The Effect of Dexmedetomidine on Oxygenation and Intrapulmonary Shunt during One Lung Ventilation

Büget, Mehmet İlke; Sungur, Zerrin; Özkan, Berker; Yornuk, Mesut; Demircan, Fatma; Şentürk, Mert

doi:10.4236/ojanes.2015.57025

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…In the present study, there was no significant difference in the demographic data of the patients and improvement was demonstrated in oxygenation during OLV in the DISO group. The results from the Buget et al study indicated that demographic data and baseline characteristics were not statistically significant and also dexmedetomidine infusion improved oxygenation and lung mechanics in patients with restrictive lung disease (14). These findings are in line with our study.…”

Section: Discussionsupporting

confidence: 90%

“…Hypoxia during OLV is considered as an important concern throughout thoracic anesthesia. Hypoxic pulmonary vasoconstriction is a defense mechanism against hypoxia reducing the shunt (14,15). In the present study, there was no significant difference in the demographic data of the patients and improvement was demonstrated in oxygenation during OLV in the DISO group.…”

Section: Discussioncontrasting

confidence: 51%

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Effect of Dexmedetomidine Combined with Inhalation of Isoflurane on Oxygenation Following One-Lung Ventilation in Thoracic Surgery

et al. 2020

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Background:One-lung ventilation (OLV) is commonly used during thoracic surgery. At this time, hypoxemia is considered one of the remarkable consequences of the anesthesia management. Hypoxic pulmonary vasoconstriction (HPV) is the defense mechanism against hypoxia. Objectives: The aim of the present study was to investigate the effect of infusion of dexmedetomidine on improving the oxygenation during OLV among the adult patients undergoing thoracic surgery. Methods: A total of 42 patients undergoing OLV by general anesthesia with isoflurane inhalation were randomly assigned into two groups: IV infusion of dexmedetomidine at 0.3 microgram/kg/h (DISO) and IV infusion of normal saline (NISO). Three Arterial Blood Gas (ABG) samples were obtained throughout the surgery. Hemodynamic parameters, PaO2, PaCO2, and complications at recovery phase were recorded. The collected information was analyzed using SPSS software version 22. Results: In the dexmedetomidine group, the mean hemodynamic parameters had a significant reduction at 30 and 60 minutes following OLV. Administration of dexmedetomidine resulted in a significant increase in the PaCO2 and a reduction in the PaO2 when changing from two-lung ventilation to OLV, where PaO2 reached its maximum value within 10 minutes after OLV in the DISO group, and it began to gradually increase to the end of operation. The duration of the recovery phase, also complications at the recovery phase decreased significantly in DISO group. Conclusions:The results of the study showed that, dexmedetomidine may improve arterial oxygenation during OLV in adult patients undergoing thoracic surgery, and can be a suitable anesthetic agent for thoracic surgery.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 51%

Effect of Dexmedetomidine Combined with Inhalation of Isoflurane on Oxygenation Following One-Lung Ventilation in Thoracic Surgery

et al. 2020

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“…This phenomenon indicates that isoflurane may increase intrapulmonary shunt and reduce the systematic oxygenation. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Effects of epidural anesthesia combined with inhalation anesthesia or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation

