Physiology of the Lateral Decubitus Position, Open Chest and One-Lung Ventilation

2011 ◽  
pp. 71-82 ◽  
Author(s):  
Jens Lohser ◽  
Seiji Ishikawa
Keyword(s):  
Lung Ventilation ◽  
Lateral Decubitus Position ◽  
One Lung Ventilation ◽  
Open Chest ◽  
Lateral Decubitus

scholarly journals Asymmetry of the bispectral index in lateral decubitus position during one-lung ventilation: A prospective-observational study

2019 ◽  
Author(s):  
Se Hee Kang ◽  
MiHye Park
Keyword(s):  
Bispectral Index ◽  
Prospective Observational Study ◽  
Lung Ventilation ◽  
Lateral Decubitus Position ◽  
One Lung Ventilation ◽  
Intraoperative Awareness ◽  
Non Invasive ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus ◽  
Two Sides

Abstract Background Use of the bispectral index (BIS) reduces cases of intraoperative awareness and deep sedation. Although non-invasive, the BIS values are often misunderstood. This study evaluated the effects of BIS readings during intra-operative positioning and ventilation. Methods Forty-four patients undergoing esophageal cancer surgery were enrolled. BIS sensors were applied on right and left sides. A > 10% difference in BIS reading between the two sides was defined as ‘asymmetry.’ Results Intraoperative BIS asymmetry was observed in 14 (32.6%) patients in the supine position, but 43 (100%) patients in the left lateral decubitus position. The maximum differences between BIS values were observed 15 minutes after one-lung ventilation in the left lateral decubitus position (mean 6.8 ± 4.6, range [1-27]). Conclusion During one-lung ventilation in the lateral decubitus position, care should be taken when placing a BIS sensor and interpreting BIS values.

scholarly journals POSITIVE END EXPIRATORY PRESSURE (PEEP);

2012 ◽  
Vol 19 (01) ◽  
pp. 098-104
Author(s):  
Usman RAZZAQUE ◽  
RAHEEL AZHAR ◽  
TASSADAQ KHURSHID ◽  
Khalid Zaeem ◽  
Syed Majid
Keyword(s):  
Lung Ventilation ◽  
Lateral Decubitus Position ◽  
Military Hospital ◽  
Random Allocation ◽  
Arterial Oxygenation ◽  
Positive End Expiratory Pressure ◽  
One Lung Ventilation ◽  
Group A ◽  
Lateral Decubitus ◽  
Group B

Introduction: Thoracic surgeries and aesthesia for lung resection has presented anaesthesiologists with certain uniquephysiological problems. These include placing (lateral decubitus position) in order to obtain optimal access for most operations on lungs, pleura,esophagus, and great vessels, opening the chest wall (open pneumothorax) and one lung ventilation anaesthesia. One lung ventilationanaesthesia and lateral decubitus position produces decrease in functional residual capacity and an obligatory right to left shunt that rangesfrom 15% to 40% leading to increase in ventilation perfusion (V/Q) mismatch thus causing hypoxia and or hypoxemia. An optimal level ofpositive end expiratory pressure of 5cmH O when added to dependent lung is known to improve arterial oxygenation and improve ventilator 2efficiency. Objectives: To compare different values of positive end expiratory pressure (PEEP) during one lung ventilation, for its effects onblood arterial oxygenation and carbon dioxide levels. Study Design: Randomized controlled trial (RCT). Setting: Conducted in surgical Unit-IIIand Department of anaesthesia and Intensive Care, Combined Military Hospital, Rawalpindi. Duration of study with dates: Ten months from25-12-2008 to 01-10-2009, Additional quantum of Data was collected from 01-01-2011 to 25-01-2011. Subjects and methods: The patientswere divided into two equal groups of 100 patients each, by random allocation of patients to either in-group A (subjected to zero PEEP) or group-B (subjected to PEEP 5cm of water). Results: At induction and start of two lung ventilation 14 (14.0%) of the patients from group-A and 16(16.0%) from group-B had normal PaCO . At initiation of one lung ventilation 25 (25.0%) of the patients from group-A and 80 (80.0%) from group- 2B had normal PaO . At initiation of one lung ventilation 26 (26.0%) of the patients from group-A and 80 (80.0%) from group-B had normal PaCO 2 2with p <0.001. At end of procedure one lung ventilation 30 (30.0%) of the patients from group-A and 90 (90.0%) from group-B had normal PaO . 2At end of procedure one lung ventilation 32 (32.0%) of the patients from group-A and 91 (91.0%) from group-B had normal PaCO . 2Conclusions: The execution of one-lung ventilation still constitutes a challenge in clinical and surgical practice.

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