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Real-time ventilati...
Real-time ventilation and perfusion distributions by electrical impedance tomography during one-lung ventilation with capnothorax
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- Reinius, Henrik (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Borges, João Batista (author)
- Uppsala universitet,Hedenstiernalaboratoriet
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- Fredén, Filip (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Jideus, Lena (author)
- Uppsala universitet,Thoraxkirurgi
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Camargo, E. D. L. B. (author)
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Amato, M. B. P. (author)
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- Hedenstierna, Göran (author)
- Uppsala universitet,Klinisk fysiologi
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- Larsson, Anders (author)
- Uppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet
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- Lennmyr, Fredrik (author)
- Uppsala universitet,Anestesiologi och intensivvård
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(creator_code:org_t)
- 2015-01-05
- 2015
- English.
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In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 59:3, s. 354-368
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Carbon dioxide insufflation into the pleural cavity, capnothorax, with one-lung ventilation (OLV) may entail respiratory and hemodynamic impairments. We investigated the online physiological effects of OLV/capnothorax by electrical impedance tomography (EIT) in a porcine model mimicking the clinical setting.Methods: Five anesthetized, muscle-relaxed piglets were subjected to first right and then left capnothorax with an intra-pleural pressure of 19cm H2O. The contra-lateral lung was mechanically ventilated with a double-lumen tube at positive end-expiratory pressure 5 and subsequently 10cm H2O. Regional lung perfusion and ventilation were assessed by EIT. Hemodynamics, cerebral tissue oxygenation and lung gas exchange were also measured.Results: During right-sided capnothorax, mixed venous oxygen saturation (P=0.018), as well as a tissue oxygenation index (P=0.038) decreased. There was also an increase in central venous pressure (P=0.006), and a decrease in mean arterial pressure (P=0.045) and cardiac output (P=0.017). During the left-sided capnothorax, the hemodynamic impairment was less than during the right side. EIT revealed that during the first period of OLV/capnothorax, no or very minor ventilation on the right side could be seen (33% vs. 97 +/- 3%, right vs. left, P=0.007), perfusion decreased in the non-ventilated and increased in the ventilated lung (18 +/- 2% vs. 82 +/- 2%, right vs. left, P=0.03). During the second OLV/capnothorax period, a similar distribution of perfusion was seen in the animals with successful separation (84 +/- 4% vs. 16 +/- 4%, right vs. left).Conclusion: EIT detected in real-time dynamic changes in pulmonary ventilation and perfusion distributions. OLV to the left lung with right-sided capnothorax caused a decrease in cardiac output, arterial oxygenation and mixed venous saturation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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