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Jens Lohser - One of the best experts on this subject based on the ideXlab platform.
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step by step clinical management of One Lung Ventilation continuing professional development
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2014Co-Authors: Charles L Brassard, Jens Lohser, Francois Donati, Jean S BussieresAbstract:Purpose The purpose of this Continuing Professional Development Module is to review the issues pertinent to One-Lung Ventilation (OLV) and to propose a management strategy for Ventilation before, during, and after Lung isolation.
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clinical management of One Lung Ventilation
2011Co-Authors: Jens Lohser, Seiji IshikawaAbstract:Ventilation needs to be individualized for the underlying Lung pathology. Ventilation is a modifiable risk factor for acute Lung injury. Protective Lung Ventilation is a combination of small tidal volumes, low peak and plateau pressures, routine PEEP and permissive hypercapnea. Hypoxia during One-Lung Ventilation is rare and often secondary to alveolar de-recruitment in the face of hypoVentilation. Management of hypoxia requires a structured treatment algorithm.
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physiology of the lateral decubitus position open chest and One Lung Ventilation
2011Co-Authors: Jens Lohser, Seiji IshikawaAbstract:Ventilation and perfusion matching is optimized for gas exchange. Induction of anesthesia, One-Lung Ventilation (OLV) and opening of the chest progressively uncouple Ventilation–perfusion (V/Q) matching. Hypoxic pulmonary vasoconstriction (HPV) improves V/Q matching during OLV, but can be impaired by anesthetic interventions.
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evidence based management of One Lung Ventilation
Anesthesiology Clinics, 2008Co-Authors: Jens LohserAbstract:One-Lung Ventilation (OLV) is essential for many thoracic and an increasing number of non-thoracic minimally invasive procedures. Beyond the well-recognized disturbance of Ventilation–perfusion matching, recent years have seen a mounting body of evidence implicating OLV in the creation of acute Lung injury. After reviewing the fundamentals of OLV physiology, this article examines the evidence for altering individual ventilatory parameters toward protective OLV.
John Gothard - One of the best experts on this subject based on the ideXlab platform.
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Lung injury after thoracic surgery and One Lung Ventilation
Current Opinion in Anesthesiology, 2006Co-Authors: John GothardAbstract:Purpose of review An update is provided for anaesthetists, on recent work investigating the incidence and cause of Lung injury following thoracic surgery. Pulmonary damage is also discussed in relation to the management of One-Lung Ventilation. Recent findings The extent of recent original literature on Lung injury, following thoracic surgery, is limited for the review period (2004–2005). Increasing evidence that pulmonary oxidative stress and an increase in proinflammatory cytokines are significant contributors to Lung injury following thoracic surgery, however, exists. This is particularly the case in patients with Lung or oesophageal carcinoma. Animal experiments confirm the above and also indicate that anaesthetic agents may offer some protection against the ischaemia–reperfusion injury sustained as a result of One-Lung Ventilation. Summary Pulmonary damage in the form of acute Lung injury and adult respiratory distress syndrome is a major cause of morbidity and mortality after thoracic surgery. An understanding of the pathogenesis of Lung damage, following thoracic surgery, may enable anaesthetists to modify this process and decrease the incidence and severity of the problem.
Elvira Garcia De Lucas - One of the best experts on this subject based on the ideXlab platform.
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arterial oxygenation during One Lung Ventilation combined versus general anesthesia
Anesthesia & Analgesia, 1999Co-Authors: Ignacio Garutti, Luis Olmedilla, Begona Quintana, Alberto Cruz, Monica Barranco, Elvira Garcia De LucasAbstract:The optimal anesthetic management of patients undergoing thoracotomy for pulmonary resection has not been definitely determined.We evaluated whether general IV anesthesia (propofol-fentanyl) provides superior PaO2 during One-Lung Ventilation (OLV) compared with thoracic epidural anesthesia (TEA) wit
S. Necek - One of the best experts on this subject based on the ideXlab platform.
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The effects of One-Lung Ventilation compared with carbon dioxide insufflation
2020Co-Authors: H. Brock, R. Rieger, Christian Gabriel, W. Moosbauer, S. NecekAbstract:Summary We investigated the haemodynamic and respiratory effects of One-Lung Ventilation and carbon dioxide insufflation in 13 adult patients undergoing video-assisted thoracoscopy. Cardiorespiratory variables were determined during carbon dioxide insufflation at intrahemithoracic pressures of 5, 10 and 15 mmHg, and after 5 and 15 min of One-Lung Ventilation. Carbon dioxide insufflation was associated with a clear deterioration in circulatory function. The cardiac index decreased subsequent to increasing intrathoracic pressures. The mean cardiac index (SD) at pressures of 10 and 15 mmHg was 1.86 (0.39) and 1.52 (0.46), respectively, and may be compared with the reduced venous return consistent with tension pneumothorax. One-Lung Ventilation did not affect haemodynamic variables but reduced arterial oxygenation indices (PaO2/FIO2) from 424.29 (160.79) after induction of anaesthesia, to 207.72 (125.50) after 5 min and 172.04 (72.03) after 15 min of One-Lung Ventilation, respectively. The oxygenation index was not influenced by intrahemithoracic carbon dioxide insufflation. One-Lung Ventilation via a double-lumen endobronchial tube is safe and convenient for video-assisted thoracoscopic surgery. It has no further consequences on haemodynamic variables, whereas the compression of the Lung by carbon dioxide insufflation may cause circulatory dysfunction.
