One-lung ventilation induces hyperperfusion and alveolar damage in the ventilated lung: an experimental study.

Abstract:

BACKGROUND:One-lung ventilation (OLV) increases mechanical stress in the lung and affects ventilation and perfusion (V, Q). There are no data on the effects of OLV on postoperative V/Q matching. Thus, this controlled study evaluates the influence of OLV on V/Q distribution in a pig model using a gamma camera technique [single-photon emission computed tomography (SPECT)] and relates these findings to lung histopathology after OLV. METHODS:Eleven anaesthetized and ventilated pigs (V(T)=10 ml kg(-1), Fio2=0.40, PEEP=5 cm H2O) were studied. After lung separation, OLV and thoracotomy were performed in seven pigs (OLV group). During OLV and in a two-lung ventilation (TLV), control group (n=4) ventilation settings remained unchanged. SPECT with (81m)Kr (ventilation) and (99m)Tc-labelled macro-aggregated albumin (perfusion) was performed before, during, and 90 min after OLV/TLV. Finally, lung tissue samples were harvested and examined for alveolar damage. RESULTS:OLV affected ventilation and haemodynamic variables, but there were no differences between the OLV group and the control group before and after OLV/TLV. SPECT revealed an increase of perfusion in the dependent lung compared with baseline (49-56%), and a corresponding reduction of perfusion (51-44%) in non-dependent lungs after OLV. No perfusion changes were observed in the control group. This resulted in increased low V/Q regions and a shift of V/Q areas to 0.3-0.5 (10(-0.5)-10(-0.3)) in dependent lungs of OLV pigs and was associated with an increased diffuse alveolar damage score. CONCLUSIONS:OLV in pigs results in a substantial V/Q mismatch, hyperperfusion, and alveolar damage in the dependent lung and may thus contribute to gas exchange impairment after thoracic surgery.

journal_name

Br J Anaesth

authors

Kozian A,Schilling T,Fredén F,Maripuu E,Röcken C,Strang C,Hachenberg T,Hedenstierna G

doi

10.1093/bja/aen021

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

549-59

issue

4

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)34376-3

journal_volume

100

pub_type

杂志文章
  • Enteral absorption and haemodynamic response of clonidine in infants post-cardiac surgery.

    abstract:BACKGROUND:Clonidine is a useful analgesic-sedative agent; however, few data exist regarding its use in infants after congenital heart disease surgery. We thus aimed to assess the absorption and safety of enterally administered clonidine in this setting. METHODS:Sixteen infants (median age 6.7 months) received a singl...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aeu258

    authors: Arenas-Lopez S,Mulla H,Manna S,Durward A,Murdoch IA,Tibby SM

    更新日期:2014-12-01 00:00:00

  • Processed electroencephalogram during combined extradural and general anaesthesia.

    abstract::The processed electroencephalogram (pEEG) was monitored in eight patients undergoing gynaecological laparotomy under combined extradural and nitrous oxide-isoflurane anaesthesia. Pre-incisional mean spectral edge frequency 95 percentile (SEF95) and median frequency (MF) were 11.67 (SD 1.63) Hz and 3.74 (0.24) Hz, resp...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1093/bja/78.6.751

    authors: Kiyama S,Tsuzaki K

    更新日期:1997-06-01 00:00:00

  • New antiplatelet drugs and new oral anticoagulants.

    abstract::In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this revi...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aew214

    authors: Koenig-Oberhuber V,Filipovic M

    更新日期:2016-09-01 00:00:00

  • Cardiac rate and rhythm during anaesthesia for dental extraction. A comparison of halothane, enflurane and isoflurane.

    abstract::Cardiac rate and rhythm were compared in 60 patients having dental extractions under conventional general anaesthesia using halothane, enflurane or isoflurane to supplement nitrous oxide in oxygen. The incidence of arrhythmia was higher in the halothane group when compared with both the enflurane (P less than 0.05) an...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/57.5.476

    authors: Casson WR,Jones RM

    更新日期:1985-05-01 00:00:00

  • Comparison of two methods of i.v. insulin administration in the diabetic patient during the perioperative period.

    abstract::We have examined the effects of two types of insulin therapy (continuous i.v. infusion (group A: 1.25 u. h-1) and direct i.v. bolus administration of 10 u. every 2 h (group B: 10 u./2 h)) on the metabolic and endocrine responses to surgery in 60 adult diabetic patients undergoing general anaesthesia for elective proce...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1093/bja/72.1.5

    authors: Raucoules-Aime M,Ichai C,Roussel LJ,Romagnan MJ,Gastaud P,Dolisi C,Grimaud D

