A prospective study on the effectiveness of intermittent ventilation of non-dependent lung in combating hypoxia during one lung ventilation

Abstract

Introduction: One lung ventilation (OLV) is required for most of the lung surgeries and one of the common problem which we encounter during this surgical procedure is hypoxia. Our prospective study evaluates the effectiveness of a low tidal volume ventilation to the operated, non- dependent lung (NDL) in improving the oxygenation during OLV. Materials and Methods: 40 ASA I, II and III patients posted for elective open thoracotomy was studied. After standard induction of anesthesia, lung separation was achieved with left sided DLT. ABG was taken on two lung ventilation (TLV) before thoracotomy and lung separation and that value was taken as base line. After thoracotomy the dependent lung alone (OLV) was ventilated for 15 mins and ABG was repeated. Then the NDL was ventilated with another ventilator with a low tidal volume and limited airway pressure and sample ABG were taken at 5 minutes and 20 minutes of NDL ventilation. Results: ABG values of PaO2 suggested that thought the values decreased during OLV compared to base line values with TLV, PaO2 had a significant increase after instituting NDL ventilation. Conclusion: NDL ventilation with low tidal volume and limited peak pressure is an effective method to avoid hypoxia and improve oxygenation during OLV requiring lung surgeries. Keywords: One lung ventilation, Hypoxemia, Two lung ventilation.