions: During one-lung ventilation in lateral decubitus, PEEP applied to the dependent lung significantly improves oxygenation and respiratory mechanics in patients with rather normal lungs as assessed by high FEV1.
AB - Background and objective: The aim of this study was to test the efficacy of positive end-expiratory pressure (PEEP) to the dependent lung during one-lung ventilation, taking into consideration underlying lung function in order to select responders to PEEP. Methods: Forty-six patients undergoing open-chest thoracic surgical procedures were studied in an operating room of a university hospital. Patients were randomized to receive zero end-expiratory pressure (ZEEP) or 10 cmH2O of PEEP to the dependent lung during one-lung ventilation in lateral decubitus. The patients were stratified according to preoperative forced expiratory volume in 1 s (FEV1) as an indicator of lung function (below or above 72%). Oxygenation was measured in the supine position, in the lateral decubitus with an open chest, and after 20 min of ZEEP or PEEP. The respiratory system pressure-volume curve of the dependent hemithorax was measured in supine and open-chest lateral decubitus positions with a super-syringe. Results: Application of 10 cmH2O of PEEP resulted in a significant increase in PaO2 (P <0.05). This did not occur in ZEEP group, considered as a time matched control. PEEP improved oxygenation only in patients with high FEV1 (from 11.6 ± 4.8 to 15.3 ± 7.1 kPa, P <0.05). There was no significant change in the low FEV1 group. Dependent hemithorax compliance decreased in lateral decubitus, more in patients with high FEV1 (P <0.05). PEEP improved compliance to a greater extent in patients with high FEV1 (from 33.6 ± 3.6 to 48.4 ± 3.9 mL cmH2O-1, P <0.05). Conclusions: During one-lung ventilation in lateral decubitus, PEEP applied to the dependent lung significantly improves oxygenation and respiratory mechanics in patients with rather normal lungs as assessed by high FEV1.
KW - Respiration, artificial, intermittent positive pressure ventilation, positive pressure respiration, one-lung ventilation
KW - Respiratory function tests, lung compliance, pulmonary gas exchange
KW - Respiratory mechanics
KW - Thoracic surgery
UR - http://www.scopus.com/inward/record.url?scp=14244266656&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=14244266656&partnerID=8YFLogxK
U2 - 10.1017/S0265021504000316
DO - 10.1017/S0265021504000316
M3 - Article
C2 - 15719856
AN - SCOPUS:14244266656
VL - 21
SP - 938
EP - 943
JO - European Journal of Anaesthesiology
JF - European Journal of Anaesthesiology
SN - 0265-0215
IS - 12
ER -