Tek akciğer ventilasyonunda uygulanan süperempoze yüksek frekansli jet ventilasyonun oksijenasyon üzerine etkileri

Effects of Superimposed High Frequency Jet Ventilation on Oxygenation in One Lung VentilationIn superimposed high frequency jet ventilation carbondioxide retention can be prevented and this ventilation mode can be applied for an extended period, while oxygenation is achieved through simultaneous use of normal and high frequency ventilation models. The aim of this study is to investigate the effects of superimposed high frequency jet ventilation on oxygenation in thoracic procedures that necessitate the use of one lung ventilation and compare it with the conventional ventilation.ASA I-II 40 patients were randomly assigned to two equal groups. After patients received 2-2.5 mg/kg propofol, 0.6 mg/kg rocuronium, 0.2 µg/kg/min remifentanil, anesthesia was maintained with total intravenous anesthesia using propofol and remifentanil. Anesthesia was delivered through conventional ventilation in both groups until 15th minute of one lung ventilation. Respiration was set at Vt:8 ml/kg, 12 breath/min, I:E ratio=1:2, FiO2:0.6. At 15 minutes into one lung ventilation, Group I was ventilated with the conventional ventilation and Group II was ventilated with superimposed high frequency jet ventilation. Superimposed high frequency jet ventilation?s normal frequency unit was set at 12 breath/min, I:E ratio=1:2; and high frequency unit at 600/min, I:E ratio=1:2. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), peripheric oxygen saturation (SpO2), end tidal carbondioxide (ETCO2) levels, PaO2, PaCO2, pH, SO2, HCO3, and peak inspiratory pressure (PIP) values were recorded at onset, induction, after intubation, during one lung ventilation and double lung ventilation, after extubation, and postoperative 1st hour.Whereas no significant difference was observed for PaO2 between the two groups, it displayed high values in II group at each recording. ETCO2 and PaCO2 were high in the group II between 30 and 90 mins for the duration of one lung ventilation. However the significant differences between the groups were kept within the clinical normal range. Peak inspiratory pressure (PIP) was significantly low in group II throughout one lung ventilation.Sufficient oxygenation can be achieved in one lung ventilation with superimposed high frequency jet ventilation application, and because it does not cause clinical CO2 retention, it can be sustained for an extended period. Also, a low inspiratory airway pressure is an important advantage to avoid lung injury.Key Words: Thoracic surgery, one lung ventilation, superimposed high frequency jet ventilation, oxygenation.