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Effects of a 1:1 inspiratory to expiratory ratio on respiratory mechanics and oxygenation during one-lung ventilation in patients with low diffusion capacity of lung for carbon monoxide: a crossover study

DC FieldValueLanguage
dc.contributor.author김신형-
dc.contributor.author오영준-
dc.contributor.author최용선-
dc.date.accessioned2018-03-26T17:11:56Z-
dc.date.available2018-03-26T17:11:56Z-
dc.date.issued2015-
dc.identifier.issn0952-8180-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/157329-
dc.description.abstractSTUDY OBJECTIVE: To investigate the effects of a 1:1 inspiratory-to-expiratory (I:E) ventilation ratio on oxygenation and respiratory mechanics during one-lung ventilation (OLV) in patients with low diffusion capacity of lung for carbon monoxide (DLCO). DESIGN: Prospective, randomized, crossover study. SETTING: Operating room, university hospital. PATIENTS: Twenty-six patients with a preoperative DLCO less than 80% who were scheduled for lung lobectomy requiring OLV under general anesthesia. INTERVENTIONS: In the first group (n = 13), OLV was begun with a 1:1 I:E ratio, which was switched to a 1:2 I:E ratio after 30 minutes. In the second group (n = 13), the modes of ventilation were performed in the opposite order. Pressure-controlled ventilation with 5 cm H2O of positive end-expiratory pressure and a tidal volume of 5 to 8 mL/kg was applied during OLV. MEASUREMENTS: Arterial and central venous blood gas analyses were recorded and used to calculate intrapulmonary shunt fraction and physiologic dead space. These measurements were taken at 4 time points: 10 minutes after two-lung ventilation in the lateral decubitus position, 30 minutes after initiation of OLV, 30 minutes after switching the I:E ratio, and 10 minutes after two-lung ventilation was resumed. MAIN RESULTS: There was no difference in arterial oxygen tension during OLV between the 2 groups (P = .429). Arterial carbon dioxide tension and peak airway pressure were lower in the 1:1 group than in the 1:2 group (P = .003; P = .008). Physiologic dead space was also decreased in the 1:1 I:E ratio group (P = .003). Mean airway pressure and dynamic compliance were higher in the 1:1 group (P = .003; P = .007). CONCLUSIONS: Pressure-controlled ventilation with a 1:1 I:E ventilation ratio did not improve oxygenation in patients with low DLCO during OLV compared with a 1:2 I:E ventilation ratio. However, it did provide benefits in terms of respiratory mechanics and increased the efficiency of alveolar ventilation during OLV.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier-
dc.relation.isPartOfJOURNAL OF CLINICAL ANESTHESIA-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHCarbon Monoxide/metabolism*-
dc.subject.MESHCross-Over Studies-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLung/metabolism*-
dc.subject.MESHLung/surgery-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHOne-Lung Ventilation/methods*-
dc.subject.MESHOxygen Inhalation Therapy/methods*-
dc.subject.MESHPositive-Pressure Respiration-
dc.subject.MESHProspective Studies-
dc.subject.MESHPulmonary Diffusing Capacity*-
dc.subject.MESHRespiratory Dead Space-
dc.subject.MESHRespiratory Function Tests-
dc.subject.MESHRespiratory Mechanics*-
dc.subject.MESHTidal Volume-
dc.subject.MESHYoung Adult-
dc.titleEffects of a 1:1 inspiratory to expiratory ratio on respiratory mechanics and oxygenation during one-lung ventilation in patients with low diffusion capacity of lung for carbon monoxide: a crossover study-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Anesthesiology and Pain Medicine-
dc.contributor.googleauthorKyuho Lee-
dc.contributor.googleauthorYoung Jun Oh-
dc.contributor.googleauthorYong Seon Choi-
dc.contributor.googleauthorShin Hyung Kim-
dc.identifier.doi10.1016/j.jclinane.2015.06.012-
dc.contributor.localIdA00676-
dc.contributor.localIdA02389-
dc.contributor.localIdA04119-
dc.relation.journalcodeJ01315-
dc.identifier.eissn1873-4529-
dc.identifier.pmid26263797-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S095281801500197X-
dc.subject.keywordOne-lung ventilation-
dc.subject.keywordinspiratory-expiratory ratio-
dc.subject.keywordoxygenation-
dc.subject.keywordrespiratory mechanics-
dc.contributor.alternativeNameKim, Shin Hyung-
dc.contributor.alternativeNameOh, Young Jun-
dc.contributor.alternativeNameChoi, Yong Seon-
dc.contributor.affiliatedAuthorKim, Shin Hyung-
dc.contributor.affiliatedAuthorOh, Young Jun-
dc.contributor.affiliatedAuthorChoi, Yong Seon-
dc.citation.volume27-
dc.citation.number6-
dc.citation.startPage445-
dc.citation.endPage450-
dc.identifier.bibliographicCitationJOURNAL OF CLINICAL ANESTHESIA, Vol.27(6) : 445-450, 2015-
dc.identifier.rimsid42362-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers

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