Abstract
Background: The use of one-lung high-frequency jet ventilation (OHFJV) during minimally invasive surgery for limited forms of pulmonary tuberculosis has advantages over one-lung convective ventilation (OCMV): elimination of transmission of respiratory movements of the ventilated lung through the mediastinum to the operated lung and creating comfortable conditions for the surgeon in a limited rib cage space pleural cavity, absenceof depression of hemodynamics and adequate oxygenation. Nevertheless, several authors noted an increasing of PaCO2 during application of OHFJV.
Objective: Carry out a comparative study the influence of two OHFJV modes (with expiratory pause and without it) on gas exchange and central hemodynamic in patients with minimally invasive operations on the lungs.
Methods: In two groups of 23 patients, conducted a study of gas exchange and central hemodynamic during a minimally invasive lung surgery at the limited forms of tuberculosis using two ventilation modes: I. OHFJV with expiratory pause; II OHFJV without expiratory pause.
Results: During the II ventilation mode PaCO2 marks an increasing of 22% in 30-35 minutes from the beginning of the application OHFJV with a tendency to develop respiratory acidosis. In parallel with this increase in cardiac index recorded by the rise in heart rate at 10%.
Conclusions: Application of OHFJV with expiratory pause prevents hypercapnia and ensures adequate gas exchange, optimizing on this background the regulation of central hemodynamic. These results allow us to recommend this mode of OHFJV during minimally invasive surgery of the lung.
- Copyright ©the authors 2016