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Variations in lung volume and compliance during pulmonary surgery
British Journal of Anaesthesia
|May 1, 1987
Summary
Mechanically ventilated patients undergoing lung surgery experienced changes in lung volumes and compliance. One-lung ventilation (OLV) helped restore functional residual capacity (FRC) in the lower lung during lateral positioning.
Area of Science:
- Pulmonary Physiology
- Thoracic Surgery
- Anesthesiology
Background:
- Mechanical ventilation is crucial for patients undergoing lung surgery.
- Understanding lung mechanics, specifically functional residual capacity (FRC) and compliance (Crs), is vital during surgical procedures.
Purpose of the Study:
- To investigate the impact of patient positioning and surgical interventions on FRC and Crs in mechanically ventilated patients during lung surgery.
- To evaluate the effect of one-lung ventilation (OLV) on FRC in the lower lung.
Main Methods:
- Measurements of FRC and Crs were performed on 10 mechanically ventilated patients during anesthesia for various lung surgeries.
- Patients were assessed in supine and lateral positions, with and without pleural opening, and during OLV.
Main Results:
- Lateral positioning significantly altered FRC distribution, decreasing lower lung FRC and increasing upper lung FRC.
- Pleural opening further reduced lower lung FRC, while OLV restored it to pre-operative supine levels.
- Respiratory system compliance (Crs) decreased in the lower lung and increased in the upper lung upon lateral positioning.
Conclusions:
- Patient positioning and OLV significantly influence lung volumes and mechanics during thoracic surgery.
- OLV plays a role in optimizing FRC in the dependent lung, potentially improving ventilation-perfusion matching.