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https://www.readbyqxmd.com/read/28619111/two-minute-disconnection-technique-with-a-double-lumen-tube-to-speed-the-collapse-of-the-non-ventilated-lung-for-one-lung-ventilation-in-thoracoscopic-surgery
#1
Qiongzhen Li, Xiaofeng Zhang, Jingxiang Wu, Meiying Xu
BACKGROUND: Thoracic surgery requires the effective collapse of the non-ventilated lung. In the majority of cases, we accomplished, accelerated lung collapse using a double-lumen tube (DLT). We hypothesized that using the two-minute disconnection technique with a DLT would improve lung collapse during subsequent one-lung ventilation. METHODS: Fifty patients undergoing thoracoscopic surgery with physical classification I or II according to the American Society of Anesthesiologists were randomly divided into two groups for respiratory management of one-lung ventilation (OLV)...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28616282/pressure-controlled-versus-volume-controlled-ventilation-during-one-lung-ventilation-for-video-assisted-thoracoscopic-lobectomy
#2
Yi-Qi Zhu, Fang Fang, Xiao-Min Ling, Jian Huang, Jing Cang
BACKGROUND: It is controversial as to which ventilation mode is better during one-lung ventilation (OLV). This study was designed to figure out whether there was any difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on oxygenation and postoperative complications under the condition of protective ventilation (PV). METHODS: Sixty-five patients undergoing video-assisted thoracoscopic lobectomy were randomized into two groups...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28615010/internet-based-perioperative-exercise-program-in-patients-with-barrett-s-carcinoma-scheduled-for-esophagectomy-ipep-study-a-prospective-randomized-controlled-trial
#3
Daniel Pfirrmann, Suzan Tug, Oana Brosteanu, Matthias Mehdorn, Martin Busse, Peter P Grimminger, Florian Lordick, Torben Glatz, Jens Hoeppner, Hauke Lang, Perikles Simon, Ines Gockel
BACKGROUND: Patients undergoing surgery for esophageal cancer have a high risk for postoperative deterioration of lung function and pulmonary complications. This is partly due to one-lung ventilation during thoracotomy. This often accounts for prolonged stay on intensive care units, delayed postoperative reconvalescence and reduced quality of life. Socioeconomic disadvantages can result from these problems. Physical preconditioning has become a crucial leverage to optimize fitness and lung function in patients scheduled for esophagectomy, in particular during the time period of neoadjuvant therapy...
June 14, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28607884/rigid-bronchoscopic-placement-of-fogarty-catheter-as-a-bronchial-blocker-for-one-lung-isolation-and-ventilation-in-infants-and-children-undergoing-thoracic-surgery-a-single-institution-experience-of-27-cases
#4
Sunil Kant Kamra, Ashwin Ashok Jaiswal, Amrish Kumar Garg, Manoj Kumar Mohanty
One-lung ventilation (OLV) is a challenging task in infants and children as few techniques are possible because of narrow anatomy. The aim of this study is to evaluate and experience lung isolation with Fogarty catheters as a bronchial blocker placed by rigid bronchoscope for OLV in infants and children with lung pathologies requiring surgical management in an industrial hospital. This study is a prospective study carried out in J.L.N. Hospital and Research Centre, Bhilai (CG), from January 2011 to December 2014...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28604996/one-lung-ventilation-for-thoracic-surgery-current-perspectives
#5
Filippo Bernasconi, Federico Piccioni
One-lung ventilation (OLV) is an anesthesiological technique that is increasingly being used beyond thoracic surgery. This requires specific skills and knowledge about airway management, maintenance of gas exchange and prevention of acute lung injury. Sometimes maintaining adequate gas exchange and minimizing acute lung injury may be opposing processes. Parameters validated for OLV titration still have not been found, but a multimodal approach based on low tidal volume, end-expiratory pressure application and alveolar recruitment maneuvers is considered the best way to ensure protective ventilation and reduce lung damage...
June 7, 2017: Tumori
https://www.readbyqxmd.com/read/28598916/protective-lung-ventilation-and-morbidity-after-pulmonary-resection-a-propensity-score-matched-analysis
#6
David Amar, Hao Zhang, Alessia Pedoto, Dawn P Desiderio, Weiji Shi, Kay See Tan
BACKGROUND: Protective lung ventilation (PLV) during one-lung ventilation (OLV) for thoracic surgery is frequently recommended to reduce pulmonary complications. However, limited outcome data exist on whether PLV use during OLV is associated with less clinically relevant pulmonary morbidity after lung resection. METHODS: Intraoperative data were prospectively collected in 1080 patients undergoing pulmonary resection with OLV, intentional crystalloid restriction, and mechanical ventilation to maintain inspiratory peak airway pressure <30 cm H2O...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28542402/evidence-for-pleural-epithelial-mesenchymal-transition-in-murine-compensatory-lung-growth
#7
Alexandra B Ysasi, Willi L Wagner, Cristian D Valenzuela, Arne Kienzle, Andrew B Servais, Robert D Bennett, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
In many mammals, including rodents and humans, removal of one lung results in the compensatory growth of the remaining lung; however, the mechanism of compensatory lung growth is unknown. Here, we investigated the changes in morphology and phenotype of pleural cells after pneumonectomy. Between days 1 and 3 after pneumonectomy, cells expressing α-smooth muscle actin (SMA), a cytoplasmic marker of myofibroblasts, were significantly increased in the pleura compared to surgical controls (p < .01). Scanning electron microscopy of the pleural surface 3 days post-pneumonectomy demonstrated regions of the pleura with morphologic features consistent with epithelial-mesenchymal transition (EMT); namely, cells with disrupted intercellular junctions and an acquired mesenchymal (rounded and fusiform) morphotype...
