| Effects of Various Ventilatory Pattern of Upper Lung on Arterial Blood Gas Tension During Thoractomy. |
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Tae Ho Chang, Kyung Han Kim |
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Department of Anesthesiology, Kosin Medical College, Pusan, Korea. |
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| Abstract |
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This study was understaken to observe the effects of various ventilatory patterns of the upper lung on pulmonary shunt fraction in the lateral decubitus position during thoractomy by assessing asterial blood gas. Twelve adult patients were intubated with Portex doube-lumen tube and the tidal volume, respiratory rare were maintained at 10ml/kg and 12/min, respectively, during anesthesia. Arterial blood gas was analyzed at 15min after beginning the following stages: 1) lateral decubitus position before the chest was opened: 2) surgical retraction of the upper lung after the chest was opened: 3) selective collapse of the upper lung while the lower lung is ventilated: 4) selective oxygen insuffiation to the upper lung(5L/min) with PEEP of 10 cmH2O. The results were as follows: 1) In stage 2, the value of PaO2 (173.6+/-21.4mmHg) was significantly decreased compared with that of stage 1 (267.5+/-32.6mmHg). 2) in the stage 3, the value of PaO2, PaCO2 and pH was 97.3+/-18.6mmHg, 48.85+/-3.33mmHg and 7.32+/-0.05, respectively, and showed a tendency toward respiratory acidosis. 3) In stage 4, the value of PaO2, was 129.8+/-18.6mmHg, and showed much improvement in arterial oxygenation compared with that of stage 3. 4) In all stages, there were no significant changes in blood pressure and heart rate except fro significant fall in blood pressure during stage 3. |
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