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One-Lung Ventilation

Q: What is One-Lung Ventilation (OLV) and when is it used?

One-Lung Ventilation (OLV) is a surgical technique where only one of the patient's lungs is ventilated during a procedure. It is commonly used in thoracic surgeries, such as lung cancer resections, to provide better access to the surgical site and minimize interference from the non-operative lung.

Q: What are the different types or variations of One-Lung Ventilation?

There are several variations of One-Lung Ventilation, including Selective Intubation, Bronchial Blocker, and Double-Lumen Endotracheal Tube. Each method has its own advantages and disadvantages, and the choice depends on factors like the patient's anatomy, the surgical procedure, and the surgeon's preference and experience.

Q: What are some common challenges or issues with One-Lung Ventilation?

Some of the main challenges with One-Lung Ventilation include maintaining adequate oxygenation, managing hemodynamic changes, and preventing lung injury. Careful monitoring and adjustments to ventilator settings are crucial to overcome these issues and ensure a successful procedure.

Q: How can PubCompare.ai help with One-Lung Ventilation research?

PubCompare.ai allows researchers to more efficiently screen the protocol literature related to One-Lung Ventilation. The platform's AI-driven analysis can help identify the most effective protocols by highlighting key differences in their effectiveness, enabling researchers to choose the best option for reproducibility and accuracy in their studies.

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Most cited protocols related to «One-Lung Ventilation»

Extubation Criteria in General Anesthesia

Cited 4 times

Patients over the age of 18 who underwent a surgical procedure in an operating room and required general anesthesia and endotracheal intubation were included in the study. In the analysis we only considered patients who were extubated at the end of the procedure. Exclusion criteria were cardiac and thoracic procedures (since the opening of the chest cavity and single lung ventilation present unique perturbations to pulmonary physiology that we believe should be evaluated separately), surgical procedure within four weeks before the index operation, height less than 119 cm (calculations of predicted body weight become inaccurate at the extremes of size),16 (link) and patients with missing data elements.

Ladha K., Vidal Melo M.F., McLean D.J., Wanderer J.P., Grabitz S.D., Kurth T, & Eikermann M. (2015). Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study. The BMJ, 351, h3646.

Publication 2015

Body Weight General Anesthesia Heart Intubation, Intratracheal Lung One-Lung Ventilation Patients physiology Thoracic Cavity

Protective Ventilation During One-Lung Surgery

Cited 3 times

Values of tidal volume (V_T), PEEP, airway pressures (mean, peak (P_MAX) and plateau pressures), end tidal carbon dioxide concentration (ETCO₂), fraction of inspired oxygen (FIO₂), respiratory rate and calculated modified driving pressure (P_MAX –PEEP) were derived for use in this study. These variables are stored in the MPOG database at 1-minute intervals. Consistent with our prior work we used a sampling methodology for evaluation of ventilation parameters.^{18 (link),19 (link)} We calculated the median value for the time period 5-15 minutes after the time-stamped documentation of initiation of one lung ventilation for each case.
Criteria for protective ventilation were based upon expert opinion and guidelines for optimal practice during one lung ventilation.^{8 (link)-10 (link)} Cases were considered to have been conducted with protective ventilation only if both of the following criteria were met: median tidal volume was ≤ 5 ml/kg predicted body weight and median PEEP ≥ 5 cm H₂O. Ventilation variables were subsequently expressed and analyzed as means of the individual case median values.
Modified driving pressure was used as a surrogate of driving pressure in this investigation, since plateau airway pressure data, required for the calculation of driving pressure, was not available from all participating institutions. This modification of driving pressure has been previously reported.^{21 (link)}

Colquhoun D.A., Leis A.M., Shanks A.M., Mathis M.R., Naik B.I., Durieux M.E., Kheterpal S., Pace N.L., Popescu W.M., Schonberger R.B., Kozower B.D., Walters D.M., Blasberg J.D., Chang A.C., Aziz M.F., Harukuni I., Tieu B.H, & Blank R.S. (2021). A lower tidal volume regimen during one lung ventilation for lung resection surgery is not associated with reduced postoperative pulmonary complications. Anesthesiology, 134(4), 562-576.

