Continuous Positive Airway Pressure Clinical Trial
Official title:
Differential Lung Ventilation vs. CPAP During One Lung Ventilation for Video Assisted Lung Surgery
In this study we compared the efficacy of continuous positive airway pressure (CPAP) to differential lung ventilation, in terms of patient's oxygenation, during video assisted thoracoscopic lung resection.
Background: One Lung Ventilation (OLV) is the technique used during lung resection surgery in
order to facilitate optimal surgical conditions. OLV may result in hypoxemia due to the shunt
created. Several techniques are used to overcome the hypoxemia, one of which is continuous
positive airway pressure (CPAP) to the non-dependent lung. Another technique is ventilating
the non-dependent lung with a minimal volume, thus creating differential lung ventilation
(DLV). In this study we compared the efficacy of CPAP to DLV during video assisted
thoracoscopic lung resection.
Patients and Method: This is a prospective study of 30 adult patients undergoing elective
video assisted thoracoscopic lung lobectomy. Each patient was ventilated in four modes: two
lung ventilation, OLV, OLV+CPAP and OLV+DLV. Fifteen patients were ventilated with CPAP first
and DLV next, and the other 15 were ventilated with DLV first and then CPAP. Five minutes
separated each mode, during which the non-dependent lung was open to room air. We measured
the patient's arterial blood gas during each mode of ventilation. The surgeons, who were
blinded to the ventilation technique, were asked to assess the surgical conditions at each
stage.
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