Improvement of arterial oxygenation by selective infusion of prostaglandin E1 to ventilated lung during one-lung ventilation

Ta-Liang Chen, T. H. Ueng, C. H. Huang, C. L. Chen, F. Y. Huang, C. J. Lin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: One-lung anesthesia provides a better surgical field for thoracic procedures but also impairs the arterial oxygenation and venous admixture. During one-lung ventilation, pulmonary vasoconstriction is assumed to be present within both ventilated and collapsed lungs. We propose that arterial oxygenation could be optimized by offsetting the vasoconstriction within the microcirculation of ventilated lung. Method: In an anesthetized dog model, incremental doses of prostaglandin E1 (PGE1) were selectively infused into the main trunk of the pulmonary artery of the ventilated lung after one-lung ventilation for 60 min (PGE1 group, n=9). Arterial oxygenation and calculated venous admixture (Qs/Qt) was also assessed in a time-course control group (Control group, n=5). During two-lung ventilation (FIO2: 0.66), arterial PO2 and venous admixture was 44.2 ± 3.5 kPa and 10.7 ± 2.3%, respectively. One-lung ventilation (FIO2: 0.66) with left lung collapsed reduced arterial PO2 to 11.6 ± 1.7 kPa and increased venous admixture to 40.7 ± 5.8% (P2 tension also decreased from 6.3 ± 0.7 kPa to 5.0 ± 0.6 kPa with a slight increase in mean pulmonary artery pressure and pulmonary vascular resistance (P1 at a dose of 0.04 to 0.2 μg kg-1 min-1, there was a dose-dependent improvement in arterial PO2 with a parallel reduction of venous admixture during one-lung ventilation. Arterial PO2 increased to a maximum of 23.0 ± 4.3 kPa, and the venous admixture decreased significantly to a minimum of 27.4 ± 4.2% by PGE1 at a dose of 0.04-0.4 μg kg-1 min-1 (P1 resulted in a small increase in cardiac output and decreases of pulmonary pressure and pulmonary vascular resistance at a relatively high dose of 0.4 μg kg-1 min-1 during selective infusion (P1 to the ventilated lung within the dose range of 0.04-0.4 μg kg-1 min-1 is practical and effective to improve arterial oxygenation and reduce venous admixture during one-lung ventilation.

Original languageEnglish
Pages (from-to)7-13
Number of pages7
JournalActa Anaesthesiologica Scandinavica
Volume40
Issue number1
Publication statusPublished - 1996
Externally publishedYes

Keywords

  • Anesthetized dog
  • Arterial oxygenation
  • Hypoxic pulmonary vasoconstriction
  • Intrapulmonary catheter
  • One-lung ventilation
  • Prostaglandin E
  • Selective infusion
  • Venous admixture
  • Ventilated lung

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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