2017: PloS One
https://www.readbyqxmd.com/read/28539301/-anesthesia-management-in-robotic-assisted-esophagectomy-with-triple-incisions-analysis-of-53-cases
#8
Xiao-Qing Liu, Tian-Hua Zhang, Jing Cheng, Hui-Ting Li, Long-Hui Cao, Zi-Hui Tan, Wen-Qian Lin
Between March, 2016 and January, 2017, 53 patients underwent robotic-assisted esophagectomy with triple incisions. All the patients were intubated with Double lumen endotracheal tub with one-lung ventilation and CO2 pneumoperitoneum, and CO2 pneumothorax was used in 7 cases. Most of the patients could tolerate OLV and CO2 pneumoperitoneum, and 4 patients with CO2 pneumothorax had hypoxemia and required double-lung ventilation or high frequency ventilation; 15 patients developed postoperative pulmonary complications and were transferred to ICU...
May 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28538782/diffuse-cystic-lung-diseases-differential-diagnosis
#9
Bruno Guedes Baldi, Carlos Roberto Ribeiro Carvalho, Olívia Meira Dias, Edson Marchiori, Bruno Hochhegger
Diffuse cystic lung diseases are characterized by cysts in more than one lung lobe, the cysts originating from various mechanisms, including the expansion of the distal airspaces due to airway obstruction, necrosis of the airway walls, and parenchymal destruction. The progression of these diseases is variable. One essential tool in the evaluation of these diseases is HRCT, because it improves the characterization of pulmonary cysts (including their distribution, size, and length) and the evaluation of the regularity of the cyst wall, as well as the identification of associated pulmonary and extrapulmonary lesions...
March 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28538393/a-comparison-of-extraluminal-and-intraluminal-use-of-the-uniblocker-in-left-thoracic-surgery-a-consort-compliant-article
#10
RANDOMIZED CONTROLLED TRIAL
Zhuo Liu, WenSheng He, QianQian Jia, XiaoChun Yang, ShuJuan Liang, XiuLi Wang
BACKGROUND: The aim of this study was to assess the feasibility and safety issues concerning extraluminal use of the Uniblocker for one-lung ventilation (OLV) in the left thoracic surgery. METHODS: Forty patients undergoing elective left thoracic surgery were included in this study, and all patients were randomly allocated to extraluminal use of Uniblocker group (E group, n = 20) or intraluminal use of Uniblocker group (I group, n = 20). Time for intubation, time for verification of the correct position of Uniblocker, incidence of Uniblocker displacement, index of pulmonary collapse, mean arterial pressure, heart rate, peak airway pressure, oxygen saturation in two-lung ventilation, and 30 minutes after OLV, bronchial damage after OLV, sore throat, and hoarseness postoperative were recorded...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28529813/difficult-management-of-a-double-lumen-endotracheal-tube-and-difficult-ventilation-during-robotic-thymectomy-with-carbon-dioxide-insufflation
#11
Yuki Sugiyama, Kunihiro Mitsuzawa, Yuki Yoshiyama, Fumiko Shimizu, Satoshi Fuseya, Takashi Ichino, Hiroyuki Agatsuma, Takayuki Shiina, Ken-Ichi Ito, Mikito Kawamata
Robotic surgery with carbon dioxide (CO2) insufflation to the thorax is frequently performed to gain a better operative field of view, although its intraoperative complications have not yet been discussed in detail. We treated two patients with difficult ventilation caused by distal migration of a double-lumen endotracheal tube (DLT) during robotic thymectomy. In the first case, migration of the DLT during one-lung ventilation (OLV) occurred after CO2 insufflation to the bilateral thoraxes was started. Oxygenation rapidly deteriorated because dependent lung expansion was restricted by CO2 insufflation...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#12
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28526465/-selective-lobar-blockade-with-a-coopdech-blocker-combined-with-a-double-lumen-endotracheal-tube-for-lung-metastases-resection-by-laser
#13
Patricia Cruz, Hugo David Orozco, Ignacio Garutti Martinez, Gloria Hernández Fernández
In recent years, laser resection of lung metastases has been established as the standard procedure worldwide. To avoid airway fire, it is necessary to collapse the surgical lung. The selective lobar bronchial blockade is a technique that allows one-lung ventilation while the operated lobe is collapsed in patients with previous pulmonary resection requiring subsequent resection or with limited pulmonary reserve. We report a clinical case about our experience of a selective lobar bronchial blockade technique with a bronchial blocker (Coopdech endobronchial blocker) that was employed successfully with a double-lumen endotracheal tube in a patient with previous contralateral pulmonary resection who was scheduled for atypical resections of pulmonary metastases by laser...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#14
