1999
DOI: 10.1046/j.1365-2044.1999.00845.x
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Gas movement in the nonventilated lung at the onset of single‐lung ventilation for video‐assisted thoracoscopy

Abstract: SummaryTo assess the potential for atmospheric nitrogen to enter the nonventilated lung following the initiation of single-lung ventilation, the nonventilated lung of 10 patients undergoing videoassisted thoracoscopy was connected to the air in a water-filled spirometer, and gas movement outof and back into the lung was measured. Airway pressure from both lungs and pleural pressure from the nonventilated side were also measured. With each breath of positive-pressure ventilation to the ventilated lung prior to … Show more

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Cited by 37 publications
(53 citation statements)
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“…The concept of early OLV has been adopted by many clinicians. However, in routine practice, the distal port of the DLT lumen to the non‐ventilated lung is opened to the atmosphere immediately after being clamped; as a result, air could enter the non‐ventilated lung due to the tidal movement caused by the ventilated lung and delay lung collapse . Previous studies used the time needed for complete lung collapse as the primary end point whereas the present study uses the duration of time from pleural incision to satisfactory lung collapse (collapse score of 8) as complete lung collapse is not always achievable in every patient.…”
Section: Discussionmentioning
confidence: 99%
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“…The concept of early OLV has been adopted by many clinicians. However, in routine practice, the distal port of the DLT lumen to the non‐ventilated lung is opened to the atmosphere immediately after being clamped; as a result, air could enter the non‐ventilated lung due to the tidal movement caused by the ventilated lung and delay lung collapse . Previous studies used the time needed for complete lung collapse as the primary end point whereas the present study uses the duration of time from pleural incision to satisfactory lung collapse (collapse score of 8) as complete lung collapse is not always achievable in every patient.…”
Section: Discussionmentioning
confidence: 99%
“…We therefore speculated that initiating OLV at least six minutes prior to pleural opening to create a confined space to the non‐ventilated lung when inhaling pure oxygen could expedite lung collapse. This can be achieved by clamping the double‐lumen endobronchial tube (DLT) lumen to the non‐ventilated lung at least six minutes earlier, but not opening the distal port of the lumen to the atmosphere until pleural opening, which prevents air entering the non‐ventilated lung due to the tidal movement caused by the ventilated lung …”
Section: Introductionmentioning
confidence: 99%
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“…OLV may cause further damage to ventilatory conditions by limiting ventilation of the non-dependent lung and create an obligatory right-to-left transpulmonary shunt through the non-dependent lung 16. Finally, hypercapnia may occur during OLV and CO 2 pneumothorax, partly due to CO 2 absorption across the pleura, and partly because of mechanical constriction of the pulmonary parenchyma 3 17. If hypercapnia occurs, the first approach is to give the patient a larger minute volume.…”
Section: Physiological Perturbation Of Olv and Co2 Insufflationmentioning
confidence: 99%
“…When the rapid collapse ceases, a consequence of small airway closure, the second, slow phase of lung collapse ensues; this is dependent on absorption atelectasis and continuous gaseous diffusion. However, prior to the thoracic cavity being opened to the atmosphere, with each breath of positive-pressure, ventilation to the ventilated lung generates pressure that is transmitted to the opposite hemithorax, resulting in a mean (range) tidal movement of 134 (65–265) ml of gas in the non-ventilated lung [4]. …”
Section: Introductionmentioning
confidence: 99%