Effect of Positive end expiratory pressure during one-lung ventilation on hemodynamics in thoracic surgeries in adult patients

Abstract

Background: One-lung ventilation (OLV) is a common practice during thoracic surgeryinvolving pulmonary resection to facilitate surgical exposure. For long time, arterialhypoxemia during OLV was is the most important problem for the anesthesiologist. Atpresent, there is increasing concern about the effects of ventilator settings on acute lunginjury.Objectives: The aim of this study is to compare the effect of different levels of Positive endexpiratory pressure (PEEP) on hemodynamics in thoracic surgeries in adult patients.Patients and Methods: This is a prospective study that included 60 adult patients undergoingelective thoracic procedures requiring one-lung ventilation through a posterio-lateralthoracotomy at cardio-thoracic surgery department in Qena university hospital “betweenOctober 2017 to April 2019”, the Sixty patients were assigned to three groups: group Ireceived no PEEP (n = 20),group II received a PEEP (5 cmH2O) (n = 20),and group IIIreceived a PEEP (10 cmH2O) (n = 20). Patient hemodynamics, pulmonary mechanics, andarterial blood gases were measured just after OLV(T1) and 20 (T2), 40 (T3), and 60 min(T4)after OLV.Results: All cases were completed successfully. The heart rate and mean arterial bloodpressure showed no significant changes between all groups.Conclusion: During OLV, mechanical ventilation with PEEP 0, 5 or 10 cmH2O has no effecton hemodynamics in thoracic surgeries in adult patients.