Supervisors info:
Πανταζόπουλος Ιωάννης, Αναπληρωτής καθηγητής, Ιατρική Σχολή, Πανεπιστήμιο Θεσσαλίας, Επιβλέπων
Κονδύλη Ευμορφία, Καθηγήτρια, Ιατρική Σχολή, Πανεπιστήμιο Κρήτης
Χαντζιάρα Βασιλική, Επιστημονική Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ
Translated title:
Comparison of mechanical properties of the respiratory system in single-lung ventilation, in planned thoracic surgeries, with an endobronchial occluder and a double-lumen endotracheal tube
Summary:
Introduction: One-lung ventilation is a common method of ventilation during thoracic surgery. Blocking the ventilation of one lung is achieved with the use of special double lumen tubes (DLT) and with bronchial blockers (BB).
Purpose: To record and compare the mechanical properties of the respiratory system in one-lung ventilation, with an endobronchial blocker and with a double-lumen tube, in patients who underwent thoracic surgery.
Method: This is a prospective observational study, which was carried out in the central operating room of the General Hospital of Thoracic Diseases of Athens "SOTIRIA" from May to September 2023. The study sample consisted of 40 patients who underwent regular thoracic surgery. Of the 40 patients, 20 received one-lung ventilation with an endobronchial blocker, and the remaining patients received one- lung ventilation with a double-lumen tube. Main outcomes studied were Ppeak, Pplateau, Pmean, driving pressure, resistance, and compliance during ventilation of both lungs before and after block in supine and lateral position and during ventilation of one lung at 20 minutes and every 1 hour until its end.
Results: Patients in the double-lumen tube group had statistically significantly higher Peak pressure (p=0.039) and DP (p=0.032) than patients in the endobronchial blocker group 20min after the start of the one lung ventilation. Furthermore, patients in the double-lumen tube group had statistically significantly lower PEEP (p=0.043) and compliance (p=0.043) than patients in the endobronchial blocker group 20 min after the start of the one lung ventilation. Additionally, it was found that the interaction between Peak pressure measurements and ventilation methods [F(2.99, 113.648)=5.846, p<0.001], the interaction between Pmean measurements and ventilation methods [F(3.429, 130.296) =4.608, p=0.003], the interaction of Pplat measurements and ventilation methods [F(3.201, 121.653)=4.055, p=0.007], the interaction of FiO2 measurements and ventilation methods [F(3.74, 142 ,26)=3.233, p=0.016], the interaction of compliance measurements and ventilation methods [F(2,642, 100,401)=5.554, p=0.002] and the interaction of DP measurements and ventilation methods [F(2.986, 46.487)=4.411, p=0.006] were statistically significant.
Conclusion: It appears, therefore, that the mechanical properties of the respiratory system differ during two-lung ventilation and during one-lung ventilation. Furthermore, there is a difference in the levels of Peak pressure, DP, PEEP and compliance between patients with an endobronchial blocker and those with a double- lumen tube 20min after the start of one-lung ventilation.
Keywords:
One-lung ventilation, Respiratory system, Endobronchial blocker, Double-lumen tube, Mechanical properties of the respiratory system
