Abstract
INTRODUCTION.
In the present day, one-lung jet ventilation is applied in case of a necessity to isolate the healthy lung during operations. HFJV ensures excellent oxygenation of arterial blood, keeps the lungs in a relaxed state without execution of a recruitment maneuver and increases venous return and cardiac output by lowering the workload of the left ventricle.
METHODS.
Three groups consisting of 50 patients who underwent lung surgery during which two-lungs conventional mechanical ventilation (CMV), one-lung conventional mechanical ventilation (OCMV) and one-lung high frequency jet ventilation (OHFJV) were applied, were compared in terms of gas exchange and hemodynamics parameters.
Artificial ventilation was applied through a single-lumen endotracheal tube located in the main bronchus of the healthy lung. In case of necessity of left main bronchus intubation, a correcting triple maneuver was executed. Usage of standard single-lumen endotracheal tubes ensured a good isolation of the healthy lung, facileness of sanitation and bronchoscopic control of the location of the tube.
RESULTS.
In comparison of OHFJV to OCMV, the results of the study demonstrated a decrease of: PIP by 26.5%; Pes by 81.6%; PVR by 41.7%, an increase of: PaO2 by 66.1%; HBI by 91.0%; CVP by 28.3% and maintaining of normal pH=7.42 and PaCO2=34.5 mm Hg.
CONCLUSIONS.
Under conditions of OHFJV, even a complete atelectasis of one lung does not go along with a considerable disorder of gas exchange in contrast to OCMV. This enabled a wider application of this kind of ventilation for lung surgeries on patients with distinct gas exchange and hemodynamics disorders.
- © 2014 ERS