Non-ventilated lung deflation during one-lung ventilation with a double-lumen endotracheal tube: a randomized-controlled trial of occluding the non-ventilated endobronchial lumen before pleural opening.
| Autor: | Somma J; Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, 2725, Chemin Sainte-Foy, Quebec City, QC, G1V 4G5, Canada., Couture ÉJ; Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, 2725, Chemin Sainte-Foy, Quebec City, QC, G1V 4G5, Canada., Pelletier S; Department of Anesthesiology and Critical Care, Laval University, Quebec City, QC, Canada., Provencher S; Department of Respirology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada., Moreault O; Department of Anesthesiology and Critical Care, Laval University, Quebec City, QC, Canada., Lohser J; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada., Ugalde PA; Department of Respirology and Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada., Vigneault L; Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, 2725, Chemin Sainte-Foy, Quebec City, QC, G1V 4G5, Canada., Lemieux J; Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, 2725, Chemin Sainte-Foy, Quebec City, QC, G1V 4G5, Canada., Somma A; Faculté des sciences et génie, Departement d'informatique et de génie logiciel, Laval University, Quebec City, QC, Canada., Guay SE; Laval University, Quebec City, QC, Canada., Bussières JS; Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, 2725, Chemin Sainte-Foy, Quebec City, QC, G1V 4G5, Canada. jbuss@criucpq.ulaval.ca. |
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| Jazyk: | angličtina |
| Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie [Can J Anaesth] 2021 Jun; Vol. 68 (6), pp. 801-811. Date of Electronic Publication: 2021 Apr 02. |
| DOI: | 10.1007/s12630-021-01957-9 |
| Abstrakt: | Purpose: Lung deflation during one-lung ventilation (OLV) is thought to be faster using a double-lumen endotracheal tube (DL-ETT) than with a bronchial blocker, especially when the non-ventilated lumen is opened to allow egress of air from the operative lung. Nevertheless, ambient air can also be entrained into the non-ventilated lumen before pleural opening and subsequently delay deflation. We therefore hypothesized that occluding the non-ventilated DL-ETT lumen during OLV before pleural opening would prevent air entrainment and consequently enhance operative lung deflation during video-assisted thoracoscopic surgery (VATS). Methods: Thirty patients undergoing VATS using DL-ETT to allow OLV were randomized to having the lumen of the operative lung either open (control group) or occluded (intervention group) to ambient air. The primary outcome was the time to lung collapse evaluated intraoperatively by the surgeons. The T Results: The median [interquartile range] time to lung deflation occurred faster in the intervention group than in the control group (24 [20-37] min vs 54 [48-68] min, respectively; median difference, 30 min; 95% confidence interval [CI], 14 to 46; P < 0.001). The estimated T Conclusion: Operative lung deflation during OLV with a DL-ETT is faster when the operative lumen remains closed before pleural opening thus preventing it from entraining ambient air during the closed chest phase of OLV. Trial Registration: www.clinicaltrials.gov (NCT03508050); registered 27 September 2017. |
| Databáze: | MEDLINE |
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