The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study

Background and Aims: Baseline difference in the perfusion of two lungs is the cause of intra-operative shunt during one-lung ventilation (OLV). This study aimed to test the hypothesis that the gradient of end-tidal carbon dioxide (EtCO2) between two lungs in lateral position (D-EtCO2lateral) would p...

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Autores principales:	Swapnil Yeshwant Parab, Aparna Chatterjee, Rishi S Saxena
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	end-tidal carbon dioxide one-lung ventilation oxygenation thoracic surgery Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/2d9c4ad4572e4a15aadec7e2cbbb23c9
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spelling	oai:doaj.org-article:2d9c4ad4572e4a15aadec7e2cbbb23c92021-11-12T10:10:47ZThe utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study0019-50490976-281710.4103/ija.ija_591_21https://doaj.org/article/2d9c4ad4572e4a15aadec7e2cbbb23c92021-01-01T00:00:00Zhttp://www.ijaweb.org/article.asp?issn=0019-5049;year=2021;volume=65;issue=10;spage=744;epage=749;aulast=Parabhttps://doaj.org/toc/0019-5049https://doaj.org/toc/0976-2817Background and Aims: Baseline difference in the perfusion of two lungs is the cause of intra-operative shunt during one-lung ventilation (OLV). This study aimed to test the hypothesis that the gradient of end-tidal carbon dioxide (EtCO2) between two lungs in lateral position (D-EtCO2lateral) would predict the quantity of shunt and hence the drop in the oxygenation during OLV. Methods: An observational study was conducted to include consecutive 70 patients undergoing thoracic surgery using a double-lumen tube in a lateral position. D-EtCO2lateral was calculated by subtracting EtCO2 from the non-dependent lung from that of the dependent lung when ventilation parameters are the same for each lung. Oxygenation was assessed by measuring PaO2/FiO2 ratios (P/F ratio) at 10, 20 and 40 min after OLV. Correlations between D-EtCO2lateral and P/F ratios were calculated. Receiver operating curves were analysed to test the ability of D-EtCO2lateral to identify patients with a P/F ratio of <100 during OLV. Results: A moderate correlation was found between D-EtCO2lateral and P/F ratios at 10 and 20 min of OLV. Among lung resection cases (n = 61), correlation was moderate at 10 (r = 0.64), and 20 min (r = 0.65) (P < 0.001) and became weak at 40 min (r = 0.489, P < 0.001). Areas under curve for D-EtCO2lateral to predict the drop in P/F ratio <100 at 10, 20 and 40 min after OLV were 0.90 (cut-off: 2.5), 0.78 (cut-off: 3.5) and 0.78 (cut-off: 4.5), respectively. Conclusion: D-EtCO2lateral could predict the drop in oxygenation in the early part of OLV in lung resection surgeries.Swapnil Yeshwant ParabAparna ChatterjeeRishi S SaxenaWolters Kluwer Medknow Publicationsarticleend-tidal carbon dioxideone-lung ventilationoxygenationthoracic surgeryAnesthesiologyRD78.3-87.3ENIndian Journal of Anaesthesia, Vol 65, Iss 10, Pp 744-749 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	end-tidal carbon dioxide one-lung ventilation oxygenation thoracic surgery Anesthesiology RD78.3-87.3
spellingShingle	end-tidal carbon dioxide one-lung ventilation oxygenation thoracic surgery Anesthesiology RD78.3-87.3 Swapnil Yeshwant Parab Aparna Chatterjee Rishi S Saxena The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study
description	Background and Aims: Baseline difference in the perfusion of two lungs is the cause of intra-operative shunt during one-lung ventilation (OLV). This study aimed to test the hypothesis that the gradient of end-tidal carbon dioxide (EtCO2) between two lungs in lateral position (D-EtCO2lateral) would predict the quantity of shunt and hence the drop in the oxygenation during OLV. Methods: An observational study was conducted to include consecutive 70 patients undergoing thoracic surgery using a double-lumen tube in a lateral position. D-EtCO2lateral was calculated by subtracting EtCO2 from the non-dependent lung from that of the dependent lung when ventilation parameters are the same for each lung. Oxygenation was assessed by measuring PaO2/FiO2 ratios (P/F ratio) at 10, 20 and 40 min after OLV. Correlations between D-EtCO2lateral and P/F ratios were calculated. Receiver operating curves were analysed to test the ability of D-EtCO2lateral to identify patients with a P/F ratio of <100 during OLV. Results: A moderate correlation was found between D-EtCO2lateral and P/F ratios at 10 and 20 min of OLV. Among lung resection cases (n = 61), correlation was moderate at 10 (r = 0.64), and 20 min (r = 0.65) (P < 0.001) and became weak at 40 min (r = 0.489, P < 0.001). Areas under curve for D-EtCO2lateral to predict the drop in P/F ratio <100 at 10, 20 and 40 min after OLV were 0.90 (cut-off: 2.5), 0.78 (cut-off: 3.5) and 0.78 (cut-off: 4.5), respectively. Conclusion: D-EtCO2lateral could predict the drop in oxygenation in the early part of OLV in lung resection surgeries.
format	article
author	Swapnil Yeshwant Parab Aparna Chatterjee Rishi S Saxena
author_facet	Swapnil Yeshwant Parab Aparna Chatterjee Rishi S Saxena
author_sort	Swapnil Yeshwant Parab
title	The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study
title_short	The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study
title_full	The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study
title_fullStr	The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study
title_full_unstemmed	The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study
title_sort	utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- a prospective observational study
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/2d9c4ad4572e4a15aadec7e2cbbb23c9
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The utility of gradient of end-tidal carbon dioxide between two lungs in lateral decubitus position in predicting a drop in oxygenation during one-lung ventilation in elective thoracic surgery- A prospective observational study

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