Zheng

Yin

et al. 2018

Pak J Med Sci

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Objective:To investigate the effect of epidural anesthesia combined with inhalation or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation.Methods:Eighty patients, aged 35-75, American Society of Anesthesiology (ASA) classification of I-III, undergoing thoracic surgery with one lung ventilation more than three hour, were randomly divided into propofol group (group Pro), propofol combined with epidural anesthesia group (group Pro+Epi), isoflurane group (group Iso) and isoflurane combined with epidural anesthesia group (group Iso+ Epi), 20 patients in each group. Arterial blood and mixed venous blood were taken for blood gas analysis, and hemodynamic data were recorded at following time points: before induction in supine position (T1), 30min after bilateral lung ventilation (T2), 15min after one lung ventilation (T3), 30min after one lung ventilation (T4), 60min after one lung ventilation (T5), 180min after one lung ventilation (T6), intrapulmonary shunt (Qs/Qt) was calculated according to the correlation formula.Results:Qs/Qt values at T2-6 in four groups were significantly higher than that of T1, and Qs/Qt values at T3-6 was significantly higher than that of T2 (P< 0.05); PaO2 at T2-6 were significantly higher than that of T1, with PaO2 at T3-6 were significantly lower than T2 (P< 0.05). Between groups, Qs/Qt values in group Iso were significantly higher than that of group Pro, Pro+Epi and Iso+Epi at T3-5 (P< 0.05). There was no significant difference in PaO2 between groups (P> 0.05). CI at T3-6 in group Iso and Iso+Epi were significantly higher than that of T1 (P<0.05), and were significantly higher than that of propofol group (P<0.05). MAP at T3-6 in group Pro+Epi and Iso+Epi were significantly lower than that at T1 (P <0.05). Heart rate at T4-6 in group Iso were significantly higher than T1, and higher than group Pro and group Iso+Epi (P <0.05).Conclusion:One lung ventilation may predispose to increase of intrapulmonary shunt and decrease in arterial partial pressure of oxygen; isoflurane inhalation anesthesia is more likely to cause intrapulmonary shunt, but no changes in arterial partial pressure of oxygen.

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“…Therefore, the lack of inhibitory effects on HPV is of great importance in anesthetizing those undergoing OLV [4,5]. It is a defense mechanism against hypoxia that reduces pulmonary stenosis [6,7].…”

Section: Introductionmentioning

confidence: 99%

Effect of Dexmedetomidine on Oxygen and Intrapulmonary Shunt (Qs/Qt) During One-Lung Ventilation in Pediatric Surgery: A Randomized Controlled Trial

Khddam,

Rostom,

Hajeer

2024

Cureus

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BackgroundOne-lung ventilation (OLV) is a common ventilation technique used during thoracic surgery. It can cause serious complications in children, and hypoxic pulmonary vasoconstriction (HPV) is a protective mechanism against the resulting hypoxia. Dexmedetomidine does not affect HPV, so we will investigate its impact on the partial pressure of oxygen in arterial blood (PaO2) and pulmonary shunt fraction (Qs/Qt). MethodsChildren who underwent OLV were divided into two equal groups. The Dex group received 0.4 μg/kg/h of dexmedetomidine intravenously. The placebo group received normal saline. Two blood samples were taken to analyze arterial and central venous blood gasses during four time periods: T1, 10 minutes after anesthesia; T2, 10 minutes after OLV; T3, 60 minutes after OLV; and T4, 20 minutes after the end of OLV. Heart rate, mean arterial pressure (MAP), PaO2, Qs/Qt, and peak inspiratory pressure (PIP) values were recorded at these time points. ResultsRegarding heart rate, the Dex group remained relatively stable, whereas the placebo group showed a slight increase in T3 and T4. Concerning MAP, the Dex group had a reduction at T1 compared with the placebo group and remained similar for other points. PaO2 decreased with OLV. However, the Dex group consistently maintained higher PaO2 values than the placebo, especially in T3 and T4. Concerning Qs/Qt, the Dex group maintained lower time values than the placebo group at OLV. Regarding PIP, the Dex group had significantly lower T2 and T3 than the placebo group. ConclusionAdministration of dexmedetomidine in children with OLV improves PaO2 and reduces pulmonary shunt fraction (Qs/Qt), thereby improving oxygen transport. It reduces the maximum PIP values, thereby reducing pressure-related complications.

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The Effect of Dexmedetomidine on Oxygenation and Intrapulmonary Shunt during One Lung Ventilation

Cited by 3 publications

References 24 publications

Effect of Dexmedetomidine Combined with Inhalation of Isoflurane on Oxygenation Following One-Lung Ventilation in Thoracic Surgery

Effect of Dexmedetomidine Combined with Inhalation of Isoflurane on Oxygenation Following One-Lung Ventilation in Thoracic Surgery

Effects of epidural anesthesia combined with inhalation anesthesia or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation

Effect of Dexmedetomidine on Oxygen and Intrapulmonary Shunt (Qs/Qt) During One-Lung Ventilation in Pediatric Surgery: A Randomized Controlled Trial

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