Background: The present study will focus on the rationale for the use of small tidal volume with 6 cmH2O positive end expiratory pressure (PEEP) with the changes of arterial oxygen tension, plateau airway pressure, and static lung compliance during one lung ventilation for endoscopic thoracic surgery. Methods: Forty-three patients were intubated with a double-lumen endobronchial tube. After positioning the patients in the lateral decubitus, one-lung ventilation was started with 100% oxygen, tidal volume 10 ml/kg without PEEP; arterial oxygen tension, plateau airway pressure, and static compliance were checked as baseline values (T0). Fifteen minutes later, same parameters were measured (T15). The tidal volume had changed to 6 ml/kg with 6 cmH2O PEEP. Fifteen minutes later, the same parameters were measured (T30). Results: Oxygen tension had decreased at T15 (282.1 } 83.4 mmHg) compared to T0 (477.2 } 82.4 mmHg) (P < 0.0001), but was maintained at T30 (270.4 } 81.9 mmHg). There was no difference in peak inspiratory pressure at T15 or T30 compared to T0, plateau airway pressure was increased at T15 and T30 (P < 0.05) and static lung compliance was decreased at T15 and T30 (P < 0.0001). Conclusions: In carrying out one-lung ventilation for thoracic surgery using an endoscope, the addition of a PEEP of 6 cmH2O in the dependent lung, while reducing the tidal volume of 6 ml/kg, both oxygen tension and lung compliance are maintained without increasing the plateau airway pressure. Protective lung ventilation is useful for one lung ventilation.
CITATION STYLE
Yun, D. G., Han, J. I., Kim, D. Y., Kim, J. H., Kim, Y. J., & Chung, R. K. (2014). Is small tidal volume with low positive end expiratory pressure during one-lung ventilation an effective ventilation method for endoscopic thoracic surgery? Korean Journal of Anesthesiology, 67(5), 329–333. https://doi.org/10.4097/kjae.2014.67.5.329
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