Effects of tidal volume on arterial oxygenation and intrapulmonary shunt during one lung ventilation / 临床麻醉学杂志

ABSTRACT

Objective To investigate the effects of different tidal volume (V_T) on arterial oxygenation and intrapulmonary shunt(Q_S/Q_T) during one lung ventilation(OLV).Methods Sixty patients scheduled for selective lobectomy under left lateral decubitus position were randomly divided into groups of A,B and C with 20 cases each.After bronchial induction,two lung ventilation(TLV) was performed with V_T 10 ml/kg,frequency(f) 12 breaths per minute(BPM),ratio of inspiration to expiration(I: E) was 1:2 at first.During OLV,I: E was kept steady,V_T 6 ml/kg and f 20 BPM were chosed in group A,V_T8 ml/kg and f 15 BPM in group B,V_T 10ml/kg,f 12 BPM in group C.Blood gas analysis was determined before OLV (T_1) and at 10 min(T_2) ,20 min(T_3) ,and 30 min after OLV (T_4).Q_S/Q_T and lung complience(Cdyn) was calculated.Results OLV Compaired to T_1,PaO_2 and Cdyn were lower (P<0.05) and Q_S,Q_T and peak airway pression were increased (P<0.05).The decrease of PaO_2 was more in groups of A and C than that in group B(P<0.05).Conclusion During OLV,a better PaO_2.may be maintained with the ventilation parameters of V_T8 ml/kg and f 15 BPM with less increase in Q_S/Q_T and higher Cdyn.