Publication 2021

Body Weight Carbon dioxide One-Lung Ventilation Oxygen Positive End-Expiratory Pressure Pressure Respiratory Rate Tidal Volume

Perioperative Management for Thoracic Surgery

Cited 3 times

Anesthesia and postoperative management were performed according to our institutional protocol. Most patients received balanced anesthesia, which was a combination of volatile anesthetic agent, non-depolarizing neuromuscular blocking agent, and a continuous intravenous infusion of remifentanil. The maintenance fluid was lactated Ringer’s solution, infused at a rate of 3–5 ml·kg⁻¹·h⁻¹. If a volume deficiency was suspected, 5% human albumin (Green Cross Corp., Gyeonggi, Korea) or 6% hydroxyethyl starch (Fresenius Kabi, Seoul, Korea) was infused. A transfusion was performed for effective resuscitation in cases of intraoperative bleeding (transfusion cut-off: hemoglobin <8 g/dl). The protective ventilation protocol was applied to all patients. Mechanical ventilation during one-lung ventilation was maintained with a tidal volume of 5–6 ml/kg predicted body weight at 5 cm H₂O positive end expiratory pressure. A recruitment maneuver applied to the dependent lung was performed at the commencement of one-lung ventilation and on restarting two-lung ventilation.
All patients stayed in the intensive care unit (ICU) for 2 days. The postoperative analgesic methods were determined according to the surgeon’s preference and contraindications for regional analgesia. Maintenance fluid was administered at a rate of 2–3 ml·kg⁻¹·h⁻¹. ICU intensivists administered additional fluids based on each patient’s vital signs. Patients were encouraged to ambulate from postoperative day 1 and received a daily physiotherapy program, which included deep-breathing exercises, incentive spirometry, and chest physiotherapy, supervised by physiotherapists and attending nurses during the ICU and ward stays.

Jeong H., Choi J.W., Ahn H.J., Choi Y.S., Kim J.A., Yang M., Kim J.K., Kim D.K., Shin B.S., Lee S.H., Kim Y.R., Park M, & Chung Y.J. (2019). The effect of preventive use of corticosteroids on postoperative complications after esophagectomy: A retrospective cohort study. Scientific Reports, 9, 11984.

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Publication 2019

Analgesics Anesthesia Anesthetics Balanced Anesthesia Blood Transfusion Body Weight Breathing Exercises Chest chrysarobin Hetastarch Intravenous Infusion Lung Management, Pain Mechanical Ventilation Neuromuscular Depolarizing Agents Nurses One-Lung Ventilation Patients Physical Therapist Positive End-Expiratory Pressure Postoperative Procedures Remifentanil Resuscitation Ringer's Solution Serum Albumin, Human Signs, Vital Spirometry Surgeons Therapy, Physical Tidal Volume

Isolated Left Lung Function Assessment

Cited 2 times

Given changes in positioning and preparation for the pneumonectomy, hemodynamic and blood gas measurements were taken immediately before the start of the procedure (labeled “Before Pneumonectomy” in Table 3). The pulmonary hilum was dissected through a mid-sternotomy, and a right pneumonectomy (including the accessory lobe) was performed to assess isolated function of the transplanted left lung. The recipient was followed for additional 4 hours following the right pneumonectomy before the experiment was terminated. During the 4 hours, the recipient was additionally monitored using a Swan-Ganz catheter as described in the Animal Preparation section. While the recipient was under one lung ventilation, the tidal volume and respiratory rate were adjusted to maintain a peak pressure less than 30 cmH₂O.

Ghaidan H., Stenlo M., Niroomand A., Mittendorfer M., Hirdman G., Gvazava N., Edström D., Silva I.A., Broberg E., Hallgren O., Olm F., Wagner D.E., Pierre L., Hyllén S, & Lindstedt S. (2022). Reduction of primary graft dysfunction using cytokine adsorption during organ preservation and after lung transplantation. Nature Communications, 13, 4173.

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Publication 2022

Animals Blood Gas Analysis Catheters Hemodynamics Lung One-Lung Ventilation Pneumonectomy Pressure Respiratory Physiology Respiratory Rate Sternotomy Tidal Volume

Surgical Approaches for Early-Stage Lung Cancer

Cited 2 times

All procedures were performed under general anesthesia and single-lung ventilation, with the patient lying on the lateral decubitus. For all surgeries, the first operator was one of the two surgeons with the widest experience in open (at least 15 years) and U-VATS surgery in our team. Patients who had undergone surgery from January 2014 to May 2016 were operated on by thoracotomy. The U-VATS program started in our center in June 2016 and, since then, all patients affected by stage IA-IIB lung cancer were operated on by the U-VATS approach, progressively. Therefore, the open approach, still used for more central and big lesions in the first months of our U-VATS program, was subsequently abandoned for the treatment of early-stage lung cancer.
Open surgery was performed through a lateral muscle-sparing thoracotomy on the V intercostal space and usually, two chest tubes are left in place after surgery. U-VATS was carried out through a 4-cm single incision on the V intercostal space, with only one chest tube in the same incision, according to our standardized procedure (11 (link), 12 (link)) (Figure 2A).
Lymphadenectomy (LND) was performed according to the oncological standard of radical LND in both techniques: lobe-related nodal stations 10 and 11 and nodes in positions 7, 8, and 9, as well as in 2, 3, and 4 for the right side, and 5 and 6 for the left side (Figure 2B) were removed.

Nachira D., Congedo M.T., Tabacco D., Sassorossi C., Calabrese G., Ismail M., Vita M.L., Petracca-Ciavarella L., Margaritora S, & Meacci E. (2022). Surgical Effectiveness of Uniportal-VATS Lobectomy Compared to Open Surgery in Early-Stage Lung Cancer. Frontiers in Surgery, 9, 840070.

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Publication 2022

Chest Tubes General Anesthesia Lung Lung Cancer Lymph Node Excision Muscle Tissue Neoplasms One-Lung Ventilation Operative Surgical Procedures Patients Staging, Cancer Surgeons Thoracic Surgery, Video-Assisted Thoracotomy

Most recents protocols related to «One-Lung Ventilation»

Anesthetic Management for Thoracic Surgery

All patients received general anesthesia, either alone or in combined with regional nerve block (including paravertebral nerve block, epidural anesthesia, and intercostal nerve block.) according to the type of surgery. Patients underwent lobectomy or sublobectomy according to surgeon’s comprehensive evaluation based on patient’s condition.
Anesthesia induction used propofol and/or etomidate, sufentanil, and rocuronium or cisatracurium. Anesthesia maintenance used sevoflurane or propofol combined with remifentanil or sufentanil. Rocuronium or cisatracurium was used to maintain muscle relaxation. Supplemental drugs such as flurbiprofen axetil were administered when necessary. The aim was to maintain BIS 40-60, blood pressure within 20% of baseline, and temperature 36-37°C.
Double-lumen endotracheal tube of sizes Ch33-39 was used for lung isolation according to patient height. The ventilation mode was volume control mode with 6-8 ml/kg of tidal volume (TV) during two-lung ventilation and 5-6 ml/kg during one-lung ventilation (OLA), and 0-5 cmH₂O of positive end-expiratory pressure (PEEP), and 12-20 breaths/min of respiratory rates. The aim was to maintain P_ETCO₂ 35-45 mmHg and SpO₂ ≥92%. At the end of anesthesia, neostigmine was used to antagonize muscular relaxant before extubation.
Fluid infusion was administrated with crystalloid at a rate of 4–6 mL/kg^-1h^-1. Colloids or blood product was used according to anesthesiologist’s comprehensive evaluation based on patient’s condition. Patient-controlled intravenous analgesia was used after surgery for postoperative analgesia to maintain numeric rating scales (NRS) ≤ 3 scores.

Jin F., Liu W., Qiao X., Shi J., Xin R, & Jia H.Q. (2023). Nomogram prediction model of postoperative pneumonia in patients with lung cancer: A retrospective cohort study. Frontiers in Oncology, 13, 1114302.

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Publication 2023

Anesthesia Anesthesiologist BLOOD Blood Pressure cisatracurium Colloids Epidural Anesthesia Etomidate flurbiprofen axetil General Anesthesia isolation Lung Management, Pain Muscle Tissue Neostigmine Nerve Block One-Lung Ventilation Operative Surgical Procedures Patient-Controlled Analgesia Patients Pharmaceutical Preparations Positive End-Expiratory Pressure Propofol Relaxations, Muscle Remifentanil Respiratory Rate Rocuronium Saturation of Peripheral Oxygen Sevoflurane Solutions, Crystalloid Sufentanil Surgeons Tidal Volume Tracheal Extubation

Uniportal Thoracoscopic Lobectomy Technique

Uniportal thoracoscopic lobectomy was performed with the patient in the lateral decubitus position under general anesthesia and receiving single-lung ventilation. A single 3.5–4-cm skin incision was made on the anterior axillary line of the 4th or 5th intercostal space, and initially covered using an extra-small wound retractor (Alexis Wound Retractor; Applied Medical, Rancho Santa Margarita, CA, USA). Figure 2 presents a single skin incision (Figure 2A), an operative finding (Figure 2B) and specific surgical instruments (Figure 2C) in uniportal thoracoscopic surgery. Dominant vessels, including the pulmonary artery and vein, were exposed sufficiently and then divided, mainly using endovascular staplers. Small branches of these vessels were divided using an energy device after proximal ligation with silk sutures. The dominant bronchus was also divided using a stapler. Interlobar fissures were mainly divided using staplers or sometimes an energy device after ligation with silk sutures. The specimen was finally removed from the thorax after placing it in a plastic bag. ND2a-1 or greater lymphadenectomy was then performed; ND2a-1 consisted of lymphadenectomy with selective mediastinal dissection, while ND2a-2 consisted of radical mediastinal dissection (13 (link)). At the end of the operation, a chest drainage tube was placed in the thorax.

Igai H., Matsuura N., Numajiri K., Ohsawa F, & Kamiyoshihara M. (2023). Supervision by an experienced surgeon can reduce the learning curve of uniportal thoracoscopic lobectomy. Translational Lung Cancer Research, 12(2), 207-218.

Publication 2023

Axilla Blood Vessel Bronchi Chest Chest Tubes Dissection Drainage General Anesthesia Ligation Lymph Node Excision Mediastinum Medical Devices One-Lung Ventilation Patients Pulmonary Artery Silk Skin Surgical Instruments Surgical Procedures, Thoracoscopic Sutures Thoracoscopes Veins Wounds

RA-MIDCAB and Hybrid Coronary Revascularization

A post hoc analysis of prospectively collected data was performed in 440 consecutive patients undergoing RA-MIDCAB in the Netherlands between January 2016 and December 2020. Three cardiac centers performed RA-MIDCAB during that time frame: the University Medical Center Utrecht, Maastricht University Medical Center, and Isala Zwolle. All patients underwent RA-MIDCAB with the LITA-LAD conduit. In addition, a proportion of patients underwent HCR in a separate stage for PCI of non-LAD vessels. The procedure was qualified as HCR if this revascularization strategy was the documented treatment intention during the heart team meeting. Separate designations were introduced to distinguish the treatment sequences for HCR: “two-staged HCR” if a patient received RA-MIDCAB followed by PCI and “reversed two-staged HCR” if a patient received a PCI with stenting because of, for example, an emergent myocardial infarction with the culprit in either the circumflex coronary artery or the right coronary artery. To be included, patients had to be adults (>18 years) with proximal LAD lesions or chronically occluded LAD with or without additional lesions in the left circumflex artery and/or right coronary artery accessible for PCI. Patients were excluded if they had contraindications for RA-MIDCAB, such as no possibility for single-lung ventilation due to severe pulmonary disease or an intramural LAD limiting the technicality of an RA-MIDCAB procedure. Contraindications for HCR were a history of major bleeding complications due to dual antiplatelet therapy (DAPT), the latter being essential after PCI with stenting. Patient written consent and ethics approval from the Medical Ethics Review Committee at every institution performing RA-MIDCAB was acquired.

