Acute Permissive Hypercapnia during One Lung Ventilation: Impact on Right Ventricular Function during Lung Resection,
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- Category: Vol. 84, March 2016
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Acute Permissive Hypercapnia during One Lung Ventilation: Impact on Right Ventricular Function during Lung Resection, AIMAN A. DESSOUKI, MAGED S. ABDULLAH, AHMED M. MUKHTAR, HISHAM H. ABD EL-WAHAB and MOHAMED W. MAHMOUD
Abstract
Background: In a quasi-experimental design study, the haemodynamic and gas exchange effects of acute permissive hypercapnia and its effect on right ventricle during one-lung ventilation in 15 thoracotomy patients who had lung resetion, were investigated.
Methods: Hypercapnia was induced by decreasing tidal volume until PaCO2 increased to 60-70mmHg.
Results: Cardiac index (from 2.93±0.44 to 3.37±0.54l min–1 m–2, p-value <0.001), tricuspid annular plane systolic excursion (2.16±0.15 to 2.4±0.17cm, p-value <0.001) and right ventricular myocardial performance index (0.319±0.01 to 0.33±0.0, p-value <0.001) increased with hypercapnia. Systemic and pulmonary oxygenation improved.
Conclusion: Permissive hypercapnia as a component of OLV management is likely to be beneficial in selected patients. PaCO2 levels up to 60-70mmHg are likely to be tolerated in the short-term and clearly beneficial in terms of lung injury attenuation.