頁籤選單縮合
題 名 | Ventilation-Perfusion Distribution and Shunt Fraction during One-Lung Ventilation: Effect of Different Inhaled Oxygen Levels |
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作 者 | Hsu, Jane-yi; Chen, Wei-teing; Kao, Chung-cheng; Lee, Shih Jun; Chang, Hung; | 書刊名 | 中國生理學雜誌 |
卷 期 | 51:1 2008.02[民97.02] |
頁 次 | 頁48-53 |
分類號 | 397 |
關鍵詞 | One lung ventilation; Hypoxic pulmonary vasoconstriction; HPV; Oxygenation; Pulmonary gas exchange; Multiple inert gas elimination technique; |
語 文 | 英文(English) |
英文摘要 | Ventilation with higher fraction of inspired oxygen (FIO₂) is one of the commonly-chosen strategies executed for treatment of hypoxemia during one lung ventilation (OLV) for thoracic surgery. In this study, we investigated the effect of FIO₂ on pulmonary ventilation-perfusion(VA/Q) distribution during OLV. Six pigs, weighing 27 to 34 kg, were selected for this study. Following by a steady-state period, randomized administrations of FIO₂ with 0.4, 0.6 and 1.0 were performed for 30 minutes at the right lateral decubitus position during OLV, while hemodynamic data and lung mechanics were simultaneously monitored. The (VA/Q) distributions of the lung(s) were assessed by the multiple inert gas elimination technique (MIGET). PaO₂ at FIO₂ of 100% was significantly reduced in OLV compared with two-lung ventilation (TLV) (522 ± 104 vs. 653 ± 21 mmHg; P < 0.001) at right lateral decubitus position. MIGET algorithms demonstrated a wider .(VA/Q) distribution during OLV at FIO₂ of 40%, as compared with distribution during TLV at FIO₂ of 100%, but a bimodal perfusion distribution shifted to lower (VA/Q) component during OLV at FIO₂ of 100%. There was an increase of pulmonary shunting in OLV, as compared with TLV at FIO₂ of 100% (1.94 ±2.2% vs. 9.5 ±9.7%; P < 0.01). In addition, OLV caused a significant increase in the dispersion of perfusion at FIO₂ of 100% (0.62 ± 0.20 vs. 0.44 ±0.23; P < 0.01), but ventilation showed no denoting changes (1.06 ± 0.20 vs. 0.98 ±0.35; P > 0.01). During OLV with right lateral decubitus position, there were no significant changes in the pulmonary shunt, the dispersion of perfusion and ventilation at different FIO₂. OLV resulted in an increase in pulmonary shunting and heterogeneity compared with TLV. Furthermore, the PaO₂ decreased during OLV regardless of the postural changes. At different FIO₂, there were no significant changes in the pulmonary shunt, the dispersion of perfusion and ventilation during OLV with right lateral decubitus posture. |
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