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Comparison of double-lung jet ventilation and one-lung ventilation for thoracotomy

Published online by Cambridge University Press:  01 January 2008

H. Misiolek ,
P. Knapik ,
J. Swanevelder ,
R. Wyatt  and
M. Misiolek
H. Misiolek*
Affiliation:
Medical University of Silesia, Department of Anaesthesia and Intensive Care, Katowice, Poland
P. Knapik
Affiliation:
Medical University of Silesia, Department of Anaesthesia and Intensive Care, Katowice, Poland
J. Swanevelder
Affiliation:
University Hospitals of Leicester NHS Trust, Glenfield Hospital, Department of Cardiothoracic Anaesthesia, Leicester, UK
R. Wyatt
Affiliation:
University Hospitals of Leicester NHS Trust, Glenfield Hospital, Department of Cardiothoracic Anaesthesia, Leicester, UK
M. Misiolek
Affiliation:
Medical University of Silesia Katowice, Department of ENT, Poland
*
Correspondence to: Hanna Misiolek, Department of Anaesthesia and Intensive Care, Medical University of Silesia, 41-800 Zabrze, ul. 3 Maja 13/15, Poland. E-mail: katanestz@slam.katowice.pl; Tel/Fax: +48 323 701 617
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Summary

Background and objective

Thoracic surgery requires immobilization of the operating area. Usually, this is achieved with one-lung ventilation (OLV), however this may still lead to some movement. High-frequency jet ventilation (HFJV) may be an alternative way of ventilation in thoracic surgery. The purpose of this study was to determine the effectiveness of HFJV as an alternative option to OLV for thoracic procedures.

Methods

Sixty patients were randomized to receive either HFJV (n = 29) or OLV (n = 31) during the operation. During the course of the study 10 patients were excluded (4 patients in HFJV group and 6 patients in OLV group). The following haemodynamic and ventilatory parameters were recorded: heart rate, systolic and mean blood pressure, ventricular stroke volume, cardiac index, systemic vascular resistance, peak inspiratory pressure, oxygen saturation, PaO2 and PaCO2. Overall parameters were documented before the initiation of the chosen mode of ventilation every 15 min during the operation.

Results

Patients in both groups showed comparable cardiovascular function. Mean values of peak inspiratory pressure were significantly higher in the OLV group. Oxygen saturation values were statistically higher in the HFJV group. PaCO2 values were similar in both during surgery, but were higher in the OLV group after awakening. Mean values of shunt fraction were lower in the HFJV group. Lower values of peak inspiratory pressure were therefore associated with higher partial pressure of carbon dioxide levels in the HFJV group. In the OLV group, 44% of patients experienced a postoperative sore throat. Operating conditions were comparable.

Conclusion

HFJV is safe option, comparable to OLV and offers some advantages for open-chest thoracic procedures.

Keywords

HIGH-FREQUENCY JET VENTILATIONMECHANICAL VENTILATION, one lungANAESTHESIA GENERALTHORACIC SURGERYPULMONARY GAS EXCHANGE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 1 , January 2008 , pp. 15 - 21
Copyright
Copyright © European Society of Anaesthesiology 2007

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