    更新日期:1994-01-01 00:00:00

  • Prospective validation of a new airway management algorithm and predictive features of intubation difficulty.

    abstract:BACKGROUND:Some patients have features that indicate possible difficulty with direct laryngoscopy for tracheal intubation. Prediction of the likely outcome and selection of patients for an enhanced management algorithm would reduce the possible harm from failed intubation attempts. METHODS:Adult elective patients were...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1016/j.bja.2018.09.021

    authors: Cook F,Lobo D,Martin M,Imbert N,Grati H,Daami N,Cherait C,Saïdi NE,Abbay K,Jaubert J,Younsi K,Bensaid S,Ait-Mamar B,Slavov V,Mounier R,Goater P,Bloc S,Catineau J,Abdelhafidh K,Haouache H,Dhonneur G

    更新日期:2019-02-01 00:00:00

  • Effect of adrenaline on venous plasma concentrations of bupivacaine after interpleural administration.

    abstract::Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of d...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/64.6.662

    authors: Gin T,Chan K,Kan AF,Gregory MA,Wong YC,Oh TE

    更新日期:1990-06-01 00:00:00

  • Feasibility of closed-loop co-administration of propofol and remifentanil guided by the bispectral index in obese patients: a prospective cohort comparison.

    abstract:BACKGROUND:We used an automated bispectral index (BIS)-guided dual-loop controller to determine propofol and remifentanil requirements during general anaesthesia in obese and lean surgical patients. METHODS:Obese patients, BMI>35 kg m(-2), and lean patients (<25 kg m(-2)) having laparoscopic procedures were prospectiv...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1093/bja/aeu401

    authors: Liu N,Lory C,Assenzo V,Cocard V,Chazot T,Le Guen M,Sessler DI,Journois D,Fischler M

    更新日期:2015-04-01 00:00:00

  • From d-tubocurarine to sugammadex: the contributions of T. Cecil Gray to modern anaesthetic practice.

    abstract::One hundred years after Morton's demonstration of the anaesthetic effects of ether, T. Cecil Gray revolutionized anaesthesia with his introduction of balanced general anaesthesia. Gray's technique involved i.v. induction, administration of a neuromuscular blocking agent (curare), tracheal intubation, controlled ventil...

    journal_title:British journal of anaesthesia

    pub_type: 传,历史文章,杂志文章

    doi:10.1093/bja/aer117

    authors: Shafer SL

    更新日期:2011-07-01 00:00:00

  • A multicentre comparison of the costs of anaesthesia with sevoflurane or propofol.

    abstract::Day-case anaesthesia requires rapidly eliminated anaesthetics which are relatively expensive. This multinational, multicentre European study assessed the relative costs of propofol or sevoflurane anaesthesia in 211 patients. Anaesthesia was induced and maintained with propofol in group 1, with propofol and sevoflurane...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1093/bja/83.4.564

    authors: Smith I,Terhoeve PA,Hennart D,Feiss P,Harmer M,Pourriat JL,Johnson IA

    更新日期:1999-10-01 00:00:00

  • Comparison of the laryngoscopy views with the size 1 Miller and Macintosh laryngoscope blades lifting the epiglottis or the base of the tongue in infants and children

    abstract:BACKGROUND:Miller laryngoscope blades are preferred for laryngoscopy in infants and children <2 yr of age. Despite their long history, the laryngeal view with the Miller blade size 1 has never been compared with that with the Macintosh (MAC) blade in children. This prospective, single-blinded, randomized study was desi...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/bja/aeu228

    authors: Passi Y,Sathyamoorthy M,Lerman J,Heard C,Marino M

    更新日期:2014-11-01 00:00:00

  • Effects of halothane on respiratory mechanics and lung histopathology in normal rats.

    abstract::It is generally accepted that halothane reduces airway and tissue resistance in lungs with preexisting airway tone. However, under conditions of resting airway tone, pulmonary resistance remains unaltered. In this study, we have determined the effects of halothane on respiratory system, pulmonary and chest wall resist...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.bja.a013443

    authors: Reta GS,Riva JA,Piriz H,Medeiros AS,Rocco PR,Zin WA

    更新日期:2000-03-01 00:00:00

  • Iontophoretically applied lidocaine reduces pain on propofol injection.

