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Gas exchange and haemodynamics during thoracotomy

Werner, Olof LU ; Malmkvist, Gunnar LU ; Beckman, Anders LU ; Stahle, S and Nordström, L (1984) In British Journal of Anaesthesia 56(12). p.1343-1350
Abstract
Cardiac index, systemic and pulmonary arterial pressures, carbon dioxide elimination and ventilation of each lung were studied during thoracotomy. Seventeen patients, placed in the full lateral position, were ventilated mechanically through a Carlens' tube to moderate hypocapnia. Mean cardiac index increased by 12% as the pleura was opened (P less than 0.05), with no further change during surgery on the still ventilated upper lung. Mean arterial pressure was unchanged after opening the pleura, but decreased from 114 +/- 15 mm Hg (mean +/- 1 SD) to 104 +/- 18 mm Hg during surgery on the lung (P less than 0.01). Mean pulmonary artery pressure was unchanged. There was a significant (P less than 0.01) increase in carbon dioxide elimination... (More)
Cardiac index, systemic and pulmonary arterial pressures, carbon dioxide elimination and ventilation of each lung were studied during thoracotomy. Seventeen patients, placed in the full lateral position, were ventilated mechanically through a Carlens' tube to moderate hypocapnia. Mean cardiac index increased by 12% as the pleura was opened (P less than 0.05), with no further change during surgery on the still ventilated upper lung. Mean arterial pressure was unchanged after opening the pleura, but decreased from 114 +/- 15 mm Hg (mean +/- 1 SD) to 104 +/- 18 mm Hg during surgery on the lung (P less than 0.01). Mean pulmonary artery pressure was unchanged. There was a significant (P less than 0.01) increase in carbon dioxide elimination from the upper lung when the pleura was opened. In addition, the ventilation of this lung increased significantly (P less than 0.05). Mean end-tidal PCO2 of the lower lung increased from 4.1 to 4.2 kPa after opening the pleura, while that of the upper lung increased from 3.0 to 3.6 kPa (P less than 0.01). VD/VT decreased from 43 to 38% as the pleura was opened (P less than 0.01). During surgical handling of the lung, marked decreases in ventilation, compliance, carbon dioxide elimination and end-tidal PCO2 were observed in the upper lung. We conclude that ventilation-perfusion mismatch decreased on opening the pleura, and that neither opening the pleura nor the subsequent lung surgery (both lungs being ventilated) caused any clinically important derangements in haemodynamics or oxygenation. (Less)
Please use this url to cite or link to this publication:
author
organization
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type
Contribution to journal
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published
subject
in
British Journal of Anaesthesia
volume
56
issue
12
pages
1343 - 1350
publisher
Macmillan
external identifiers
  • pmid:6498043
  • scopus:0021712859
ISSN
1471-6771
language
English
LU publication?
yes
id
2f23eb7a-8f9f-43fa-8f57-459ce0778f72 (old id 1103177)
alternative location
http://bja.oxfordjournals.org/cgi/reprint/56/12/1343
date added to LUP
2008-08-12 13:49:21
date last changed
2017-01-01 05:11:32
@article{2f23eb7a-8f9f-43fa-8f57-459ce0778f72,
  abstract     = {Cardiac index, systemic and pulmonary arterial pressures, carbon dioxide elimination and ventilation of each lung were studied during thoracotomy. Seventeen patients, placed in the full lateral position, were ventilated mechanically through a Carlens' tube to moderate hypocapnia. Mean cardiac index increased by 12% as the pleura was opened (P less than 0.05), with no further change during surgery on the still ventilated upper lung. Mean arterial pressure was unchanged after opening the pleura, but decreased from 114 +/- 15 mm Hg (mean +/- 1 SD) to 104 +/- 18 mm Hg during surgery on the lung (P less than 0.01). Mean pulmonary artery pressure was unchanged. There was a significant (P less than 0.01) increase in carbon dioxide elimination from the upper lung when the pleura was opened. In addition, the ventilation of this lung increased significantly (P less than 0.05). Mean end-tidal PCO2 of the lower lung increased from 4.1 to 4.2 kPa after opening the pleura, while that of the upper lung increased from 3.0 to 3.6 kPa (P less than 0.01). VD/VT decreased from 43 to 38% as the pleura was opened (P less than 0.01). During surgical handling of the lung, marked decreases in ventilation, compliance, carbon dioxide elimination and end-tidal PCO2 were observed in the upper lung. We conclude that ventilation-perfusion mismatch decreased on opening the pleura, and that neither opening the pleura nor the subsequent lung surgery (both lungs being ventilated) caused any clinically important derangements in haemodynamics or oxygenation.},
  author       = {Werner, Olof and Malmkvist, Gunnar and Beckman, Anders and Stahle, S and Nordström, L},
  issn         = {1471-6771},
  language     = {eng},
  number       = {12},
  pages        = {1343--1350},
  publisher    = {Macmillan},
  series       = {British Journal of Anaesthesia},
  title        = {Gas exchange and haemodynamics during thoracotomy},
  volume       = {56},
  year         = {1984},
}