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Effects of head-up tilt on intrapulmonary shunt fraction and oxygenation during 1-lung ventilation in the lateral decubitus position.

Authors
Park, SY; Kim, DH; Kim, JS; Lee, SS; Hong, YW
Citation
The Journal of thoracic and cardiovascular surgery, 139(6):1436-1440, 2010
Journal Title
The Journal of thoracic and cardiovascular surgery
ISSN
0022-52231097-685X
Abstract
OBJECTIVE: Hypoxemia is a common problem of 1-lung ventilation. Arterial oxygenation progressively decreases after 1-lung ventilation. The surgical position influences the shunt and arterial oxygenation. Therefore we evaluated the effect of head-up tilt on intrapulmonary shunt and oxygenation during 1-lung ventilation in the lateral decubitus position.



METHODS: Twenty patients requiring 1-lung ventilation were included in this study. During 1-lung ventilation, hemodynamic and respiratory variables were measured 15 minutes after horizontal positioning in the lateral decubitus position (baseline), 5 and 10 minutes after a 10-degree head-up tilt (T5 and T10, respectively), and 10 minutes after the patient was returned to a horizontal position (T20). Arterial and mixed venous blood analyses were performed at the same time points.



RESULTS: Arterial oxygenation was increased, and shunt was decreased significantly during head-up tilt position in 1-lung ventilation. These changes were accompanied by decreases in the mean arterial pressure and cardiac filling pressures without significant changes in cardiac index.



CONCLUSIONS: Head-up tilt during 1-lung ventilation in the lateral decubitus position caused a significant decrease in shunt and an increase in arterial oxygenation that persisted after the patient was returned to the horizontal lateral decubitus position.
MeSH terms
Female*HemodynamicsHumansIntraoperative CareMaleMiddle AgedOxygen/*blood*Patient Positioning*Pneumonectomy/methods*Pulmonary Gas Exchange
DOI
10.1016/j.jtcvs.2009.07.041
PMID
19709681
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Thoracic & Cardiovascular Surgery
Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
AJOU Authors
박, 성용김, 대희김, 진수이, 성수홍, 용우
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