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Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study

Patients undergoing one-lung ventilation (OLV) in the supine position face an increased risk of intraoperative hypoxia compared with those in the lateral decubitus position. We hypothesized that iloprost (ILO) inhalation improves arterial oxygenation and lung mechanics. Sixty-four patients were enro...

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Autores principales: Lee, Kyuho, Kim, Mina, Kim, Namo, Kang, Su Jeong, Oh, Young Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323331/
https://www.ncbi.nlm.nih.gov/pubmed/35887551
http://dx.doi.org/10.3390/jpm12071054
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author Lee, Kyuho
Kim, Mina
Kim, Namo
Kang, Su Jeong
Oh, Young Jun
author_facet Lee, Kyuho
Kim, Mina
Kim, Namo
Kang, Su Jeong
Oh, Young Jun
author_sort Lee, Kyuho
collection PubMed
description Patients undergoing one-lung ventilation (OLV) in the supine position face an increased risk of intraoperative hypoxia compared with those in the lateral decubitus position. We hypothesized that iloprost (ILO) inhalation improves arterial oxygenation and lung mechanics. Sixty-four patients were enrolled and allocated to either the ILO or control group (n = 32 each), to whom ILO or normal saline was administered. The partial pressure of the arterial oxygen/fraction of inspired oxygen (PaO(2)/FiO(2)) ratio, dynamic compliance, alveolar dead space, and hemodynamic variables were assessed 20 min after anesthesia induction with both lungs ventilated (T1) and 20 min after drug nebulization in OLV (T2). A linear mixed model adjusted for group and time was used to analyze repeated variables. While the alveolar dead space remained unchanged in the ILO group, it increased at T2 in the control group (n = 30 each) (p = 0.002). No significant differences were observed in the heart rate, mean blood pressure, PaO(2)/FiO(2) ratio, or dynamic compliance in either group. Selective ILO nebulization was inadequate to enhance oxygenation parameters during OLV in the supine position. However, it favorably affected alveolar ventilation during OLV in supine-positioned patients without adverse hemodynamic effects.
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spelling pubmed-93233312022-07-27 Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study Lee, Kyuho Kim, Mina Kim, Namo Kang, Su Jeong Oh, Young Jun J Pers Med Article Patients undergoing one-lung ventilation (OLV) in the supine position face an increased risk of intraoperative hypoxia compared with those in the lateral decubitus position. We hypothesized that iloprost (ILO) inhalation improves arterial oxygenation and lung mechanics. Sixty-four patients were enrolled and allocated to either the ILO or control group (n = 32 each), to whom ILO or normal saline was administered. The partial pressure of the arterial oxygen/fraction of inspired oxygen (PaO(2)/FiO(2)) ratio, dynamic compliance, alveolar dead space, and hemodynamic variables were assessed 20 min after anesthesia induction with both lungs ventilated (T1) and 20 min after drug nebulization in OLV (T2). A linear mixed model adjusted for group and time was used to analyze repeated variables. While the alveolar dead space remained unchanged in the ILO group, it increased at T2 in the control group (n = 30 each) (p = 0.002). No significant differences were observed in the heart rate, mean blood pressure, PaO(2)/FiO(2) ratio, or dynamic compliance in either group. Selective ILO nebulization was inadequate to enhance oxygenation parameters during OLV in the supine position. However, it favorably affected alveolar ventilation during OLV in supine-positioned patients without adverse hemodynamic effects. MDPI 2022-06-27 /pmc/articles/PMC9323331/ /pubmed/35887551 http://dx.doi.org/10.3390/jpm12071054 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Kyuho
Kim, Mina
Kim, Namo
Kang, Su Jeong
Oh, Young Jun
Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study
title Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study
title_full Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study
title_fullStr Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study
title_full_unstemmed Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study
title_short Effects of Iloprost on Arterial Oxygenation and Lung Mechanics during One-Lung Ventilation in Supine-Positioned Patients: A Randomized Controlled Study
title_sort effects of iloprost on arterial oxygenation and lung mechanics during one-lung ventilation in supine-positioned patients: a randomized controlled study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323331/
https://www.ncbi.nlm.nih.gov/pubmed/35887551
http://dx.doi.org/10.3390/jpm12071054
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