Ventilatory Efficiency Identifies Patients Prone to Hypoxemia During One-Lung Ventilation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F19%3A00070712" target="_blank" >RIV/00159816:_____/19:00070712 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/19:00110179 RIV/65269705:_____/19:00070712

Výsledek na webu

<a href="https://www.sciencedirect.com/science/article/pii/S105307701930093X?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/pii/S105307701930093X?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1053/j.jvca.2019.01.057" target="_blank" >10.1053/j.jvca.2019.01.057</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Ventilatory Efficiency Identifies Patients Prone to Hypoxemia During One-Lung Ventilation

Popis výsledku v původním jazyce

Objectives: One-lung ventilation (OLV) may be complicated by hypoxemia. Ventilatory efficiency, defined as the ratio of minute ventilation to carbon dioxide output (VE/VCO2), is increased with ventilation/perfusion mismatch and pulmonary artery hypertension, both of which may be associated with hypoxemia. Hence, the authors hypothesized increased VE/VCO2 will predict hypoxemia during OLV. Design: Prospective observational study. Setting: Single-center, university, tertiary care hospital. Participants: The study comprised 50 consecutive lung resection candidates. Interventions: All patients underwent cardiopulmonary exercise testing before surgery. Patients who required inspired oxygen fraction (FiO2) GREATER-THAN OR EQUAL TO0.7 to maintain arterial oxygen (O2) saturation &gt;90% after 30 minutes of OLV were considered to be hypoxemic. The Student t or Mann-Whitney U test were used for comparison of patients who became hypoxemic and those who did not. Multiple regression analysis adjusted for age, sex, and body mass index was used to evaluate which parameters were associated with the VE/VCO2 slope. Data are summarized as mean +- standard deviation. Measurements and Main Results: Twenty-four patients (48%) developed hypoxemia. There was no significant difference in age, sex, and body mass index between hypoxemic and nonhypoxemic patients. However, patients with hypoxemia had a significantly higher VE/VCO2 slope (30 +- 5 v 27 +- 4; p = 0.04) with exercise and lower partial pressure of oxygen/FiO2 (129 +- 92 v 168 +- 88; p = 0.01), higher mean positive end-expiratory pressure (6.6 +- 1.5 v 5.6 +- 0.9 cmH2O; p = 0.02), and lower mean pulse oximetry O2 saturation/FiO2 index (127 +- 20 v 174 +- 17; p &lt; 0.01) during OLV. Multiple regression showed VE/VCO2 to be independently associated with the mean pulse oximetry O2 saturation/FiO2 index (b = -0.28; F = 3.1; p = 0.05). Conclusions: An increased VE/VCO2 slope may predict hypoxemia development in patients who undergo OLV.

Název v anglickém jazyce

Ventilatory Efficiency Identifies Patients Prone to Hypoxemia During One-Lung Ventilation

Popis výsledku anglicky

Objectives: One-lung ventilation (OLV) may be complicated by hypoxemia. Ventilatory efficiency, defined as the ratio of minute ventilation to carbon dioxide output (VE/VCO2), is increased with ventilation/perfusion mismatch and pulmonary artery hypertension, both of which may be associated with hypoxemia. Hence, the authors hypothesized increased VE/VCO2 will predict hypoxemia during OLV. Design: Prospective observational study. Setting: Single-center, university, tertiary care hospital. Participants: The study comprised 50 consecutive lung resection candidates. Interventions: All patients underwent cardiopulmonary exercise testing before surgery. Patients who required inspired oxygen fraction (FiO2) GREATER-THAN OR EQUAL TO0.7 to maintain arterial oxygen (O2) saturation &gt;90% after 30 minutes of OLV were considered to be hypoxemic. The Student t or Mann-Whitney U test were used for comparison of patients who became hypoxemic and those who did not. Multiple regression analysis adjusted for age, sex, and body mass index was used to evaluate which parameters were associated with the VE/VCO2 slope. Data are summarized as mean +- standard deviation. Measurements and Main Results: Twenty-four patients (48%) developed hypoxemia. There was no significant difference in age, sex, and body mass index between hypoxemic and nonhypoxemic patients. However, patients with hypoxemia had a significantly higher VE/VCO2 slope (30 +- 5 v 27 +- 4; p = 0.04) with exercise and lower partial pressure of oxygen/FiO2 (129 +- 92 v 168 +- 88; p = 0.01), higher mean positive end-expiratory pressure (6.6 +- 1.5 v 5.6 +- 0.9 cmH2O; p = 0.02), and lower mean pulse oximetry O2 saturation/FiO2 index (127 +- 20 v 174 +- 17; p &lt; 0.01) during OLV. Multiple regression showed VE/VCO2 to be independently associated with the mean pulse oximetry O2 saturation/FiO2 index (b = -0.28; F = 3.1; p = 0.05). Conclusions: An increased VE/VCO2 slope may predict hypoxemia development in patients who undergo OLV.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30223 - Anaesthesiology

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of cardiothoracic and vascular anesthesia

ISSN

1053-0770

e-ISSN

—

Svazek periodika

33

Číslo periodika v rámci svazku

7

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

1956-1962

Kód UT WoS článku

000473249900028

EID výsledku v databázi Scopus

2-s2.0-85062476077