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Haemodynamic changes during thoracoscopic surgery The effects of One‐Lung Ventilation compared with carbon dioxide insufflation
Anaesthesia, 2002Co-Authors: H. Brock, R. Rieger, Christian Gabriel, W. Moosbauer, W Polz, S. NecekAbstract:We investigated the haemodynamic and respiratory effects of One-Lung Ventilation and carbon dioxide insufflation in 13 adult patients undergoing video-assisted thoracoscopy. Cardiorespiratory variables were determined during carbon dioxide insufflation at intrahemithoracic pressures of 5, 10 and 15 mmHg, and after 5 and 15 min of One-Lung Ventilation. Carbon dioxide insufflation was associated with a clear deterioration in circulatory function. The cardiac index decreased subsequent to increasing intrathoracic pressures. The mean cardiac index (SD) at pressures of 10 and 15 mmHg was 1.86 (0.39) and 1.52 (0.46), respectively, and may be compared with the reduced venous return consistent with tension pneumothorax. One-Lung Ventilation did not affect haemodynamic variables but reduced arterial oxygenation indices (Pao2/FIo2) from 424.29 (160.79) after induction of anaesthesia, to 207.72 (125.50) after 5 min and 172.04 (72.03) after 15 min of One-Lung Ventilation, respectively. The oxygenation index was not influenced by intrahemithoracic carbon dioxide insufflation. One-Lung Ventilation via a double-lumen endobronchial tube is safe and convenient for video-assisted thoracoscopic surgery. It has no further consequences on haemodynamic variables, whereas the compression of the Lung by carbon dioxide insufflation may cause circulatory dysfunction.
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haemodynamic changes during thoracoscopic surgery the effects of One Lung Ventilation compared with carbon dioxide insufflation
Anaesthesia, 2000Co-Authors: H. Brock, R. Rieger, Christian Gabriel, W. Moosbauer, W Polz, S. NecekAbstract:We investigated the haemodynamic and respiratory effects of One-Lung Ventilation and carbon dioxide insufflation in 13 adult patients undergoing video-assisted thoracoscopy. Cardiorespiratory variables were determined during carbon dioxide insufflation at intrahemithoracic pressures of 5, 10 and 15 mmHg, and after 5 and 15 min of One-Lung Ventilation. Carbon dioxide insufflation was associated with a clear deterioration in circulatory function. The cardiac index decreased subsequent to increasing intrathoracic pressures. The mean cardiac index (SD) at pressures of 10 and 15 mmHg was 1.86 (0.39) and 1.52 (0.46), respectively, and may be compared with the reduced venous return consistent with tension pneumothorax. One-Lung Ventilation did not affect haemodynamic variables but reduced arterial oxygenation indices (Pao2/FIo2) from 424.29 (160.79) after induction of anaesthesia, to 207.72 (125.50) after 5 min and 172.04 (72.03) after 15 min of One-Lung Ventilation, respectively. The oxygenation index was not influenced by intrahemithoracic carbon dioxide insufflation. One-Lung Ventilation via a double-lumen endobronchial tube is safe and convenient for video-assisted thoracoscopic surgery. It has no further consequences on haemodynamic variables, whereas the compression of the Lung by carbon dioxide insufflation may cause circulatory dysfunction.
Ignacio Garutti - One of the best experts on this subject based on the ideXlab platform.
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Deep versus moderate neuromuscular block during One-Lung Ventilation in Lung resection surgery
Revista Brasileira De Anestesiologia, 2017Co-Authors: Javier Casanova, Patricia Piñeiro, Francisco De La Gala, Luis Olmedilla, Patricia Cruz, Patricia Duque, Ignacio GaruttiAbstract:Abstract Background and objectives Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in One-Lung Ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during One-Lung Ventilation is not deleterious. Methods A prospective, longitudinal observational study was made in which each patient served as both treated subject and control. 76 consecutive patients programmed for Lung resection surgery in Gregorio Maranon Hospital along 2013 who required One-Lung Ventilation in lateral decubitus were included. Ventilator data, hemodynamic parameters were registered in different moments according to train-of-four response (intense, deep and moderate blockade) during One-Lung Ventilation. Results Peak, plateau and mean pressures were significantly lower during the intense and deep blockade. Besides compliance and peripheral oxygen saturation were significantly higher in that moments. Heart rate was significantly higher during deep blockade. No mechanical Ventilation parameters were modified during measurements. Conclusions Deep neuromuscular blockade attenuates the poor Lung mechanics observed during One-Lung Ventilation.
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arterial oxygenation during One Lung Ventilation combined versus general anesthesia
Anesthesia & Analgesia, 1999Co-Authors: Ignacio Garutti, Luis Olmedilla, Begona Quintana, Alberto Cruz, Monica Barranco, Elvira Garcia De LucasAbstract:The optimal anesthetic management of patients undergoing thoracotomy for pulmonary resection has not been definitely determined.We evaluated whether general IV anesthesia (propofol-fentanyl) provides superior PaO2 during One-Lung Ventilation (OLV) compared with thoracic epidural anesthesia (TEA) wit
