Effects of tidal volume and PEEP on arterial blood gases and pulmonary mechanics during one-lung ventilation

• Published in: Journal of anesthesia 2012-08, Vol.26 (4), p.568-573
• Main Authors: Kim, Sang Hun, Jung, Ki Tae, An, Tae Hun
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Analysis; Anesthesia, General; Anesthesiology; Arterial Pressure - physiology; Blood Gas Analysis - methods; Critical Care Medicine; Emergency Medicine; Female; Heart Rate - physiology; Hemodynamics; Humans; Intensive; Intraoperative Complications - epidemiology; Intraoperative Complications - therapy; Lung - physiology; Lung - surgery; Lung Compliance - physiology; Male; Medicine; Medicine & Public Health; Middle Aged; One-Lung Ventilation - methods; Original Article; Oxygen - blood; Pain Medicine; Positive-Pressure Respiration - methods; Respiratory Mechanics - physiology; Tidal Volume - physiology; Toy industry; Young Adult
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-012-1348-z

Purpose The main problem of one-lung ventilation (OLV) is hypoxemia. The use of a high tidal volume for preventing hypoxemia during OLV is controversial. We compared the effects of a high tidal volume versus a low tidal volume with or without PEEP on arterial oxygen tension (PaO 2 ) and pulmonary mechanics during OLV. Methods Sixty patients (age range, 16–65 years; ASA I, II) who underwent wedge resection with video-assisted thoracostomy during OLV were assigned to three groups: group I received a high tidal volume (10 ml/kg) ( n  = 20), group II received a low tidal volume (6 ml/kg) ( n  = 20), and group III received a low tidal volume (6 ml/kg) with PEEP (5 cmH 2 O) ( n  = 20). Patient hemodynamics, pulmonary mechanics, and arterial blood gases were measured before (T 0 ) OLV and 5 (T 1 ), 15 (T 2 ), 30 (T 3 ), and 45 min (T 4 ) after OLV. Results The PaO 2 /FiO 2 ratios of group II and III were significantly decreased and the incidence of hypoxemia was significantly higher in groups II and III than in group I ( P