Department of Anaesthesiology and Pain medicine, Konkuk University Hospital and Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, South Korea.
Eur J Anaesthesiol. 2011 Nov;28(11):807-12. doi: 10.1097/EJA.0b013e32834ad993.
Cardiac surgery through a thoracotomy using one-lung ventilation (OLV) is thought to be associated with worse postoperative pulmonary gas exchange than sternotomy using two-lung ventilation (TLV), but this has not been confirmed yet. We, therefore, compared postoperative pulmonary gas exchange after mitral valve repair between sternotomy (group TLV) and thoracotomy (group OLV).
Randomised controlled study.
University teaching hospital.
Cardiac surgery patients.
Sternotomy or thoracotomy was used for mitral valve repair.
The ratio of arterial partial pressure of oxygen (PaO2) to fraction of inspired oxygen (FiO2) was compared in both groups before induction of anaesthesia (T0) and just before departure from the operating room to the ICU (T1). Fluid administration, transfusion requirements and urine output were checked intraoperatively. Postoperative haemoglobin (Hb), haematocrit (Hct) and creatinine were evaluated. Cardiopulmonary bypass (CPB) time, intubation time and ICU stay were also recorded.
The PaO2/FiO2 ratio (mean ± SD) at T1 was significantly lower than at T0 in both groups (326.9 ± 120.1 vs. 431.9 ± 73.7 mmHg in group TLV, P < 0.001; 374.9 ± 130.9 vs. 445.4 ± 73.7 mmHg in group OLV, P = 0.001), but did not differ significantly between the two groups. The doses of inotropes and vaopressors used were not significantly different between the groups. Intraoperative fluid administration, transfusion requirements, urine output and postoperative Hb/Hct and creatinine did not differ significantly between the groups. CPB time, intubation time and ICU stay also did not differ significantly between the groups.
Perioperative pulmonary function following OLV via a thoracotomy was not significantly worse than that following TLV via a sternotomy in mitral valve repair.
Not registered.
通过单肺通气（OLV）进行的开胸心脏手术被认为与使用双肺通气（TLV）进行的胸骨切开术相比，术后肺部气体交换更差，但这尚未得到证实。因此，我们比较了二尖瓣修复术经胸骨切开术（TLV 组）和经胸切开术（OLV 组）后的术后肺部气体交换。
随机对照研究。
大学教学医院。
心脏手术患者。
经胸骨切开术或经胸切开术进行二尖瓣修复。
在麻醉诱导前（T0）和离开手术室到 ICU 前（T1）比较两组的动脉血氧分压（PaO2）与吸入氧分数（FiO2）的比值。术中检查液体输入、输血需求和尿量。评估术后血红蛋白（Hb）、红细胞压积（Hct）和肌酐。还记录体外循环（CPB）时间、插管时间和 ICU 停留时间。
两组 T1 时的 PaO2/FiO2 比值（平均值±标准差）均明显低于 T0（TLV 组 326.9±120.1 与 431.9±73.7mmHg，P<0.001；OLV 组 374.9±130.9 与 445.4±73.7mmHg，P=0.001），但两组间无显著差异。两组间使用的正性肌力药和加压素剂量无显著差异。术中液体输入、输血需求、尿量以及术后 Hb/Hct 和肌酐无显著差异。CPB 时间、插管时间和 ICU 停留时间也无显著差异。
经胸切开术 OLV 术后的围手术期肺功能与经胸骨切开术 TLV 术后的围手术期肺功能无显著差异。
未注册。
