Is Hypoxic Pulmonary Vasoconstriction Exaggerated During One-Lung Ventilation in Patients With Patent Ductus Arteriosus?

1991 ◽  
Vol 72 (2) ◽  
pp. 238-240 ◽  
Author(s):  
Anis S. Baraka ◽  
Samar K. Taha ◽  
Rania A. El-Khatib
Keyword(s):  
Patent Ductus Arteriosus ◽  
Hypoxic Pulmonary Vasoconstriction ◽  
Ductus Arteriosus ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Pulmonary Vasoconstriction ◽  
Patent Ductus

One-Lung Ventilation for Video-Assisted Thoracoscopic Interruption of Patent Ductus Arteriosus

Surgery Today ◽  
2004 ◽  
Vol 34 (12) ◽  
pp. 1006-1009 ◽  
Author(s):  
Kagami Miyaji ◽  
Koui Ka ◽  
Hirotsugu Okamoto ◽  
Tai-ichi Takasaki ◽  
Kuniyoshi Ohara ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Video Assisted ◽  
Patent Ductus

Lung Isolation

2018 ◽  
Author(s):  
Bryan Hierlmeier ◽  
Vanetta Levesque ◽  
Henrique Vale
Keyword(s):  
Thoracoscopic Surgery ◽  
Hypoxic Pulmonary Vasoconstriction ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Lung Protective Ventilation ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lung Isolation ◽  
Pulmonary Vasoconstriction ◽  
Protective Strategies

Lung isolation is being used more frequently in adult patients due to increasing incidence of thoracoscopy and video-assisted thoracoscopic surgery. There are several indications for lung isolation and one-lung ventilation (OLV) during surgery. Isolation is usually achieved by double-lumen endotracheal tubes or use of some type of bronchial blocker system. The initiation of OLV frequently leads to hypoxemia, the management of which should be stepwise. Additionally, clinical outcomes are significantly improved with the use of lung protective strategies during OLV. This review covers the use of few of the most common lung isolation devices, management of OLV using lung protective ventilation strategies, and management of oxygenation and hypoxemia during OLV. This review contains 12 figures, 6 tables, and 36 references. Key Words: bronchial blockers, double-lumen tube, uninvent, hypoxemia, hypoxic pulmonary vasoconstriction, one lung ventilation, positive end expiratory pressure, tracheal anatomy, lung isolation

Hypoxic Pulmonary Vasoconstriction

2015 ◽  
Vol 122 (4) ◽  
pp. 932-946 ◽  
Author(s):  
Andrew B. Lumb ◽  
Peter Slinger
Keyword(s):  
Hypoxic Pulmonary Vasoconstriction ◽  
Lung Ventilation ◽  
Second Phase ◽  
Lung Pathology ◽  
Regional Ventilation ◽  
One Lung Ventilation ◽  
Intravenous Anesthetic ◽  
Anesthetic Drugs ◽  
Pulmonary Vasoconstriction ◽  
Ventilation And Perfusion

Abstract Hypoxic pulmonary vasoconstriction (HPV) represents a fundamental difference between the pulmonary and systemic circulations. HPV is active in utero, reducing pulmonary blood flow, and in adults helps to match regional ventilation and perfusion although it has little effect in healthy lungs. Many factors affect HPV including pH or Pco2, cardiac output, and several drugs, including antihypertensives. In patients with lung pathology and any patient having one-lung ventilation, HPV contributes to maintaining oxygenation, so anesthesiologists should be aware of the effects of anesthesia on this protective reflex. Intravenous anesthetic drugs have little effect on HPV, but it is attenuated by inhaled anesthetics, although less so with newer agents. The reflex is biphasic, and once the second phase becomes active after about an hour of hypoxia, this pulmonary vasoconstriction takes hours to reverse when normoxia returns. This has significant clinical implications for repeated periods of one-lung ventilation.

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