scholarly journals A Simple Effective Pharmacological Treatment of Hypoxemia During One-Lung Ventilation

2019 ◽  
Vol 8 (8) ◽  
pp. 1139
Author(s):  
Davide Chiumello ◽  
Silvia Coppola ◽  
Erica Ferrari
Keyword(s):  
Clinical Practice ◽  
Pharmacological Treatment ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Physiological Mechanisms

Hypoxemia during one-lung ventilation is a challenge in the clinical practice. Moving from the results of the study conducted by Choi et al., we discuss the possibility to modulate hypoxemia by administering iloprost via inhalation, in the light of the physiological mechanisms.

scholarly journals A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chuan-Yi Kuo ◽  
Ying-Tung Liu ◽  
Tzu-Shan Chen ◽  
Chen-Fuh Lam ◽  
Ming-Cheng Wu
Keyword(s):  
Clinical Practice ◽  
Practice Guideline ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Ventilator Support ◽  
Lung Protection ◽  
Expert Opinions ◽  
Survey Form ◽  
Thoracic Anesthesia ◽  
Protective Lung Ventilation

Abstract Background There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan. Methods This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV. Results A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6–7 ml/kg PBW (67.6%) and a PEEP level of 4–6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 > 0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established. Conclusions This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

scholarly journals Pharmacological Treatment of Hypoxemia during One-lung Ventilation

2011 ◽  
Vol 115 (2) ◽  
pp. 439-441
Author(s):  
Hadrien Rozé ◽  
Mathieu Lafargue ◽  
Alexandre Ouattara
Keyword(s):  
Pharmacological Treatment ◽  
Lung Ventilation ◽  
One Lung Ventilation

scholarly journals Pharmacological Treatment of Hypoxemia during One-lung Ventilation

2011 ◽  
Vol 115 (2) ◽  
pp. 439-439 ◽  
Author(s):  
Lluís Gallart ◽  
Teresa Silva-Costa-Gomes ◽  
Silvia Bermejo ◽  
Jordi Vallès
Keyword(s):  
Pharmacological Treatment ◽  
Lung Ventilation ◽  
One Lung Ventilation

scholarly journals A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

2020 ◽  
Author(s):  
Chuan-Yi Kuo ◽  
Ying-Tung Liu ◽  
Tzu-Shan Chen ◽  
Chen-Fuh Lam ◽  
Ming-Cheng Wu
Keyword(s):  
Clinical Practice ◽  
Practice Guideline ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Ventilator Support ◽  
Lung Protection ◽  
Expert Opinions ◽  
Survey Form ◽  
Thoracic Anesthesia ◽  
Protective Lung Ventilation

Abstract Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan. Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV. Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established. Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

scholarly journals A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

2019 ◽  
Author(s):  
Chuan-Yi Kuo ◽  
Ying-Tung Liu ◽  
Chen-Fuh Lam ◽  
Ming-Cheng Wu
Keyword(s):  
Clinical Practice ◽  
Practice Guideline ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Ventilator Support ◽  
Lung Protection ◽  
Expert Opinions ◽  
Survey Form ◽  
Thoracic Anesthesia ◽  
Protective Lung Ventilation

Abstract Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan.Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV.Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established.Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

scholarly journals A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

2020 ◽  
Author(s):  
Chuan-Yi Kuo ◽  
Ying-Tung Liu ◽  
Tzu-Shan Chen ◽  
Chen-Fuh Lam ◽  
Ming-Cheng Wu
Keyword(s):  
Clinical Practice ◽  
Practice Guideline ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Ventilator Support ◽  
Lung Protection ◽  
Expert Opinions ◽  
Survey Form ◽  
Thoracic Anesthesia ◽  
Protective Lung Ventilation

Abstract Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan.Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV.Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established.Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

scholarly journals A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

2020 ◽  
Author(s):  
Chuan-Yi Kuo ◽  
Ying-Tung Liu ◽  
Tzu-Shan Chen ◽  
Chen-Fuh Lam ◽  
Ming-Cheng Wu
Keyword(s):  
Clinical Practice ◽  
Practice Guideline ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Ventilator Support ◽  
Lung Protection ◽  
Expert Opinions ◽  
Survey Form ◽  
Thoracic Anesthesia ◽  
Protective Lung Ventilation

Abstract Background: There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan. Methods: This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV. Results: A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6-7 ml/kg PBW (67.6%) and a PEEP level of 4-6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 >0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established. Conclusions: This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

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