Single Lung Ventilation versus Two Lung Ventilation in Video Assisted Thoracoscopic Lung Surgeries

Abstract

Abstract Background VATS is being widely used nowadays in thoracic surgeries. One lung ventilation (OLV) is a technique routinely used in thoracic anesthesia to facilitate thoracic surgery. Double-lumen tubes (DLT) remain the most popular and reliable choice for one lung ventilation especially in adult patients. Objective To evaluate single lung ventilation as an alternative to conventional ventilation in video assisted thoracoscopic lung surgeries despite the claimed intra operative and post-operative hypoxemia which could be avoided or even minimized by changing ventilatory setting. Patients and Methods After approval of anaesthesiology department scientific and ethical committees in Ain Shams University Hospitals, Patients were included in the study in form of two equal groups (each of 30 patients). Group A: (no.=30) Patients did lung surgeries with single lung ventilation using double lumen endotracheal tube. Group B: (no.=30) Patients did lung surgeries with two lung ventilation using conventional single lumen endotracheal tube (two lung ventilation). Results In our study it was found that intraoperative hypoxemia (SaO2 < 90%) occurred during some cases of single lung ventilation in 4 out of 30 cases. However, it was irrelevant to any other intraoperative or post-operative complication. Moreover, it was irrelevant to post-operative arterial oxygen saturation or any end organ complication. In our study also all comorbidities which can affect arterial oxygen saturation were excluded from the study from the start. However, better studies are urgently needed to investigate an individual “best oxygen content” concept for each patient undergoing one-lung ventilation. Conclusion The result of this study comparing single lung ventilation versus to lung ventilation in video assisted thoracoscopic surgeries concerning mainly intraoperative and post-operative hypoxia demonstrated that intra operative hypoxia occurred in some cases of single lung ventilation. However, this intraoperative hypoxia was irrelevant to post-operative hypoxia or any intraoperative or post-operative complications. So, our study recommends that using DLT for one lung ventilation is ideal for video assisted thoracoscopic lung surgeries, providing better surgical field, lesser surgery duration and better surgeon satisfaction.