Effect of permissive hypercarbia on lung oxygenation during one-lung ventilation and postoperative pulmonary complications in patients undergoing thoracic surgery: A prospective randomised controlled trial.
Eur J Anaesthesiol
; 40(9): 691-698, 2023 09 01.
Article
em En
| MEDLINE
| ID: mdl-37455644
ABSTRACT
BACKGROUND:
The effect of hypercarbia on lung oxygenation during thoracic surgery remains unclear.OBJECTIVE:
To investigate the effect of hypercarbia on lung oxygenation during one-lung ventilation in patients undergoing thoracic surgery and evaluate the incidence of postoperative pulmonary complications.DESIGN:
Prospective randomised controlled trial.SETTING:
A tertiary university hospital in the Republic of Korea from November 2019 to December 2020. PATIENTS Two hundred and ninety-seven patients with American Society of Anaesthesiologists physical status II to III, scheduled to undergo elective lung resection surgery. INTERVENTION Patients were randomly assigned to Group 40, 50, or 60. An autoflow ventilation mode with a lung protective ventilation strategy was applied to all patients. Respiratory rate was adjusted to maintain a partial pressure of arterial carbon dioxide of 40â±â5âmmHg in Group 40, 50â±â5âmmHg in Group 50 and 60â±â5âmmHg in Group 60 during one-lung ventilation and at the end of surgery. MAIN OUTCOMEMEASURES:
The primary outcome was the arterial oxygen partial pressure/fractional inspired oxygen ratio after 60âmin of one-lung ventilation.RESULTS:
Data from 262 patients were analysed. The partial pressure/fractional inspired oxygen ratio was significantly higher in Group 50 and Group 60 than in Group 40 (269.4 vs. 262.9 vs. 214.4; P â<â0.001) but was not significantly different between Group 50 and Group 60. The incidence of postoperative pulmonary complications was comparable among the three groups.CONCLUSION:
Permissive hypercarbia improved lung oxygenation during one-lung ventilation without increasing the risk of postoperative pulmonary complications or the length of hospital stay. TRIAL REGISTRATION NCT04175379.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cirurgia Torácica
/
Ventilação Monopulmonar
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article