ID 110837
著者
Lesser, Thomas Department of Thoracic and Vascular Surgery, SRH Wald-Klinikum Gera
Schubert, Harald Institute of Animal Experimentation, Friedrich-Schiller-University of Jena
Klinzing, Stephan Department of Anaesthesiology, Friedrich-Schiller-University of Jena
キーワード
pulmonary right-to-left shunt volume
side-separated determination
one-lung ventilation
資料タイプ
学術雑誌論文
抄録
Background :With the present method of intrapulmonary right-to-left shunt volume calculation, no differentiation can be made between the shunt volume shares of the right and left lungs. For a better understanding of pathophysiological processes during thorax surgery with side-separated ventilation, a side-separated shunt volume determination would be useful. Materials and Methods : In 14 young female pigs, catheters were implanted into the left atrium after left thoracotomy. After transient clamping of the ipsilateral pulmonary veins, pulmonary venous blood was selectively obtained from the right lung. Cardiac output (CO) and side-separated pulmonary perfusion were determined with flowprobes at the pulmonary trunk and the left pulmonary artery. The shunt volumes were determined before and after thoracotomy during two-lung ventilation (Two-LV), after one-lung (right) ventilation (One-LV) with a continuous positive airway pressure (CPAP) of +7.5, +5.0 cm H2O, and under atelectasis of the non-dependent left lung (NDL). Results : After thoracotomy in lateral decubitus position and Two-LV, the shunt volumes of the two lungs differ. The right lung holds the major share (11.0±1.7%CO) [mean±SD]. The share of the left NDL is only 3.3±1.4. Under One-LV (right) and CPAP in the NDL, the total pulmonary shunt volume rises. This is caused by the increase in the NDL shunt volume share to 8.8±5.2 under CPAP +7.5 (p<0.05) and to 9.7±2.5 under CPAP +5.0 (p<0.05). Conclusions : The new intraoperative method of side-separated arterial blood gas analysis in conjunction with side-separated perfusion measurement makes side- separated rightto- left shunt volume determination possible and may lead to interesting new pathophysiological insights.
掲載誌名
The journal of medical investigation : JMI
ISSN
13431420
cat書誌ID
AA11166929
55
1-2
開始ページ
44
終了ページ
50
並び順
44
発行日
2008-02
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版