Lung mechanics and gas exchange in one-lung ventilation following contralateral resection
| Autor: | Garrett Kovarik, Pedro Ruiz |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Anesthetic management Respiratory physiology Resection Plateau pressure Anesthesiology Monitoring Intraoperative Medicine Humans Continuous positive airway pressure Oximetry Hypoxia Lung Aged Emphysema Sleep Apnea Obstructive business.industry Pulmonary Gas Exchange Lung mechanics General Medicine One lung ventilation Respiration Artificial Surgery Anesthesiology and Pain Medicine Barotrauma Anesthesia Respiratory Mechanics sense organs business |
| Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie. 52(9) |
| ISSN: | 0832-610X |
| Popis: | To describe the anesthetic management of a patient with previous left lower lobe resection who was submitted to a right upper lobectomy and review the changes in gas exchange and respiratory mechanics which occurred intraoperatively.A 69-yr-old male with lung cancer, emphysema and obstructive sleep apnea, presented for a right upper lobectomy. His history was also positive for a left lower lobectomy six years previously. Intraoperative lung isolation was achieved using a 41 F left double-lumen tube (DLT). Monitoring the respiratory mechanics allowed for continuous adjustment of ventilator settings during the various phases of the surgery avoiding the risks of barotrauma and volutrauma. Problems with oxygenation occurred during one-lung ventilation.This case report shows that a severe level of hypoxemia and hypercarbia associated to lung mechanical property changes can be observed during the OLV phase. Application of continuous positive airway pressure on the non-dependent lung partially corrected blood oxygenation. Lobe isolation techniques should be considered as useful options for intraoperative airway management for these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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