Oxygenierung während Ein-Lungen-Ventilation: Ein Vergleich von FiO2 0,5 und CPAP auf der nichtventilierten Lunge vs. FiO2 1,0

Autor: M. Layer, K. Wiedemann, A. Toker, Mert Şentürk, K. Akpir, Kamil Pembeci
Rok vydání: 2004
Předmět:
Zdroj: AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie. 39:360-364
ISSN: 1439-1074
0939-2661
DOI: 10.1055/s-2004-814506
Popis: OBJECTIVE In a prospective, randomised, double-blind study the effects of FiO (2) of 0,5 with CPAP and a FiO (2) of 1.0 without CPAP on oxygenation and pulmonary shunt during one-lung ventilation (OLV) were examined. METHODS In 20 patients undergoing thoracotomy (ASA II/III) two sequential ventilation methods were used during OLV: a) FiO (2) of 1.0 (OLV-100) and b) a FiO (2) of 0.5 in N (2)O combined with CPAP of 5 cm H (2)O to the non-ventilated lung (OLV-CPAP), whereby the sequence in 10 patients was OLV-CPAP followed by OLV-100; and the opposite in the remaining 10 patients. Operating conditions were graded by the surgeon. RESULTS OLV-CPAP was associated with a better oxygenation and a lower shunt compared to OLV-100 (paO (2) : 198 +/- 40 mmHg vs 181 +/- 38 mmHg; p < 0.05 and Qs/Qt: 30 +/- 6 % vs. 34 +/- 8 %; p < 0.01, respectively). The different sequence of the ventilation methods did not cause significant differences in the results. The surgical conditions were not impaired by the CPAP of 5 cm H (2)O. CONCLUSION The application of low FiO (2) with CPAP provided a better oxygenation and a lower pulmonary shunt during the OLV compared to high FiO (2) without CPAP.
Databáze: OpenAIRE