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Revista Cubana de Anestesiología y Reanimación

2014, Number 3

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Revista Cubana de Anestesiología y Reanimación 2014; 13 (3)

Predictive factors for hypoxemia during one-lung ventilation at 'Dr. Salvador Allende' hospital

Salgado BY, Orizondo PSA, Valderrama IMJ, González CJM

Language: Spanish
References: 21
Page: 241-252
PDF size: 140.05 Kb.


ABSTRACT

Introduction: maintaining adequate oxygenation during one-lung ventilation is the main concern in thoracic surgery. Prior identification of patients who may present arterial oxygenation alterations is an important advantage.
Objectives: determine the incidence of hypoxemia during one-lung ventilation, as well as the pre- and intraoperative variables predicting it.
Methods: an observational analytical retrospective cohort study was conducted at Dr. Salvador Allende hospital. The study population was all patients requiring intrathoracic surgery from January 2007 to December 2011.
Results: incidence of hypoxemia during one-lung ventilation was 9.7%. Height under 160 cm and the side operated on (right) showed a statistically significant relationship to the possibility of developing hypoxemia during one-lung ventilation.
Conclusions: hypoxemia during one-lung ventilation is a current problem at the study hospital. Although statistically significant variables are not very modifiable, at least they serve as indicators for patients at greater risk.


REFERENCES

  1. Weiss JS, Ochroch EA. Anesthesia Thoracic. En: Anesthesiology. Longneker ED, Newman FM, Brown LD, Zapol MW. McGrew Hill Medical. New York. 2008. p.1213-83.

  2. Morgan GE, Maged SM, Murray MJ, Larson P. Anestesiologia Clínica. 4ta Edición. El Manual Moderno. México. 2007. p.563-89.

  3. Pardos PC, Garutti I, Piñeiro P, Olmedilla L, Gala de la F. Effects of mode during one-lung ventilation on intraoperative and postoperative arterial oxygenation in thoracic surgery. J Cardiothorac Vasc Anesth. 2009;23(6):770-74.

  4. Guenoun T, Journois D, Silleran-Chassany J, Frappier J, D´attellis N, Salem A. et al. Prediction of arterial oxygen tensión during one-lung ventilation: analysis of preoperative and intraoperative variables. J Cardiothorac Vasc Anesth. 2002;16(2):199-203.

  5. Waheedullah K, Schwarzkoff K. Hypoxemia during one-lung ventilation. Anesthesiology. 2009;110(6):5-15.

  6. Slinger P, Suissa S. Predicting arterial oxygenation during one-lung anaesthesia. Can J. Anaesth. 1992;39(10):1030-5.

  7. Molina-Mendez FJ, Lesprón RM. Manejo de la hipoxemia durante la ventilación de un solo pulmón. Rev Mex de Anestesiolog. 2011;34(supl1):64-67.

  8. Slinger P. Low tidal volumen is indicated during one-lung. Anesth and Analg. 2006;103(2):268-70.

  9. Brodsky J, Lemmes HJ. Left double-lumen tubes: clinical experience with 1170 patients. J Cardiothorac Vasc Anesth. 2003;17:289-98.

  10. Jimenez MJ. Anestesia para cirugía torácica y resección pulmonar. [En linea]. [Consultado octubre 2013]. URL disponible en: http://www.acmb.es-societats-dolorarxius- torax02.pdf.

  11. Barash PG, Cullen BF, Stoelting RK Anestesia Clínica. Volumen II. 6ta ed. McGraw-Hill Interamericana. New York. 2010. Pp905-943.

  12. Pruszkowski O, Dalibon N, Moutafis M. Effects of propofol vs sevoflurane on arterial oxygenation during one-lung ventilation. Br J Anaesth. 2007;98:539-44.

  13. Fukuoka N, Iida H, Akamatsu S, Nagase K, Iwata H, Dohi S. The association between the initial end-tidal carbon dioxide difference and the lowest arterial oxygen tension value obtained during one-lung anesthesia with propofol or sevoflurane. J Cardiothorac Vasc Anesth. 2009; 23(6):775-779.

  14. Garutti I, Quintana B, Olmedilla L. Arterial oxygenation during one-lung ventilation: combined versus general anesthesia. Anesth & Analg. 1999;88:494-499.

  15. Casati A, Mascotto G, Iemi K, Nzepa-Batonga J, De Luca M. Epidural block does not worsen oxygenation during one-lung ventilation for lung resections under isoflurane/nitrous oxide anesthesia. Eur J Anaesthesiol. 2005;22:363–8.

  16. Schultz MJ. Lung-protective mechanical ventilation with lower tidal volumes in patients not suffering from acute lung injury: a review of clinical studies. Med Sci Monit 2008; 14: RA22–RA26.

  17. Pardos PC, Garutti I, Piñero P, Olmedilla L, Gala F. Effects of ventilatory mode during one-lung ventilation on intraoperative and postoperative arterial oxygenation in thoracic surgery. J Cardithorac Vasc Anesth. 2009;23(6):770-74.

  18. Orizondo Pajón SA, Morúa-Delgado Varela M, Falcón Guerra M, Pimienta Peguero M, Nicolau Cruz I. Ventilación por presión en cirugía torácica. Rev Cuba Anestesiol Reanim. [En línea]. [Consultado: Agosto 2014]. URL disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726- 67182009000200006&lng=es.

  19. Unzueta MC, Casas JI, Moral MV. Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery. Anesth & Analg. 2007;104:1029-1033.

  20. Losher J. Evidence-based management of one-lung ventilation. Anesthesiology Clin. 2008;26:241-272.

  21. Cadi P, Guenoun T, Journois D. Pressure-controlled ventilation improves oxygenation during laparoscopic obesity surgery compared with volume-controlled ventilation. Br J Anaesth. 2008;100:709-716.




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