Related Experiment Videos
Pulmonary air trapping during two-lung and one-lung ventilation
L Ducros1, M Moutafis, M H Castelain
1Département d'Anesthésie-Réanimation, Centre Hospitalo-Universitaire Lariboisière, Paris, France.
Journal of Cardiothoracic and Vascular Anesthesia
|March 9, 1999
Summary
Pulmonary air trapping is significant during one-lung ventilation in thoracic surgery patients, especially those with obstructive lung disease. Auto-PEEP and trapped volumes increase with reduced FEV1/FVC ratios, indicating potential respiratory complications.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Pulmonary Physiology
Background:
- Pulmonary air trapping can complicate thoracic surgery and lung transplantation.
- Understanding air trapping during different ventilation strategies is crucial for patient management.
Purpose of the Study:
- To evaluate the magnitude of pulmonary air trapping during routine thoracic surgery and single-lung transplantation.
- To assess auto-positive end-expiratory pressure (auto-PEEP) and trapped volume (delta FRC) under various ventilation conditions.
Main Methods:
- Prospective study involving 28 patients undergoing thoracic surgery or single-lung transplantation.
- Measurement of auto-PEEP and delta FRC using an occlusion maneuver during two-lung ventilation (supine and lateral) and one-lung ventilation (OLV).
- Patients were categorized based on obstructive lung disease severity.
Main Results:
- Significant air trapping (auto-PEEP and delta FRC) was observed during OLV in patients with no or moderate obstructive lung disease.
- Patients with severe emphysema showed substantial air trapping across all ventilation modes.
- Air trapping correlated inversely with FEV1/FVC% during OLV, but not with PaO2.
Conclusions:
- Pulmonary air trapping should be suspected in patients with obstructive lung disease during OLV.
- In severe obstructive disease, air trapping can occur even during two-lung ventilation.
- These findings highlight the importance of monitoring respiratory mechanics in at-risk patients.