The effects of prolonged inspiratory time during one-lung ventilation: a randomised controlled trial

Systemic oxygen delivery (DO2) is a more comprehensive marker of patient status than arterial oxygen saturation (SaO2), and DO2 in the range of 330–500 mL min−1 is reportedly adequate during anaesthesia. We measured DO2 during one-lung ventilation (OLV) for thoracic surgery—where the risk of pulmonary shunt is significant, and hypoxia occurs frequently—and compared sevoflurane and propofol, the two most commonly used anaesthetics in terms of DO2. Sevoflurane impairs hypoxic pulmonary vasoconstriction. Thus, our hypothesis was that propofol-based anaesthesia would show a higher DO2 value than sevoflurane-based anaesthesia. This was a double-blinded randomised controlled trial conducted at a university hospital from 2017 to 2018. The study population consisted of patients scheduled for lobectomy under OLV (N = 120). Sevoflurane or propofol was titrated to a bispectral index of 40–50. Haemodynamic variables were measured during two-lung ventilation (TLV) and OLV at 15 and 45 min (OLV15 and OLV45, respectively) using oesophageal Doppler monitoring. The mean DO2 (mL min−1) was not different between the sevoflurane and propofol anaesthesia groups (TLV: 680 vs. 706; OLV15: 685 vs. 703; OLV45: 759 vs. 782, respectively). SaO2 was not correlated with DO2 (r = 0.09, p = 0.100). Patients with SaO2 < 94% showed adequate DO2 (641 ± 203 mL min−1), and patients with high SaO2 (> 97%) showed inadequate DO2 (14% of measurements < 500 mL min−1). In conclusion, DO2 did not significantly differ between sevoflurane and propofol. SaO2 was not correlated with DO2 and was not informative regarding whether the patients were receiving an adequate oxygen supply. DO2 may provide additional information on patient status, which may be especially important when patients show a low SaO2.

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Effect Of N-acetylcysteine In Preventing Inflammation After Lung Resection And One-Lung Ventilation. A Randomised Controlled Trial

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a5860 ◽

2010 ◽

Author(s):

Anthony J. Bastin ◽

Anna L. Lagan ◽

Sharon Mumby ◽

Gregory J. Quinlan ◽

Mark J.D. Griffiths

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Lung Resection ◽

Lung Ventilation ◽

One Lung Ventilation ◽

Randomised Controlled

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Effects of dexmedetomidine infusion on inflammatory responses during one-lung ventilation in thoracoscopic surgery: a randomised controlled trial

10.26226/morressier.58f5b02fd462b80296c9e25c ◽

2017 ◽

Author(s):

Chun Yu Wu

Keyword(s):

Randomised Controlled Trial ◽

Inflammatory Responses ◽

Thoracoscopic Surgery ◽

Controlled Trial ◽

Lung Ventilation ◽

One Lung Ventilation ◽

Randomised Controlled ◽

Dexmedetomidine Infusion

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Faculty Opinions recommendation of Effect of tidal volume on extravascular lung water content during one-lung ventilation for video-assisted thoracoscopic surgery: a randomised, controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718335784.793493569 ◽

2014 ◽

Author(s):

Greg Martin

Keyword(s):

Randomised Controlled Trial ◽

Extravascular Lung Water ◽

Thoracoscopic Surgery ◽

Controlled Trial ◽

Lung Ventilation ◽

One Lung Ventilation ◽

Lung Water ◽

Randomised Controlled ◽

Lung Water Content ◽

Video Assisted Thoracoscopic Surgery

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A randomised controlled trial on roles of prostaglandin E1 nebulization among patients undergoing one lung ventilation

BMC Pulmonary Medicine ◽

10.1186/s12890-022-01831-4 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Pengyi Li ◽

Lianbing Gu ◽

Jing Tan ◽

Zhenghuan Song ◽

Qingming Bian ◽

...

Keyword(s):

Prostaglandin E1 ◽

Controlled Trial ◽

Lung Ventilation ◽

Inflammatory Factors ◽

Pulmonary Shunt ◽

One Lung Ventilation ◽

Reference Concentration ◽

Group A ◽

Group B ◽

Randomised Controlled

Abstract Background Prostaglandin E1 (PGE1) has been reported to maintain adequate oxygenation among patients under 60% FiO2 one-lung ventilation (OLV). This research aimed to explore whether PGE1 is safe in pulmonary shunt and oxygenation under 40% FiO2 OLV and provide a reference concentration of PGE1. Methods Totally 90 esophageal cancer patients treated with thoracotomy were enrolled in this study, randomly divided into three groups (n = 30/group): Group A (60% FiO2 and 0.1 µg/kg PGE1), Group B (40% FiO2 and 0.1 µg/kg PGE1), and Group C (40% FiO2, 0.2 µg/kg PGE1). Primary outcomes were oxygenation and pulmonary shunt during OLV. Secondary outcomes included oxidative stress after OLV. Results During OLV, patients in Group C and B had lower levels of PaO2, SaO2, SpO2, MAP, and Qs/Qt than those in Group A (P < 0.05). At T2 (OLV 10 min), patients in Group C and B exhibited a lower level of PaO2/FiO2 than those in Group A, without any statistical difference at other time points. The IL-6 levels of patients in different groups were different at T8 (F = 3.431, P = 0.038), with IL-6 in Group C being lower than that in Group B and A. MDA levels among the three groups differed at T5 (F = 4.692, P = 0.012) and T7 (F = 5.906, P = 0.004), with the MDA level of Group C being lower than that of Group B and A at T5, and the MDA level of Group C and B being lower than that of Group A at T7. In terms of TNF-α level, patients in Group C had a lower level than those in Group B and A at T8 (F = 3.598, P = 0.033). Compared with patients who did not use PGE1, patients in Group C had comparable complications and lung infection scores. Conclusion The concentration of FiO2 could be reduced from 60 to 40% to maintain oxygenation. 40% FiO2 + 0.2 µg/kg PGE1 is recommended as a better combination on account of its effects on the inflammatory factors. Trial registration: Chictr.org.cn identifier: ChiCTR1800018288, 09/09/2018.

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