Thorac Cardiovasc Surg 2006; 54(8): 516-520
DOI: 10.1055/s-2006-924413
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Pressure-Controlled versus Volume-Controlled One-Lung Ventilation for MIDCAB

C. Heimberg1 , M. Winterhalter1 , M. Strüber2 , S. Piepenbrock1 , M. Bund3
  • 1Department of Anaesthesiology, Hanover Medical School, Hannover, Germany
  • 2Department of Thoracic and Cardiovascular Surgery, Hanover Medical School, Hannover, Germany
  • 3Department of Anaesthesiology and Intensive Care, Albert Schweitzer Hospital, Northeim, Germany
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Publikationsverlauf

Received January 2, 2006

Publikationsdatum:
06. Dezember 2006 (online)

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Abstract

One-lung ventilation is limited by hypoventilation and hypoxemia because of increasing airway pressure and intrapulmonary shunt. Previous clinical studies compared pressure-controlled versus volume-controlled ventilation during one-lung ventilation in patients with pre-existing pulmonary disease. We studied 50 patients undergoing thoracotomy and one-lung ventilation because of cardiovascular disease. After two-lung ventilation with volume-controlled ventilation, patients were divided randomly into two groups. In one group, ventilation was switched to pressure-controlled ventilation after starting one-lung ventilation. In the other group, volume-controlled ventilation was continued. Parameters of ventilation, pulmonary function and systemic and pulmonary hemodynamics were recorded. We observed, that peak airway pressure, dead space ventilation and arterial carbon dioxide partial pressure were significantly higher during volume-controlled ventilation. After one-lung ventilation patients with pressure controlled ventilation had lower alveolar-arterial oxygen tension difference and a higher arterial oxygen partial pressure with significant differences for those patients in the intensive care unit. We conclude that pressure-controlled ventilation may be useful to improve gas exchange and alveolar recruitment during one – lung ventilation.

References

Dr. C. Heimberg

Zentrum Anästhesiologie
Medizinische Hochschule Hannover

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30625 Hannover

Germany

Telefon: + 49 51 15 32 24 89

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eMail: heimberg.claus@mh-hannover.de