Objective To study the effects of hemodilution on oxygenation during one-lung ventilation(OLV).Methods Forty patients undergoing lung surgery with or without chronic obstructive pulmonary disease（COPD）were enrolled.The study was performed in the supine position before surgery.The tracheas were intubated with a double-lumen tube.OLV was initiated for 15 min.After 15 min of OLV，arterial and venous blood gas samples were collected and analyzed.The cardiac output (CO) was measured.Two-lung ventilation was reinstituted，and hemodilution was performed (6% hydroxyethyl starch，10 mL/kg).Subsequently，OLV was performed again for 15 min.Then arterial and venous blood gas samples were collected and analyzed.The cardiac output (CO) was measured.Results Hemodilution resulted in a significant and similar decrease in HB concentration in patients both with or without COPD.However，hemodilution resulted in a significant decrease in PaO2 in COPD patients rather than subjects without COPD.Conclusion Mild hemodilution impairs gas exchange during OLV in COPD patients.
Citation：
JIANG Xiaoqin,LIN Xuemei,MA Yushan,YIN Yan,LIU Jin. The effects of acute hemodilution on oxygenation during one-lung ventilation in patients with chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(2): 101-103. doi:
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
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Abe K,Shimizu T,Takashina M,et al.The effects of propofol, isoflurane, and sevoflurane on oxygenation and shunt fraction during one-lung ventilation.Anesth Analg,1998,87:1164-1169.
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陈振毅,于忠元,黄曦,等.比较异氟醚、丙泊酚在单肺通气时对肺内分流的影响.临床麻醉学杂志,2003,19:719-721.
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张坤全,刘东辉.两种不同的麻醉方法在单肺通气时对肺内分流影响的比较.中国基层医药,2005:12:303-304.
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- 1. 刘俊杰,赵俊,主编.现代麻醉学.第2版.北京:人民卫生出版社,2000,748.
- 2. Deem S,Hedges RG,Mckinney S,et al.Mechanisms of improvement in pulmonary gas exchange during isovolemic hemodilution.J Appl Physiol,1999:87:132-141.
- 3. Voeckel NF.Mechanism of hypoxic pulmonary vasoconstriction.Am Rev Respir Dis,1986,133:1186-1195.
- 4. Voelkel NF.Mechanism of hypoxic pulmonary vasoconstriction.Am Rev Respir Physiol,1988,72:109-121.
- 5. Deem s,Bishop MJ,Alberts MK.Effect of anemia on intrapulmonary shunt during atelectasis in rabbits.J Appl Physiol,1995,79:1951-1957.
- 6. 邓硕曾,刘进,主编.血液保护与输血安全.成都:四川科学技术出版社,2007,123.
- 7. Abe K,Shimizu T,Takashina M,et al.The effects of propofol, isoflurane, and sevoflurane on oxygenation and shunt fraction during one-lung ventilation.Anesth Analg,1998,87:1164-1169.
- 8. 陈振毅,于忠元,黄曦,等.比较异氟醚、丙泊酚在单肺通气时对肺内分流的影响.临床麻醉学杂志,2003,19:719-721.
- 9. 张坤全,刘东辉.两种不同的麻醉方法在单肺通气时对肺内分流影响的比较.中国基层医药,2005:12:303-304.
