One-lung flooding reduces the ipsilateral diaphragm motion during mechanical ventilation

Area of Science:

• Medical Imaging and Interventional Procedures
• Pulmonary Physiology
• Surgical Techniques

Background:

• Diaphragm motion complicates image-guided percutaneous interventions in the lung and upper abdomen.
• Existing motion-tracking methods increase procedure complexity and duration.
• One-lung flooding (OLF) offers a potential solution by creating an acoustic pathway and suppressing diaphragm motion.

Purpose of the Study:

• To quantify the impact of OLF on ipsilateral diaphragm motion.
• To assess diaphragm motion during contralateral one-lung ventilation.

Main Methods:

• M-mode ultrasonography of the right hemidiaphragm during spontaneous and mechanical ventilation, and after right-side OLF in three pigs.
• Magnetic resonance imaging analysis of diaphragm motion during left-side OLF and mechanical ventilation in four pigs.

Main Results:

• Mechanical ventilation increased diaphragm movement compared to spontaneous breathing (17.8 vs. 12.2 mm).
• OLF during contralateral one-lung ventilation significantly reduced ipsilateral diaphragm movement (3.9 vs. 17.8 mm).
• MRI showed reduced ipsilateral hemidiaphragm displacement (average 4.2 mm, max 15 mm near the ventilated lung).

Conclusions:

• OLF drastically reduces ipsilateral diaphragm motion.
• This reduction may negate the need for targeting and motion compensation algorithms in interventions.
• Potential benefits for procedures like high-intensity focused ultrasound ablation of thoracic and hepatic lesions.