    abstract::We have compared iontophoretically and locally applied lidocaine for relief of pain on propofol injection. Pain was assessed on insertion of a 20-gauge i.v. cannula and at 10-s intervals for 30 s after injection of propofol. Pain scores on cannulation were significantly less in the iontophoresis group (median 1.1) tha...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/82.3.432

    authors: Sadler PJ,Thompson HM,Maslowski P,Liddle A,Rowbotham DJ

    更新日期:1999-03-01 00:00:00

  • A double-blind trial of bupivacaine (Marcain) and etidocaine (Duranest) in extradural block for surgical induction of labour.

    abstract::A double-blind randomized trial was conducted to compare etidocaine, the new local anaesthetic agent, with bupivacaine. One hundred patients were each given a single dose of one of the drugs during the surgical induction of labour. The results showed that etidocaine had a quicker onset of action than bupivacaine, but ...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/47.12.1305

    authors: Phillips G

    更新日期:1975-12-01 00:00:00

  • Comparison of CNS effects of propofol and thiopentone in cats.

    abstract::Using cats with chronically implanted brain electrodes, we have compared the effects of propofol on CNS electrical activities with those of thiopentone. Ten cats were allocated to receive either propofol (n = 5) or thiopentone (n = 5). Cats were anaesthetized initially with 4% halothane in oxygen. The trachea was intu...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/71.3.383

    authors: Tomoda K,Shingu K,Osawa M,Murakawa M,Mori K

    更新日期:1993-09-01 00:00:00

  • Ultrasound-guided infraclavicular axillary vein cannulation for central venous access.

    abstract:BACKGROUND:Infraclavicular axillary vein cannulation is not commonly used for central venous access because identifying the surface landmarks is difficult. Ultrasound guided axillary vein puncture has not been well described. We assessed ultrasound imaging to guide catheterization of the infraclavicular axillary vein. ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aeh187

    authors: Sharma A,Bodenham AR,Mallick A

    更新日期:2004-08-01 00:00:00

  • Depression of cortical somatosensory evoked potentials by nitrous oxide.

    abstract::The effects of the inhalation of 50% nitrous oxide on somatosensory evoked potentials during a fentanyl-oxygen anaesthetic technique for central nervous system surgery were evaluated. The latency and amplitude of the first cortical wave were obtained using conventional somatosensory techniques with median or posterior...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/57.9.849

    authors: Sloan TB,Koht A

    更新日期:1985-09-01 00:00:00

  • Using educational video to enhance protocol adherence for medical procedures.

    abstract:BACKGROUND:Better education of clinicians is expected to enhance patient safety. An important component of education is adherence to standard protocols, which are mainly available in written form. Believing in the potential power of videos, we hypothesized that the introduction of an educational video, based on an inst...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aew030

    authors: Kandler L,Tscholl DW,Kolbe M,Seifert B,Spahn DR,Noethiger CB

    更新日期:2016-05-01 00:00:00

  • Usefulness of the pain sensitivity questionnaire to discriminate the pain behaviour of chronic pain patients.

    abstract:BACKGROUND:Chronic pain is no longer an effective warning system, but a syndrome with co-morbidities and many causes, needing a careful evaluation. Questions remain about the pain behaviour of chronic pain patients compared with patients with acute pain, or healthy subjects that we investigated. METHODS:We compared th...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.bja.2018.04.042

    authors: Tuna T,Van Obbergh L,Van Cutsem N,Engelman E

    更新日期:2018-09-01 00:00:00

  • Rationalization of the selection of tracheal tubes.

    abstract::The problems of selection of tracheal tubes, and the need for a rationale, are outlined. Tracheal tubes of 7.5 mm and 8.5 mm i.d. are recommended for female and male patients, respectively. Tracheal size was determined using high pressure-low volume cuffs as measuring devices. The average diameter of the cuff at seal ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/58.1.111

    authors: Chandler M,Crawley BE

    更新日期:1986-01-01 00:00:00

  • Effects of inhalation anaesthetics on the release of acetylcholine in the rat cerebral cortex in vivo.

    abstract::By analysing the EEG, reticular multi-unit activity and behavioural changes, we have classified general anaesthetics into three groups: central nervous system (CNS) depressant, CNS excitant and epileptogenic agents. Changes in CNS neural activity are associated with alteration in transmitter release. We have attempted...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/80.3.365

    authors: Shichino T,Murakawa M,Adachi T,Arai T,Miyazaki Y,Mori K

    更新日期:1998-03-01 00:00:00

  • Spinal anaesthesia for paediatric day-case surgery: a double-blind, randomized, parallel group, prospective comparison of isobaric and hyperbaric bupivacaine.

