open access

Vol 47, No 1 (2015)
Original and clinical articles
Submitted: 2015-03-06
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Effects of unilateral PEEP on biomechanics of both lungs during independent lung ventilation in patients anaesthetised for thoracic surgery

Katarzyna Trela-Stachurska, Andrzej Nestorowicz, Edyta Kotlińska-Hasiec, Sławomir Sawulski, Wojciech Dąbrowski
DOI: 10.5603/AIT.2015.0001
·
Anaesthesiol Intensive Ther 2015;47(1):1-6.

open access

Vol 47, No 1 (2015)
Original and clinical articles
Submitted: 2015-03-06

Abstract

BACKGROUND: Synchronous independent lung ventilation (ILV) is the treatment of choice for unilateral pathology of lung parenchyma. Numerous studies have documented the improved blood oxygenation and clinical efficacy of this procedure. The aim of the present study was to evaluate the effects of ILV on the selected biomechanical parameters of the lungs.

METHOD: The study involved ASA I-II patients undergoing thoracic surgery in the lateral decubitus position under the standard conditions of general anaesthesia with the thoracic cavity closed. ILV with equal separation of the tidal volume was performed with a prototype volume separator, using incremental a PEEP of 0−15 cm H2O in the dependent lung. Peak pressures, dynamic compliance and airway resistance of both lungs were evaluated.

RESULTS: The study included 36 patients. In all of the patients, a PEEP of 5−15 cm H2O in one lung increased its peak pressures, dynamic compliance and resistances, and variably affected the biomechanical parameters of the other lung. Irrespective of patient positioning on the right or left side, the highest compliance was recorded at a PEEP of 10 cm H2O.

CONCLUSIONS: In ILV, peak pressures and airway resistances are higher in the dependent lung compared to compliances in the non-dependent lung. ILV with a PEEP of 5−15 cm H2O increases the biomechanical parameters of the dependent lung while variably influencing the parameters in the non-dependent lung.

Abstract

BACKGROUND: Synchronous independent lung ventilation (ILV) is the treatment of choice for unilateral pathology of lung parenchyma. Numerous studies have documented the improved blood oxygenation and clinical efficacy of this procedure. The aim of the present study was to evaluate the effects of ILV on the selected biomechanical parameters of the lungs.

METHOD: The study involved ASA I-II patients undergoing thoracic surgery in the lateral decubitus position under the standard conditions of general anaesthesia with the thoracic cavity closed. ILV with equal separation of the tidal volume was performed with a prototype volume separator, using incremental a PEEP of 0−15 cm H2O in the dependent lung. Peak pressures, dynamic compliance and airway resistance of both lungs were evaluated.

RESULTS: The study included 36 patients. In all of the patients, a PEEP of 5−15 cm H2O in one lung increased its peak pressures, dynamic compliance and resistances, and variably affected the biomechanical parameters of the other lung. Irrespective of patient positioning on the right or left side, the highest compliance was recorded at a PEEP of 10 cm H2O.

CONCLUSIONS: In ILV, peak pressures and airway resistances are higher in the dependent lung compared to compliances in the non-dependent lung. ILV with a PEEP of 5−15 cm H2O increases the biomechanical parameters of the dependent lung while variably influencing the parameters in the non-dependent lung.

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Keywords

lung ventilation, independent, biomechanics; lung ventilation, independent, PEEP; anaesthesia, thoracic surgery

About this article
Title

Effects of unilateral PEEP on biomechanics of both lungs during independent lung ventilation in patients anaesthetised for thoracic surgery

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47, No 1 (2015)

Pages

1-6

DOI

10.5603/AIT.2015.0001

Bibliographic record

Anaesthesiol Intensive Ther 2015;47(1):1-6.

Keywords

lung ventilation
independent
biomechanics
lung ventilation
independent
PEEP
anaesthesia
thoracic surgery

Authors

Katarzyna Trela-Stachurska
Andrzej Nestorowicz
Edyta Kotlińska-Hasiec
Sławomir Sawulski
Wojciech Dąbrowski

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