Changes in respiratory mechanics of artificial pneumothorax two-lung ventilation in video-assisted thoracoscopic esophagectomy in prone position
| Autor: | Yoshinori Tanigawa, Tomoko Yamashita, Yoshiro Sakaguchi, Kimihide Nakamura, Akira Nakagawachi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Supine position Esophageal Neoplasms medicine.medical_treatment Science Respiratory physiology Patient Positioning Article Hypoxemia 03 medical and health sciences 0302 clinical medicine Medical research medicine Pneumothorax Artificial Prone Position Intubation Humans Laparoscopy Aged Retrospective Studies Multidisciplinary medicine.diagnostic_test business.industry Thoracic Surgery Video-Assisted Esophageal cancer respiratory system medicine.disease Prognosis respiratory tract diseases Esophagectomy Prone position Oncology 030220 oncology & carcinogenesis Anesthesia Breathing Respiratory Mechanics Medicine 030211 gastroenterology & hepatology Female medicine.symptom business Pulmonary Ventilation Follow-Up Studies |
| Zdroj: | Scientific Reports Scientific Reports, Vol 11, Iss 1, Pp 1-8 (2021) |
| ISSN: | 2045-2322 |
| Popis: | We aimed to clarify the changes in respiratory mechanics and factors associated with them in artificial pneumothorax two-lung ventilation in video-assisted thoracoscopic esophagectomy in the prone position (PP-VATS-E) for esophageal cancer. Data of patients with esophageal cancer, who underwent PP-VATs-E were retrospectively analyzed. Our primary outcome was the change in the respiratory mechanics after intubation (T1), in the prone position (T2), after initiation of the artificial pneumothorax two-lung ventilation (T3), at 1 and 2 h (T4 and T5), in the supine position (T6), and after laparoscopy (T7). The secondary outcome was identifying factors affecting the change in dynamic lung compliance (Cdyn). Sixty-seven patients were included. Cdyn values were significantly lower at T3, T4, and T5 than at T1 (p 1.0% were found to significantly influence Cdyn reduction during artificial pneumothorax and two-lung ventilation (OR [95% CI]: 1.29 [1.03–2.24] and 0.20 (0.05–0.44); p = 0.010 and p = 0.034, respectively]. Changes in driving pressure were nonsignificant, and hypoxemia requiring treatment was not noted. This study suggests that in PP-VATs-E, artificial pneumothorax two-lung ventilation is safer for the management of anesthesia than conventional one-lung ventilation (UMIN Registry: 000042174). |
| Databáze: | OpenAIRE |
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