ANESTEZJOLOGIA I INTENSYWNA TERAPIA
Application of various types of ventilation for lung decortication operation

Background : Lung decortication ( decorticati o) is a procedure in which pulmonary pleura is surgically removed. Indications for the procedure include pyothorax, haemothorax, as well as non-specific process of fibrination. Intra-operative ventilation should provide immobilization of the operative site. The study compared universally used one-lung ventilation (OLV) with high-frequency jet ventilation (HFJV).

Aim : Establish an optimal method of lung ventilation during lung decortication operation through analysis of ventilation, gas exchange and hemodynamic parameters.

Material and methods : The study was prospective and randomized. Forty patients have been allocated for the study, risk scores according to the ASA being I-III, scheduled for elective lung decortication operation via thoracotomy. The group I

(n = 19), ventilated using high-frequency jet ventilator. The group II

(n = 21), ventilated in a traditional way (OLV). Standard monitoring accompanied by continuous, non-invasive measurement of cardiac output at the appropriate times was maintained in all patients.

Results : Forty patients were examined. In the OLV group significantly higher values of desaturated venous blood shunt, lower arterial O2 partial pressures after institution of the aforementioned method of ventilation and before closure of the thoracic cavity, higher arterial CO2 partial pressures were noted throughout the course of the study, compared to HFJV. The values of all examined hemodynamic parameters were comparable in the both groups.

Conclusions : High-frequency jet ventilation constitutes an optimal method of ventilation during lung decortication operation and should be perceived as an alternative to one-lung ventilation, providing optimal conditions for ventilation, gas exchange, as well as proper hemodynamic parameters.