The History of One-Lung Anesthesia and the Double-Lumen Tube

McGrath, Brendan A.; Tennuci, Christopher; Lee, George

doi:10.1016/j.janh.2017.05.002

Cited by 24 publications

(26 citation statements)

References 26 publications

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“…One-lung ventilation, is a routine technique to control the ventilation of each lung separately during general anesthesia; this application is widely used in thoracic surgery because of its safety and less complications [15,16]. Recently, some researchers began to employ this technique as an ancillary method to asist the thermal ablation of tumors in the hepatic dome.…”

Section: Discussionmentioning

confidence: 99%

One-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome

Long

Zeng

et al. 2020

International Journal of Hyperthermia

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Purpose: To investigate the feasibility, efficacy and safety of one-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome. Materials and methods: From 5 January 2017 to 16 April 2019, 64 patients who underwent ultrasound-guided thermal ablation with a total of 75 liver malignant tumors located in the hepatic dome were enrolled in the present study. One-lung ventilation was employed to improve the acoustic window and protect the lung and diaphragm. If the one-lung ventilation was unsuccessful, artificial pleural effusion was added. The technical efficacy was confirmed by contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) 1 month later. After that, CT/MRI was performed every 3-6 months. Results: Among the enrolled patients, the technical success rate of one lung ventilation was 92.2% (59/64). The visibility scores of tumors were improved significantly after one-lung ventilation compared to those before one-lung ventilation (p < .001). Finally, 78.6% (55/70) of the tumors achieved clinical success of one-lung ventilation to become clearly visible and underwent thermal ablation. Fourteen of the remaining 15 tumors achieved a satisfactory acoustic window after combination of artificial pleural effusion. One lesion remained inconspicuous and partly affected by pulmonary gas. The follow-up period was 8 months (3-30 months). The technical efficacy rate was confirmed to be 100% (75/75). During the follow-up period, local tumor progression occurred in 2 patients (2/75, 2.7%). Major complications occurred in two patients (2/64, 3.1%) receiving one-lung ventilation. Conclusions: One-lung ventilation is a promising noninvasive method for the thermal ablation of hepatic dome tumors due to its efficacy and safety.

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Section: Discussionmentioning

confidence: 99%

One-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome

Long

Zeng

et al. 2020

International Journal of Hyperthermia

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“…Erste Einsätze in der klinischen Anwendung sind in den 30er-Jahren des 20. Jahrhunderts dokumentiert [1].…”

Section: Introductionunclassified

Extrakorporale Membranoxygenierung in der Thoraxchirurgie: die Sicht des Anästhesisten

Rehers¹,

Beiderlinden

Ziegeler³

2019

Zentralbl Chir

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ZusammenfassungAuch in der Thoraxchirurgie sind in den letzten Jahren Behandlungspfade im Rahmen von „Enhanced-Recovery-after-Surgery“-Programmen entwickelt worden. Neben minimalinvasiven Operationstechniken sind dabei eine Vielzahl von anästhesiologischen Aspekten wie die Wahl kurz wirksamer Narkoseregime, der Einsatz von Regionalanalgesie, eine ausgeglichene intraoperative Flüssigkeitstherapie, die Vermeidung von postoperativer Übelkeit und Erbrechen und vor allem eine protektive Beatmung zu berücksichtigen. Bei einem Patientenkollektiv, das zunehmend auch bei vorbestehenden, teils schweren Lungenfunktionsstörungen operiert werden muss, führt eine protektive Beatmung unter den Bedingungen einer Ein-Lungen-Ventilation häufig zu schweren Gasaustauschstörungen. In dieser Situation stellt der Einsatz einer venovenösen extrakorporalen Membranoxygenierung (vvECMO) eine suffiziente und sichere Methode dar, die perioperative Behandlung dieser Patienten zu ermöglichen. Auch postoperativ kann die Genesung der Patienten durch eine Weiterführung des Verfahrens im Wachzustand sowohl notwendige Maßnahmen, wie Physio- und Atemtherapie und die Frühmobilisation, als auch die Ausheilung von Luftfistelung der operierten Lunge begünstigen. Zur Vermeidung von Blutungskomplikationen kann die ECMO aufgrund der Heparinbeschichtung der Schlauchsysteme intraoperativ zunächst ohne Antikoagulation betrieben werden. Postoperative Optionen der Antikoagulation stellen Heparin, Argatroban oder Bivalirudin dar. Auch neue Techniken, wie die minimalinvasive Thoraxchirurgie unter Regionalanästhesie mit Sedierung, können in der Zukunft möglicherweise durch den Einsatz einer vvECMO weiterentwickelt werden.