de Jong A.R., Gianoli M., Namba H.F., Roefs M.M., Singh S., Segers P., Jacob K.A, & Suyker W.J. (2023). A Nationwide Study of Clinical Outcomes After Robot-Assisted Coronary Artery Bypass Surgery and Hybrid Revascularization in the Netherlands. Innovations (Philadelphia, Pa.), 18(1), 73-79.

Publication 2023

Adult Arteries Artery, Coronary Blood Vessel Dual Anti-Platelet Therapy Heart Lung Diseases Myocardial Infarction One-Lung Ventilation Patients Reading Frames

Robotic-Assisted Minimally Invasive Direct Coronary Artery Bypass

The RA-MIDCAB procedure was performed in a standardized fashion by a dedicated team in each institution. In each institution, there was a single surgeon who performed the RA-MIDCAB procedures. Standard surgical procedures of each institution were followed. In summary, patients were placed in the supine position with a 10 cm soft roll or balloon under the chest between the scapulae and the left arm, allowing the left shoulder to be deflected posteriorly. The camera port was placed in the fourth/fifth intercostal space (ICS) medial to the anterior axillary line. Working ports were typically placed in the second/third and the sixth/seventh ICS medial to the anterior axillary line. Preferably, the distance between the ports was at least 10 cm to avoid instrument collisions and to maximize the working area. Once adequate port placement was achieved, LITA harvesting occurred. Single-lung ventilation or a bronchial blockage was used to deflate the left lung and therefore optimize the intrathoracic working space. In addition, CO₂ insufflation from 5 to 10 mm Hg was exploited, and a 0° or 30° up-scope was used in most cases. The LITA was taken down with care using a combination of blunt dissection and electrocautery in either a skeletonized or pedicled fashion. Once the LITA was harvested, a pericardiectomy was performed robotically, and the target coronary vessel, namely, the LAD, was identified. Appropriate heparinization was achieved if the activated clotting time was >300 s. With the robotic camera still in place, a needle was used to identify the optimal intercostal space for the small thoracotomy, usually 4 to 7 cm long. After robot undocking, the minithoracotomy was made and a soft tissue retractor placed. The endoscopic Octopus Nuvo (Medtronic, Dublin, Ireland) or Acrobat-i Stabilizer (MAQUET, Getinge, Göteborg, Sweden) off-pump stabilizer was inserted via a previous port site or direct through the minithoracotomy and was used to stabilize the target vessel while off-pump coronary anastomosis was performed in the usual fashion. If a conversion to sternotomy was required, a conventional on-pump or off-pump CABG was performed.

Publication 2023

Axilla Blood Vessel Bronchi Chest Coronary Artery Bypass Surgery Coronary Vessels Dissection Electrocoagulation Endoscopy Heart Insufflation Lung Needles Nuvo Octopus One-Lung Ventilation Operative Surgical Procedures Patients Pericardiectomy Scapula Shoulder Sternotomy Surgeons Surgical Anastomoses Thoracotomy Tissues

Anesthetic Induction and Epidural Analgesia

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Publication 2023

Anesthesia Bupivacaine Catheters Dipyrone Epidural Anesthesia Intravenous Infusion Management, Pain Needles Normal Saline One-Lung Ventilation Operative Surgical Procedures Patients Pirinitramide Propofol Rocuronium Spaces, Epidural Sufentanil

Top products related to «One-Lung Ventilation»

Da vinci surgical system by Intuitive Surgical

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The da Vinci Surgical System is a robotic-assisted surgical device designed for minimally invasive procedures. It consists of a surgeon's console, a patient-side cart with four robotic arms, and a high-definition 3D vision system. The system allows the surgeon to perform complex surgical maneuvers with enhanced dexterity, precision, and control.

