Application of One-Lung High Frequency Jet Ventilation in Lung Surgery
INTRODUCTION: In the present day, one-lung jet ventilation is applied in case of a necessity to isolate the healthy lung during operations. HFJV ensures excellent oxygenation of arterial blood, keeps the lungs in a relaxed state without execution of a recruitment maneuver and increases venous return and cardiac output by lowering the workload of the left ventricle.
METHODS: Three groups consisting of 50 patients who underwent lung surgery during which two-lungs conventional mechanical ventilation (CMV), one-lung conventional mechanical ventilation (OCMV) and one-lung high frequency jet ventilation (OHFJV) were applied, were compared in terms of gas exchange and hemodynamics parameters. Artificial ventilation was applied through a single-lumen endotracheal tube located in the main bronchus of the healthy lung. In case of necessity of left main bronchus intubation, a correcting triple maneuver was executed. Usage of standard single-lumen endotracheal tubes ensured a good isolation of the healthy lung, facileness of sanitation and bronchoscopic control of the location of the tube.
RESULTS: In comparison of OHFJV to OCMV, the results of the study demonstrated a decrease of: PIP by 26.5%; Pes by 81.6%; PVR by 41.7%, an increase of: PaO2 by 66.1%; HBI by 91.0%; CVP by 28.3% and maintaining of normal pH=7.42 and PaCO2=34.5 mm Hg.
CONCLUSIONS: Under conditions of OHFJV, even a complete atelectasis of one lung does not go along with a considerable disorder of gas exchange in contrast to OCMV. This enabled a wider application of this kind of ventilation for lung surgeries on patients with distinct gas exchange and hemodynamics disorders.
PRAKTEK Alamat baru: