Evaluation of the clinical efficacy of inhaled nitric oxide synthesized from natural air in conditions of thoracic surgical intervention on the lung tissue

Abstract

Introduction. Despite the significant development of an-esthetic procedures in the XX–XXI centuries the problem of optimal one-lung ventilation (OLV) of comorbid pa-tients isn’t resolved. Occasionally, there would be a situa-tion when the resectable patient is functionally inoperable or has high risk of intra- and postoperative complications. This article provides one possible solution of this problem. Purpose of the study. To analyze the use of inhaled nitric oxide (INO) on the dependent lung in order to increase the oxygenation index in the clinical practice of thoracic surgery. Materials and research methods. This is a prospec-tive study of the influence of INO on oxyge nation during thoracic operations on the organs of the respiratory sys-tem. The study participants were divided into 2 groups, each comprised of 10 individuals. Group A received INO intraoperatively as part of a combined multicomponent general anesthesia; group B received standard combined multicomponent general anesthesia. All patients under-went analysis of the gas composition of arterial blood at 2 control points: the 1st one was 10 minutes after the be-ginning of OLV; the 2nd — 40 minutes after INO entered the respiratory circuit (immediately after receiving the result of the 1st control point). Research results. In the INO group an increasing of oxygenation index was observed in 8 out of 10 cases (p=0.022). In the control group an increasing of oxygenation index occured in 2 cases out of 10 (p=0.037). Conclusions. Based on the available data a positive cor-relation was found between the raise of oxygenation in-dex and the use of INO in conditions of ALV for thoracic interventions. It could potentially help to increase the number of operable patients, reduce operative risks and intraoperative time for the borderline operability group.