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Randomised study. PATIENTS: Adults scheduled for thoracic elective surgery, requiring one-lung ventilation with a predicted difficult intubation score of at least 7 (Arné risk index)...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28504996/stroke-volume-variation-and-pulse-pressure-variation-are-not-useful-for-predicting-fluid-responsiveness-in-thoracic-surgery
#15
Dae Myoung Jeong, Hyun Joo Ahn, Hyo Won Park, Mikyung Yang, Jie Ae Kim, Joohyun Park
BACKGROUND: Stroke volume variation (SVV) and pulse pressure variation (PPV) are used as indicators of fluid responsiveness, but little is known about the usefulness of these dynamic preload indicators in thoracic surgery, which involves an open thoracic cavity and one-lung ventilation (OLV). Therefore, we investigated whether SVV and PPV could predict fluid responsiveness, and whether the thresholds of these parameters should be adjusted for thoracic surgery. METHODS: This was a prospective, controlled study conducted in a tertiary care center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28502060/comparison-of-univent-tube-and-ez-blocker-in-one-lung-ventilation-airway-pressures-and-gas-exchange
#16
Tülay Hoşten, Can Aksu, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Mine Solak
Univent tube (UT) and EZ-blocker were used for one-lung ventilation (OLV). UT is a single lumen tube with a small separate lumen containing a bronchial blocker. EZ-blocker differs with its unique y-shaped double-cuffed distal end. We aimed to compare these two airway devices effects on airway pressures, oxygenation, ventilation and haemodynamics during OLV. Patients undergoing elective thoracotomy for the first time were included in this prospective randomized study. Patients were divided into two groups as UT and EZ...
May 13, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28442980/safety-issues-of-endobronchial-intubation-for-one-lung-ventilation-in-video-assisted-thoracoscopic-surgery-in-neonates-can-we-extubate-on-the-table
#17
Lokesh Kashyap, Neisevilie Nisa, Apala Roy Chowdhury, Punit Khanna
No abstract text is available yet for this article.
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28442965/unusual-airways-management-during-one-lung-ventilation-in-thoracic-surgery
#18
Paolo Primieri, Paolo Ancona, Elisabetta Gualtieri
Airways management in thoracic surgery is usually more difficult than in other surgery. We reported a case of a patient who underwent surgery of evacuation of empyema where after a correct insertion of a left double-lumen tube 37 Fr (DLT), one-lung ventilation was not permitted by the high airways pressure. In fact, the hole of bronchial tip was just against the left bronchial wall retracted probably from inflammatory process. We introduced blindly an Arndt blocker 9 Fr inside the tracheal lumen of DLT until the orifice of the right upper lobe bronchus, the distance was checked before...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28428006/the-relation-between-the-location-and-the-perforation-rate-of-lung-hydatid-cysts-in-children
#19
Omer Onal, Omer Faruk Demir
BACKGROUND/OBJECTIVE: The pressure, size, and central or peripheral location of lung hydatid cysts are the most studied topics among the factors affecting perforation. The aim of this study is to investigate the relation between the location and the perforation rate of lung hydatid cysts in children. METHODS: 197 patients under the age of 16 years, who were operated between January 2000 and December 2016 due to pulmonary hydatid cysts, were evaluated retrospectively...
April 17, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28413273/intraoperative-low-tidal-volume-ventilation-strategy-has-no-benefits-during-laparoscopic-cholecystectomy
#20
Vandna Arora, Asha Tyagi, Surendra Kumar, Aanchal Kakkar, Shukla Das
BACKGROUND AND AIMS: Benefits of intraoperative low tidal volume ventilation during laparoscopic surgery are not conclusively proven, even though its advantages were seen in other situations with intraoperative respiratory compromise such as one-lung ventilation. The present study compared the efficacy of intraoperative low tidal volume ventilatory strategy (6 ml/kg along with positive end-expiratory pressure [PEEP] of 10 cmH2O) versus one with higher tidal volume (10 ml/kg with no PEEP) on various clinical parameters and plasma levels of interleukin (IL)-6 in patients undergoing laparoscopic cholecystectomy...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
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