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“…One-lung ventilation (OLV) means the mechanical separation of the two lungs in order to create ventilation conditions for a lung independently of another lung ( 1 ). Hypoxemia during OLV is one of the undesirable but unavoidable consequences in the management of anesthesia among patients undergoing thoracic surgery that occurs in 1 to 10% of patients in the presence of fraction of inspired oxygen (FIO2) =100% ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of propofol and isoflurane on gas exchange parameters following one-lung ventilation in thoracic surgery: a double-blinded randomized controlled clinical trial

et al. 2018

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BackgroundThe use of anesthetic drugs with minimal inhibitory effects on the hypoxic pulmonary vasoconstriction (HPV) could have a decisive role in preventing the hypoxemia during one-lung ventilation (OLV).ObjectiveThe aim of this study was to compare the effects of propofol and isoflurane on the changes in gas exchange parameters following OLV in thoracic surgery.MethodsThis double-blinded randomized controlled clinical trial was conducted on patients who were candidates for elective right thoracotomy referred to the central operating room of Ghaem Hospital in Mashhad, Iran, during February 2016–2017. Patients with age range of 18 to 75 years, class I and II American Society of Anesthesiologists (ASA) and thoracotomy with OLV for pulmonary resection or cyst drainage were included. The patients were randomly allocated (1:1 ratio) into two groups of propofol (P, 50–100μg/kg/min) and isoflurane (I, 1 minimum alveolar concentration (MAC) 1.1%). Partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), end-tidal carbon dioxide (ETCO2) and arterial oxygen saturation (SPO2) were recorded before and 15 minutes after OLV and compared between the two groups. The comparison of the mean gas exchange parameters before and 15 minutes after OLV was performed using Mann-Whitney test in SPSS version 19 software. P<0.05 was considered statistically significant.ResultsIn this study, 122 patients with mean age of 59.4±14.1 years (two groups of 61) were studied. Both groups were matched for age or gender. The two groups had no significant difference in the gas exchange parameters before the OLV. Only PaCO2 (p=0.001) and ETCO2 (p=0.001) were significantly higher in the propofol group after 15 minutes OLV than in the isoflurane group. However, PaO2 (p=0.67), O2Sat (p=0.333) and PaCO2-ETCO2 gradient (p=0.809) showed no significant difference between the two groups at this minute.ConclusionBased on the results of this study, the propofol or isoflurane selection seems to have no significant effect on the arterial oxygenation. On the other hand, isoflurane and propofol could be an appropriate anesthetic for thoracic surgery by normalizing the carbon dioxide gradient range during the OLV.Clinical Trial RegistrationThe study was also registered at the Iranian Registry of Clinical Trials (IRCT2015123013159N8).FundingThe study was financially supported by the Deputy of Research of Mashhad University of Medical Sciences (grant number: 940119).

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The History of One-Lung Anesthesia and the Double-Lumen Tube

Cited by 24 publications

References 26 publications

One-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome

One-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome

Extrakorporale Membranoxygenierung in der Thoraxchirurgie: die Sicht des Anästhesisten

Effect of propofol and isoflurane on gas exchange parameters following one-lung ventilation in thoracic surgery: a double-blinded randomized controlled clinical trial

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