    abstract::We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.5 mg kg-1 orally. Seventy-two children were sedated...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/81.4.502

    authors: Kokki H,Tuovinen K,Hendolin H

    更新日期:1998-10-01 00:00:00

  • Diurnal variations in recovery times after general anaesthesia in children.

    abstract:BACKGROUND:Circadian rhythms coordinate almost all physiological functions and are implicated in major disease development. Even though circadian rhythms have a major impact on human health, little is known about how they affect general anaesthesia. The purpose of this study was to understand if the time of day affects...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1016/j.bja.2018.06.027

    authors: Szolnoki J,Polaner DM,Eckle T

    更新日期:2018-10-01 00:00:00

  • In vivo determination of concentration-effect curves of local anaesthetics in man.

    abstract::In clinical use, the concentrations of local anaesthetics at the site of action are unknown. With the method described here, concentrations of local anaesthetics can be predetermined and kept constant at the site of action. In six volunteers, a blister was raised on the ventral surface of the forearm. After removal of...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/70.5.552

    authors: Wiesemes R,Klement W,Novotny GE,Lipfert P

    更新日期:1993-05-01 00:00:00

  • Lumbar extradural injection pressures in pregnant women. An investigation of relationships between rate of infection, injection pressures and extent of analgesia.

    abstract::Before the induction of labour in 34 pregnant women 1.5% lignocaine 10 ml was injected into the lumbar extradural space at constant rates between 0.143 and 0.333 ml s-1. Injection pressures and residual pressures were recorded and the extent of analgesia to pinprick was assessed. No significant correlation was found b...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/52.1.55

    authors: Husemeyer RP,White DC

    更新日期:1980-01-01 00:00:00

  • Randomized cross-over comparison of cervical-spine motion with the AirWay Scope or Macintosh laryngoscope with in-line stabilization: a video-fluoroscopic study.

    abstract:BACKGROUND:The AirWay Scope (AWS) is a fibreoptic device that allows for intubation without alignment of the oral, pharyngeal, and tracheal axes. It may be useful for patients with an unstable cervical-spine (C-spine) or when C-spine movement is undesirable. This study was conducted to fluoroscopically evaluate upper C...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/bja/aen207

    authors: Maruyama K,Yamada T,Kawakami R,Hara K

    更新日期:2008-10-01 00:00:00

  • Probable histamine liberation with atracurium. A case report.

    abstract::An histaminoid reaction after the administration of thiopentone and atracurium is described. Serial blood sampling showed no evidence of complement activation. Intradermal testing 6 weeks later yielded a positive result with atracurium (1 in 1000), but not with thiopentone. The clinical course of the reaction and the ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/57.8.811

    authors: Lavery GG,Boyle MM,Mirakhur RK

    更新日期:1985-08-01 00:00:00

  • Effect of volatile anaesthetics on cell survival as measured by colony forming ability.

    abstract::Chinese hamster fibroblast cells in stirred suspension cultures were exposed to volatile anaesthetic agents for 3 hr or for 24 hr. Cell viability was measured as colony forming ability and was found to be reduced, in a dose related manner, by halothane, chloroform, methoxyflurane, trichloroetheylene and diethyl ether....

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/47.8.831

    authors: Sturrock JE

    更新日期:1975-08-01 00:00:00

  • Study to determine the repeatability of supra-sternal Doppler (ultrasound cardiac output monitor) during general anaesthesia: effects of scan quality, flow volume, and increasing age.

    abstract:BACKGROUND:The ultrasound cardiac output monitor (USCOM) is a continuous wave Doppler system designed to measure cardiac output (CO) non-invasively and intermittently either from the pulmonary or from the aortic valve. USCOM scan quality is critical to obtaining reliable data and during anaesthesia it is said to deteri...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aet254

    authors: Huang L,Critchley LA

    更新日期:2013-12-01 00:00:00

  • Measurement of lung volume by multiple indicator dilution. Testing a modelled hypothesis with on-line computation.

    abstract::Respiratory mass spectrometry and on-line computation were used to estimate lung volume in normal subjects by a rebreathing technique, using oxygen, nitrogen and argon as indicators. The computation had previously been tested in a numerical model. In real normal lungs, it performed well enough for practical purposes, ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/56.5.509

    authors: Black AM,Scott IL,Hahn CE,Maynard P,Baker AB

    更新日期:1984-05-01 00:00:00