Endoscopic stapler by Johnson & Johnson

Sourced in United States

The Endoscopic stapler is a medical device designed for use in endoscopic surgical procedures. It is a tool used to apply surgical staples, which are used to join or seal tissues during the surgical process. The device is intended to provide a secure and consistent method of tissue closure during minimally invasive surgical procedures.

Spss 13.0 statistical by IBM

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SPSS 13.0 is a statistical software package developed by IBM. It provides a comprehensive set of tools for data analysis, including descriptive statistics, regression analysis, and hypothesis testing. The software is designed to help users extract insights from data and make informed decisions.

Enseal by Johnson & Johnson

Sourced in United States

Enseal is a surgical instrument designed for sealing blood vessels and small tissue structures during surgical procedures. It utilizes advanced electrosurgical technology to provide precise and controlled tissue sealing. The core function of Enseal is to facilitate hemostasis and minimize bleeding during operations.

Injectomat tiva agilia by Fresenius

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The Injectomat TIVA Agilia is a syringe infusion pump designed for the administration of anesthetic and analgesic drugs during Total Intravenous Anesthesia (TIVA) procedures. The device is capable of precisely controlling the flow rate and volume of infused medications.

Surgicel absorbable hemostat by Johnson & Johnson

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SURGICEL Absorbable Hemostat is a sterile, absorbable surgical cotton fabric that is used to help control bleeding during surgical procedures. It is composed of oxidized regenerated cellulose and is designed to be used as a hemostatic agent.

Spss 18 by IBM

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SPSS 18.0 is a statistical software package designed for data analysis. It provides a wide range of data management and analysis capabilities, including descriptive statistics, advanced statistical modeling, and data visualization tools. The software is intended to help users analyze and interpret data effectively.

Spss statistics for windows version 20 by IBM

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SPSS Statistics for Windows, Version 20.0 is a software application for statistical analysis. It provides tools for data management, visualization, and advanced statistical modeling. The software is designed to work on the Windows operating system.

Arndt endobronchial blocker by Cook Medical

The Arndt Endobronchial Blocker is a medical device used to temporarily occlude the bronchus during surgical procedures. It is designed to provide selective lung isolation and ventilation control during various thoracic and pulmonary interventions.

What is One-Lung Ventilation (OLV) and when is it used?

What are the different types or variations of One-Lung Ventilation?

What are some common challenges or issues with One-Lung Ventilation?

How can PubCompare.ai help with One-Lung Ventilation research?

More about "One-Lung Ventilation"

One-Lung Ventilation (OLV) is a critical technique used in thoracic surgery to facilitate access to the chest cavity.
It involves the selective ventilation of a single lung, allowing the surgeon to operate on the other lung without interference from respiratory movements.
OLV is commonly employed during procedures such as lobectomies, pneumonectomies, and other thoracic surgeries.
The Da Vinci Surgical System, a robotic platform, has revolutionized minimally invasive thoracic surgeries, often requiring OLV to provide optimal surgical access.
Endoscopic staplers, such as the Enseal device, are frequently used in conjunction with OLV to perform precise tissue resections and anastomoses.
Accurate monitoring and control of the ventilation parameters are essential during OLV.
The Injectomat TIVA Agilia, an anesthesia delivery system, can be utilized to precisely manage the patient's ventilation and anesthesia requirements.
Additionally, the SURGICEL Absorbable Hemostat may be employed to assist with hemostasis during the procedure.
Statistical analysis tools, such as SPSS (Statistical Package for the Social Sciences), version 13.0, 18.0, or 20.0, can be employed to analyze the outcomes and data associated with OLV research and clinical studies.
The Arndt Endobronchial Blocker is a specialized device used to facilitate OLV by selectively blocking the airflow to one lung.
By leveraging the insights and technologies mentioned, researchers and clinicians can optimize their One-Lung Ventilation research and procedures, leading to improved patient outcomes and a more streamlined surgical process.